AMREF (Nairobi)
15 August 2006
press release
Bill and Melinda Gates have called for the speeding up of research into prevention strategies such as microbicides, that will give women the power to protect themselves from infection with HIV.
They pointed out that, though the ABC (Abstinence, Be Faithful, Condoms) strategy had had some good results, it was not fully effective because matters to do with sexuality were largely in the domain of men.
"Abstinence is no option for girls who are forced into early marriage; being faithful is not an option for a wife whose husband is unfaithful; and a condom is not an option for a woman, because it is the man who decides whether or not to use it," said Bill Gates.
"Whether she is a mother with kids, or a commercial sex worker, a woman should never need a man's permission to save her life," he said.
The co-founders of the Bill and Melinda Gates Foundation, who were speaking at the opening of the 16th International Aids Conference in Toronto last night, said they were determined to help medical science develop an oral drug or microbicide that would put that power into the hands of women.
Melinda said that, while development of a vaccine was a priority, this was a long-term venture; an alternative that could be available sooner needed to be found. She said 16 microbicides - a gel that can be used by women to block HIV transmission - were being studied, and that five were at advanced stages of development. Clinical trials for oral prevention pills are also on trial in Peru, Thailand, USA and Botswana, she added.
Bill Gates acknowledged that increase in funding for HIV in the past five years, particularly from the Global Fund and Pepfar, had created a new sense of optimisim in continents like Africa where the pandemic has hit hardest. But much more still needs to be done to produce cheaper drugs with less side effects and more effective diagnostics, he said.
While scaling up treatment was important, Bill Gates emphasised the need to increase prevention efforts if HIV interventions were to be effective. He pointed out that while there are had been a huge increase in the number of people on anti-retroviral treatment - 450,000 new cases annually - the number of new infections was much higher - 40 million every year.
"We need to do everything possible to bring down treatment costs. But we also need to increase prevention efforts. Treatment without prevention is unsustainable."
AMREF's programme leader for HIV, Dr Daraus Bukenya, agrees. "There are at least five new infections in Africa every hour. That is huge, because as you treat those already infected, new cases keep coming up. We need to be creative in coming up with ways to convince young people to prevent infection. Prevention is the only sustainable strategy. We need to get more people to know their status so that they can change their behaviour and get treatment, and so we need to invest more in testing and counseling.
Bukenya observes that while there have been increased levels of funding for HIV, a lot of that money does not reach the people for which it is intended. It only gets to the national level, but its effects are not felt on the ground. In Kenya for instance, the government has not fully implemented projects with Round 2 of money received from the Global Fund two years ago. This is where organisations like AMREF need to step in and play a major role in ensuring that funding does the work on the ground that it is meant to do.
Organisations that work with communities would also be key in getting new tools such as microbicides and oral prevention pills to the people on the ground, he says, as well as testing models for suitability - affordability and availability, whether they can be used in areas without electricity or reliable water supply, whether they are user-friendly.
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