Over the last 20 years, researchers and activists have taken interest in a product that could be the most important innovation in reproductive health since the pill: microbicides. Like the pill, microbicides are being promoted as a woman-controlled or initiated prevention method. But, unlike the pill, microbicides go beyond just preventing pregnancy to preventing sexually transmitted infections (STIs) as well. In fact, at this point the prevention of STIs, with an emphasis on Human Immunodeficiency Virus (HIV) prevention, makes up the majority of microbicide research, development, and advocacy. Although they are not yet available, it is hoped that microbicides will greatly reduce the transmission of HIV worldwide.
Generally, an ideal microbicide would be odorless, colorless, tasteless, non-irritating, fast-acting, long-lasting, inexpensive to manufacture and purchase, and available in contraceptive and non-contraceptive forms. Microbicides come in a variety of forms, including gels, creams, films, suppositories, pre-loaded diaphragms or cervical caps, sponges, vaginal rings, etc. Although most microbicides are designed to be applied topically to the vagina, there are some baseline studies being done on rectal microbicides.
The woman-controlled strategy employed by microbicide advocates is in response to both social and biological factors uniquely affecting women. Social factors like gender inequality and violence against women have led to the feminization of HIV. Biological factors affecting women include women being more likely than men to contract HIV after just one exposure. Worldwide there are now more adult women (15 years or older) than ever before living with HIV. According to UNAIDS, the 17.7 million women living with HIV in 2006 represents an increase of over one million compared with 2004. Clearly, microbicide research and development is greatly needed.
A key factor in getting microbicides available to the public is adequate funding. One way that advocates of microbicides are attempting to increase U.S. government funding is through legislation that would establish and coordinate units specifically designed for microbicide research and development. One piece of legislation that attempts to do this is the Microbicide Development Act (MDA). It is hoped that with this bill, microbicide funding will soon become the priority it should be in the federal government's budget to combat HIV/AIDS. Versions of the MDA have been introduced seven times since 2000, but none have ever passed. It was most recently introduced again in both the House and the Senate on March 8, 2007 (International Women's Day). The Senate version currently has 18 cosponsors and the House version has 54 cosponsors; both versions are in committees.
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Although the U.S. government has appropriated some funding, it has not been adequate to produce an effective microbicide for public use. According to the Global Campaign, barely 3% of the U.S. budget for HIV/AIDS research is spent on microbicide research and development. Passing the MDA would help to secure the funding needed by coordinating microbicide research and development efforts within the three U.S. federal agencies already involved in HIV/AIDS research. It is unclear why exactly the MDA has not received adequate support from Congress in the past. I would hope that curbing and hopefully stopping not only the spread of STIs, but also the HIV/AIDS pandemic is important to the United States. To learn more about what you can do to support the MDA, visit the Global Campaign for Microbicides.