Ten years ago Peter Piot, the Executive Director for UNAIDS called for the development of a microbicide and large-scale clinical trials are scheduled to begin soon for several microbicidal compounds. Microbicides are gels applied to the vagina or rectum that may prevent pregnancy and the transmission of STDs such as chlamydia, gonorrhea and HIV. The need for microbicide development is great as many women are unable to negotiate condom use with their partners and are more susceptible to HIV. More than 55 microbicidal compounds have been developed and six of the most promising microbicides have begun or will soon begin Phase III trials. A microbicide effective against HIV will likely be available in 2007 at the earliest, however. Theorectically, microbicides promise to be play an especially important role in developing countries where HIV/AIDS runs rampant. The major obstacle in developing this female-controlled method of HIV prevention and contraception has been major pharmaceutical firms’ expectations of low sales revenues. Concerns about low profits have stalled drug development and clinical trials. For example, drug companies can expect a 5% return from sales in developing countries compared to approximately 19% in developed nations. Microbicide advocates have looked to interested individuals, private foundations such as the Rockefeller Foundation and the Bill and Melinda Gates Foundation and the government for funding sources. Fashion designer Kenneth Cole is using his firm’s “advertising savvy” by teaming up with the American Foundation for AIDS Research in order to create billboards drawing attention to the plight of women and HIV/AIDS and the need to develop effective microbicides. The U.S. government is also considering legislation to increase microbicidal research. Currently, the House is considering the Microbicide Development Act of 2001 (HR 2405), a bill that would formally establish microbicide research programs at the National Institutes of Health and the Center for Disease Control.
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