Another hope bites the dust .....

I feel a bit sheepish since i've been meaning to write about microbicides ever since the Toronto conference last summer (and yes i DID do more than just accessory shop there). I even had a snappily titled post all set up in my head in honour of Gates and Clinton, the chief celebs that i followed around star struck ... although admittedly rather typically never got around to actually writing the post ...

But to summarise post haste - the overwhelming themes at the conference were:-

1) that the face of HIV globally is now the face of a woman (especially a poor black or asian one)
2) that the funds committed to provide ARV treatment to all that need it are never ever going to suffice (despite the best efforts of Gates, Buffet and dare i say George Bush) .... and
3) that the pendulum needs urgently to swing back to prevention efforts (as opposed to solely treatment advocacy) .... BUT a very different kind of prevention this time ...

Stephen Lewis (possibly the greatest Canadian ever) made an impassioned speech regarding the fact that funds such as PEPFAR, originally the largest fund donated to a single disease are now already woefully inadequate for the current state of the pandemic, much less for the projected numbers in a few years time .... three by five might would need to be fifty by ten at this rate .... an inconceivable burden of disease ....

But the one positive message that shone through was that finally sisters might be able to do it for themselves ....

We all know that condoms don't work (correction: condoms could work if only men could be persuaded or even volunteer to wear them) .... and that vaccines are still the same ubiquitous 20 years away that they were 20 years ago .... but microbicides were presented as the possible salvation of every woman in the developing world wanting to protect herself surreptitiously .... (the other breakthrough touted was that some ARV drugs could be taken on a Friday night to protect someone having unprotected sex until sunday night .... a whole new take on "something for the weekend - sir" and not unsurprisingly top of the agenda for the MSM contingent at the conference .... speaking of which I had never seen such a circus at a conference ... there sections for grannies against aids, prostitutes, transvestites, transsexuals, multisexxuals ... frankly anything went and had a stall or an advocacy group .... ).

So it is with great sadness and disappointment that we learned earlier this week that the trials into microbicides had been universally halted in all research centres across Africa because the provisional results showed that women who had used the gel actually had higher rates of infection than women who used the placebo gel .... bloody typical ....

Now it could be because women with the microbicide took more "risks" with the confidence of the gel whereas the placebo group somehow managed to make their men wear condoms or even that the gel candidates were somehow placed at greater risk through some other means (barrel scraping) ... but it does look like the great white hope of a female-centric method of protection has bitten the dust .... a disaster for women on this continent ....

I've just got home from a day in an antenatal clinic in Kwa-Zulu Natal where 80% of all the expecting mums are HIV positive ... someone pass the Prozac and quick ....