Breakthroughs Blog: Microbicides

Jeff Meer is special advisor for global health policy and development at the Public Health Institute (PHI), a GHTC member. Based in Washington, DC, he provides strategic guidance to the organization on global health advocacy and develops new business proposals for global health projects. On Nov. 3-4, the Coalition Advancing Multipurpose Innovations (CAMI), a project of PHI, convened a symposium in Washington, DC, on “Multipurpose Prevention Technologies (MPTs) for Reproductive Health.” The gathering was attended by more than 100 product developers, researchers, academics, funding organizations, nongovernmental organization leaders, policymakers, and reproductive health practitioners. Participants discussed how best to advance emerging MPT science, with the goal of providing women around the world with safe, effective, low cost, and user-friendly means of protecting themselves simultaneously from HIV, other sexually transmitted and reproductive tract infections, and/or unintended pregnancy. The conference, funded primarily by the US Agency for International Development (USAID)’s Global Health Bureau and held at the Henry J. Kaiser Family Foundation’s Barbara Jordan Conference Center, follows a think tank convened earlier this year under the auspices of the Initiative for Multipurpose Prevention Technologies (IMPT), which is led by Bethany Young Holt of PHI. Other funders for the symposium include the National Institute of Health’s Office of AIDS Research, Gilead, and the Mary Wohlford Foundation. Dr. Young Holt directs CAMI, which serves as secretariat to the IMPT at PHI. Conference held to discuss Multipurpose Prevention Technologies (MPTs) and how they can help improve reproductive health to help women around the world . Photo Credit: Nguyen Ba Quang/PATH There are technologies already available to prevent unintended pregnancy and also block sexually transmitted infections. These include the male and female condom. However, newer MPTs are based on other technologies that may be more useable in some geographic and cultural contexts. These include impregnated vaginal rings, barrier devices, gels, and vaccines. The MPT field is developing a range of options for women, some of which may be more appropriate for different points in the life cycle. There are more than one dozen important MPTs now in development and testing, and some are much closer to commercial introduction than others. Among the topics covered at the symposium were: the state of the scientific field in developing MPTs; pressing issues like the effect of hormonal contraception on acquisition of HIV; the perspective of product developers; and regulatory pathways for MPTs in the United States and abroad. Other topics covered include: lessons learned from introduction of other reproductive health technologies; integrating end-user needs in product development; donor perspectives; public-private partnerships for MPT development; and political leadership on MPTs. Many experts consider MPTs to be a key global health technology area. Technologies such as MPTs that address multiple global health challenges—similar to vaccines that address more than one illness—can be both efficient and cost-effective interventions. And the twin challenges of preventing unintended pregnancy in order to reduce maternal mortality and reducing the transmission of HIV and AIDS are certainly high on the global agenda: they are the subject of United Nations Millennium Development Goals 5 and 6. Also, making inroads in these areas could offer substantial cost savings to governments and consumers alike. For example, in the United States alone, the estimated direct medical cost of unintended pregnancies in 2002 was $5 billion. Direct medical costs associated with treatment and care of sexually-transmitted infections in the United States in 2006 were even higher—approximately $14.6 billion. Despite this encouraging landscape, the MPT field is also fraught with challenges. Collaboration across scientific disciplines is never simple, and the worlds of research on contraception and sexually-transmitted infections do not necessarily regularly intersect. There are also significant regulatory hurdles to the introduction of technologies that deal with multiple health issues, and these can be daunting in trying to introduce even helpful and potentially life-saving technologies on a global scale. And any global health technology must pass the ultimate test of user acceptability. This symposium is meant to ask and answer some of these vexing questions, so that MPTs can be introduced successfully the first and every time. More information about the rationale for MPTs can be reviewed here.