Monday, August 1, 2011

Have we learned what we need to know to deliver microbicides?

ROME — The first day of this Sixth IAS Conference I attended a satellite session “From Proof to Delivery: Scaling Up HIV Prevention for Women: The Challenge of Delivering the First Microbicide in Africa.” The promise of microbides and “treatment as prevention” are proving to be the biggest stories of this conference — new prevention tools showing highly positive results.

Demonstrators in the IAS Media Centre in Rome 
demand fast action on a microbicide.
(Photo by David J. Olson)
This is perhaps the most encouraging moment in the long, and often frustrating, history of HIV prevention, and I believe there is not a person here that is not tremendously excited about the potential these technologies hold for its future. Exactly a year ago, at the Vienna International AIDS Conference, we heard the results of the CAPRISA trials in South Africa  and how effective the product had proven to be.

A year later, I am struck by how the conversation has moved far beyond mere effectiveness and now focuses on the delivery, marketing and pricing of the eventual product, and how we will get women to use it correctly. It is amazing that the conversation has moved so dramatically in only 12 months, and wonderful that we are thinking about these issues now, years before we are likely to have a product on the market. This augurs well for thinking this through properly and getting it right.

But I noticed something missing from this conversation — both in the event I attended here in Rome and more broadly . That is, there was much talk of the need to deliver the product through multiple channels — presumably including the private sector, although that was not explicitly mentioned — and much talk about the need for finding innovative ways of doing that.

Farewell to Deauville: How did global health fare?

DEAUVILLE, France — Nothing of significance for global health came out of the G8 Summit here. We expected little, and the G8 lived up to our expectations.

President Sarkozy briefs the media at the Deauville Summit.
(Photo by David J. Olson)
Overall, the NGO community found the Deauville Declaration, in the words of Sherpa Times,  “vague, confused and lacking any sort of concrete advances on the main issues.” Most NGOs had criticized the Deauville Accountability Report, on global health and food security, as lacking in clarity and honesty.

The Global Health Council, in our official reaction to the Deauville Declaration, was kinder than most. We said the GHC “welcomes the G8 leaders’ reaffirmation of their commitment to global health as expressed in their Deauville G8 Declaration and urges them to live up to the promises of the declaration and to track their implementation in a fully transparent manner.” Frankly, we were vastly relieved that the declaration did address global health, and reaffirmed previous commitments, specifically, the Muskoka Initiative, the Global Fund to Fight AIDS, TB and Malaria, and the GAVI Alliance.