Dispatch: Highs & Lows Of Vienna AIDS Conference

A promising new vaginal microbicidal gel could be used to sharply reduce HIV infection among women, according to a study released yesterday at the XVIII International AIDS conference in Vienna by a South African AIDS research center. The gel contains tenofovir, an antiretroviral medication, that when applied 12 hours before and after unprotected sex, reduced the risk of HIV transmission in women by 39 percent and by up to 54 percent if the gel was used regularly. Further studies are needed before the product becomes publicly available, but if produced in mass quantities, the gel is estimated to cost less than 25 cents per application.

Emphasizing the importance of this ground-breaking research for the future prevention of HIV transmission, ACSH’s Dr. Gilbert Ross notes, “While 39 percent doesn’t sound like a huge number to those of us more attuned to curing diseases with drugs in the Western world, the fact is this would save hundreds of thousands of lives or more from HIV infection over the next decade.”

The study findings, which will appear in today’s online issue of Science, were universally well received. According to Dr. Michel Sidibe, executive director of UNAIDS, the gel is “empowering” to women since “they do not have to ask the man for permission to use it.” Dr. Ross agrees, “This female-controlled prophylactic agent can prove to be very successful.”

The gel was also found to reduce the risk of contracting genital herpes by 51 percent, and according to study co-author Dr. Salim S. Abdool Karim, this is important in further reducing the transmission of HIV since people infected with genital herpes are twice as likely to become infected with HIV. “This lends further credence to the gel’s protective ability and the fact that it was not a confounder of the study,” says Dr. Ross.

Amid the excitement surrounding the positive study results, there was a sour note to the Vienna conference when a coalition of AIDS groups accused the U.S. of making it harder for people in other countries to obtain access to lifesaving drugs. The accusations stem from the “Special 301” report — an annual report released by the U.S. Trade Representative’s office that ranks countries with the worst records of protecting U.S. intellectual property rights for goods — that holds foreign countries accountable for the unlawful reproduction of drugs manufactured by U.S. pharmaceutical companies.

Under TRIPS, a World Trade Organization agreement on intellectual property rights, countries possess the right to produce cheaper versions of U.S. patented pharmaceuticals if they declare a public health emergency, but according to the “Special 301,” Brazil, India, Thailand and other countries are “taking advantage of TRIPS flexibilities, including utilizing transition periods and issuing compulsory licenses.”

ACSH’s Jeff Stier reasons that “intellectual property rights advance human rights by promoting scientific innovation like the microbicidal gel.”

To counter the baseless accusations made against the U.S. trade protection policies, Dr. Ross points out that California-based biopharmaceutical company Gilead Sciences, developer of tenofovir, donated 65 pounds of the ingredient to the CAPRISA gel study. In addition, the company has agreed to relinquish any potential royalties on the gel if it will be distributed in Africa or other third-world nations.

“These activist groups — with the complicity and support of their country’s public health officials — are using the AIDS conference as a backdrop to the real issue, which is the fact that foreign countries are stealing U.S. patented drugs and they’re upset that the U.S. is now holding them accountable,” says Dr. Ross.