Rectal Microbicides Seen As Key in Preventing New HIV transmissions

By Chief K.Masimba Biriwasha | Global Editor At Large

Washington DC, US – Unprotected anal sex is a key driver of HIV transmission in many parts of the world. The practice is surrounded with much stigma and discrimination which is a key barrier to developing protective measures.

Microbicide research has gained momentum in recent years with focus largely on products to prevent HIV transmission during vaginal sex. However, there is a growing momentum to develop rectal microbicides for women, men, and transgender individuals around the world who engage in anal intercourse.

Rectal microbicides are products – that could take the form of gels or lubricants – being developed and tested to reduce a person’s risk of HIV or other sexually transmitted infections from anal sex. In spite of the public health need for rectal microbicide research, there is serious institutional, socio-cultural and political stigma around the issue.

According to estimates, the risk of becoming infected with HIV through anal sex is 10 to 20 times greater than vaginal sex because the rectal lining, the mucosa, is thinner and much more fragile than the lining of the vagina.  Because the rectal lining is only one-cell thick, the virus can more easily reach immune cells to infect.

Against this background, developing safe, effective, affordable rectal microbicides is key priority to turning the tide against HIV among populations that engage in anal sex, said Dr Ian McGowan, a leading rectal microbicide researcher.

“We are moving through the early and middle phases of the development of a rectal microbicide,” McGowan, adding that funding is part of the science and that more researchers are required as the research unfolds.

“We need mo people engaged, we need communities to take up the issue – we should follow the science.”

Jim Pickett, Chair of the International Rectal Microbicide Advocates (IRMA) and Directyor of Advocacy at AIDS Foundation of Chicago said that funding for rectal microbicides remains a key challenge for developing rectal microbicide. Pickett said that a total of US 100 million is required to engage in the next phase of studies.

“What is important in developing the next phase of studies is to develop a product that is about pleasure, intimacy, connection, emotion and love. The tools that are out there do not adequately fulfil this need,” he said. “Making the rectal microbicide safe, effective, affordable and acceptable for all who need them is a key priority.”

AIDS Vaccine Advocacy Coalition (AVAC) Executive Director, Michael Warren, said that money dedicated to rectal microbicide has been a blip on the map and a more strategic approach is required to attract additional resources.

“We need to articulate what exactly is required for the rectal microbicides; we need to build a comprehensive ask for what is required. It must come with a specific plan so that it does not appear like we are requesting for a blank. We need a clear strategy described scientifically and costed effectively in order to get support,” said Warren.

 

Carol Odada, a Kenyan AIDS activist said that rectal microbicides were not an innovation limited to men who have sex with men only.

“HIV has a woman’s faces, a woman is the main victim but nobody thinks. Every other prevention is other. Every prevention works differently works differently. There is a lot of anal sex going around. It’s unfortunate that some women are forced to engage in anal sex. Rectal micorbicide is not a gay issue. Women have to drive the call for rectal microbicide,” she said.

Cervical Cancer Kills Women in Developing Countries

By Chief K.Masimba Biriwasha

CERVICAL cancer, caused by infection with some type of human papillomavirus (HPV), is the leading cancer-related cause of death among women in developing countries.

The disease affects an estimated 500,000 women every year and kills a nearly quarter million worldwide. Eighty percent of the cases occur in developing countries where women have limited access to screening and treatment services.

“Among the most tragic public health failures of the last decade are the preventable deaths of young women in developing countries from maternal mortality and cervical cancer,” says Sue J. Goldie, a professor in the Department of Health Policy and Management at the Harvard School of Public Health.

HIV positive women are significantly more susceptible to having an HPV infection turn into cervical cancer.

This is despite the fact that there are tools available that can reverse this trend. Many governments in the affected countries have not prioritized the problem of cervical cancer in their national and health programs.

“We are now facing unprecedented opportunities to prevent these unnecessary and tragic deaths. In fact, recent concerted efforts have been made to assemble, synthesize, and interpret the available data with an eye towards actionable steps, and to comprehensively reflect on what has worked and what has not,” says Goldie. “Moreover, researchers, public health scientists, and policymakers are beginning to engage with the distinct purpose of agreeing on the most promising strategic approaches to eradicating preventable deaths in women.”

In developing countries, the vast majority of women with cervical cancer are diagnosed in late stages of the condition, and usually have little chances for long-term survival. To make matters worse, treatment for cervical cancer is rarely available even where the condition has been diagnosed.

“Unlike most cancers, cervical cancer is preventable through screening to detect and treat precancerous lesions. A conventional screening program, based on the cytological examination of cervical smears, can require up to three visits: an initial screening visit, colposcopic evaluation of abnormalities, and treatment. In countries that have been able to achieve broad cervical cancer screening coverage using cytology at frequent intervals, deaths have decreased considerably,” says Goldie.

For many developing countries, especially in sub-Saharan Africa, where poverty is endemic, and where health systems are in a state of dilapidation, cervical cancer is killing more women than necessary.

“In the vast majority of resource-poor settings such screening programs have proven difficult to implement and sustain due to a lack of human, technical, and monetary resources, and often inadequate health infrastructure,” says Goldie. “Additionally, the requirement for multiple visits, together with the need to screen at frequent intervals, has made it impossible to implement and sustain widespread organized screening in most poor countries.”

There’s need for a greater awareness of the severity of cervical cancer among women in developing countries. Also, there’s need for low-cost interventions that can be applied over a wide-scale.

No Condoms in Schools, Says Parirenyatwa

By Chief K.Masimba Biriwasha

Harare, Zimbabwe – Former Health and Child Welfare Minister, David Parirenyatwa said that distributing condoms at schools was a non-starter.

Adding his voice to the controversial proposal by the National AIDS Council (NAC) to distribute condoms at schools, Parirenyatwa said what is needed is schools is strengthening of sex education which could start as early as second grade.

“Let’s not entertain that debate of condoms in schools. It’s a non-starter. Let’s forget about putting condoms in schools. Of course, we can have condoms in tertiary institutions such as universities and colleges but in schools it’s a complete no-no,” said Parirenyatwa. “What we need instead is comprehensive sex education, and that can start quite early within the school system.”

The issue of putting condoms at schools recently hogged the media limelight following revelations by NAC that a consultant hired to review HIV and Aids policies in Zimbabwe had made the recommendation. Zimbabwe uses condoms as one of its HIV preventative measures. As a result of that the country has managed to reduce its HIV prevalence rate from over 20% to 14,2% in five years.

“In as much as we teach our children about protected sex, we need as well to provide them with the protection we will be teaching them. So we are saying condoms should be made available even in primary schools, because from the research we as UNFPA recently did it came out clearly that sex is happening in primary schools, with either teachers abusing young girls or even among the school children,” said Samson Chidiya, an official with the United Nations Population Fund (UNFPA).

Neighbouring country, South Africa,  introduced the Children’s Act which gives children 12 years and older the right to access contraceptives in 2007.

But locally, the issue has been controversial to say the least. According to media reports, some parents said that such a development will negatively affect the education system, arguing that schools should not be allowed to become bases for sexual activities.

“It will worsen sexual activities among school pupils, so we do not want to permit such behaviour at schools. If condoms are given to them, that is the end of abstinence as school pupils will take it as a sign that we condone sexual behaviour at schools,” said one parent.

Deputy Minister of Education, Sport, Arts and Culture, Lazarus Dokora said that his ministry will not give room for such a development as it is not government policy.

Water & Sanitation As A Human Right

waterMANY governments around the world pay only lip service to the problem of water and sanitation thereby denying an essential human right to their populations.  Though governments attest to the importance of water and sanitation as evidenced by MDG on water and sanitation, they make very little investment in the sector. The matter is rarely given prominence on national political agendas.

Water as a human right refers to the human right to safe water and adequate sanitation without which the enjoyment of other essential human rights can be jeopardized.  The availability of safe drinking water and hygienic sanitation facilities can indeed play a key role in the fight against poverty, hunger, child deaths and gender inequality.

According to the UN, over 1,100 million people do not have access to safe drinking water and over 2,600 million have no access to adequate sanitation. To complicate matters, water sources throughout the world are drying up, chiefly due to climate change and the mismanagement of water resources.

Dirty water and lack of sanitation affects mainly the poor, disadvantaged and voiceless in society, that is, women, girls and children.

Approximately, 1,8 million children die every year to diarrhea because of lack of access to clean water, more than AIDS, malaria and measles combined. More than 50 percent of the cases occur in Africa and Asia despite the existence of inexpensive and efficient means of water treatment.

 “In the developing world, 24,000 children under the age of five die every day from preventable causes like diarrhea contracted from unclean water,” said Caryl M. Stern, President and CEO, the U.S. Fund for UNICEF at the launch of a report, titled “Diarrhea: Why Children Are Still Dying and What Can Be Done“.  Continue reading

Quote of the Day

We are at the very beginning of time for the human race. It is not unreasonable that we grapple with problems. But there are tens of thousands of years in the future. Our responsibility is to do what we can, learn what we can, improve the solutions, and pass them on.

 Richard Feynman (1918 – 1988)

Will Water Fuel An Armageddon?

water_crisisThere is no consensus among water analysts on whether there will be global wars over water ownership.

 According to UNESCO, globally there are 262 international river basins: 59 in Africa, 52 in Asia, 73 in Europe, 61 in Latin America and the Caribbean and 17 in North America — overall, 145 countries have territories that include at least one shared river basin.

UNESCO states that between 1948 and 1999, there have been 1,831 “international interactions” recorded, including 507 conflicts, 96 neutral or non-significant events and, most importantly, 1,228 instances of cooperation around water-related issues.

As a result, some experts argue that the idea of water wars is rather farfetched given the precedent of water cooperation that has been exhibited by many of the countries around the world.

“Despite the potential problem, history has demonstrated that cooperation, rather than conflict, is likely in shared basins,” says UNESCO. Continue reading