Friday, 31 October 2014

So when will The Next Big Thing be available for general use?

WYCLIFFE MUGA writes: The one question research scientists dread most – but one which journalists are obliged to ask – is, “So when will this be available for general use?”

What makes this question so difficult to answer is that there is a large gap between the successful implementation of an early medical trial and and the products arising from this trial actually reaching the intended market.

After the creation of a new intervention against HIV, for example, there will still be the issues of regulatory approval; scaling up production to obtain economies of scale; arranging for distribution channels etc.

All this will be even more difficult with the Next Big Thing in the fight against AIDS: Multipurpose Prevention Technologies (or MPTs).

For example, research is under way to test the efficacy of vaginal rings embedded with antiretroviral drugs, (the dapivirine vaginal ring) as an intervention to prevent HIV infection.

If and when efficacy is proved,  application for regulatory approval for general use is the next step. Hopefully, one day, it will be possible to embed slow-release drugs in the same vaginal ring, for three different interventions: microbicides to block HIV infection; other microbicides to fight the more routine sexually transmitted infections (STIs); and contraceptives.

In theory this would take the question of “extending choice” to a whole new level. Women could decide which combination of options would best address their individual needs.

But in practice, there are bound to be problems – especially in Africa – even with something this innovative. For there is a long-entrenched resistance to contraception in much of Africa, where large families are still preferred. And of course there is the continuing stigmatization of those who are HIV+ve.

Still, what is crucial about this new approach, and the research into these new technologies, is that it puts the woman in charge, which in itself represents a great leap forward.

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