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[LUSAKA] Africa's scientific community should develop standards to guide research on microbicides — substances that kill or block the HIV virus —  said participants at a meeting on vaginal microbicides held last week (17-19 November) by the Southern African AIDS Trust.

The aim of the guidelines would be to prevent unethical clinical trials and to minimise health risks to women taking part in them.

The meeting took place in Johannesburg, South Africa, and was funded by the Swedish International Development Agency. Delegates from women's organisations involved in HIV/AIDS activities, research institutions and the donor community attended the event.

According to a preliminary report on the meeting's key discussions, made available to SciDev.Net by the trust, participants raised concerns that women participating in clinical trials risk becoming infected with HIV during the testing of microbicides if they have sex with men who have the virus.

The delegates added that little support is given to women participating in the trials, and few attempts are made to protect their rights in the event of them suffering side-effects.

Participants at the meeting also questioned the transparency and accountability of researchers running clinical trials. The delegates expressed fears that the low literacy level of many women in rural areas of Africa countries means they would have difficulty understanding and information provided and the contract they are asked to sign.

Sisonke Msimang, a South African HIV/AIDS and gender activist, said at the meeting that an effective microbicide would not help tackle HIV/AIDS on its own. Women would also need to be consulted about how they would use such drugs, to develop a practical product that is safe, effective and affordable.

Researchers will need to investigate ways to enable women to discuss with their partners currently taboo topics such as sexuality and contraception, so that the subject of microbicides is easier to broach, said Msimang.

The importance of tackling the socio-economic difficulties facing African women was highlighted this week in a report from the Joint United Nations Programme on HIV/AIDS (UNAIDS).

The agency states that almost half of the 37.2 million adults who have HIV worldwide are women — a stark contrast from the start of the AIDS epidemic when most infected individuals were men. According the report, in sub-Saharan Africa almost 60 per cent (13.3 million) of adults with HIV are women.

Women are biologically more susceptible to the virus than men, but they also have less power than men over the measures they are able to take to prevent infection, says the UNAIDS report.

As UNAIDS's deputy director Kathleen Cravero explained at a press conference in London on 23 November, cultural norms and taboos prevent women from asking their husbands or sexual partners to use condoms or to take HIV tests. 

In response to the UNAIDS report, Zeda Rosenberg of the International Partnership for Microbicides called on the world's governments to boost investment in microbicide research and development. She added that "the pharmaceutical industry must also continue to make new antiviral agents available for testing as microbicides".

Funding is crucial, Rosenburg points out. "With an additional global investment of US$1 billion, microbicides could be in the hands of women in developing countries within the next five to ten years, potentially saving 2.5 million lives over three years."

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