Director of Public Policy
Junior League of Los Angeles
Microbicides: An Economic and Ethical Solution to the New Face of HIV/AIDS
Since heterosexual sex has become the main conduit of HIV transmission worldwide, women have come to bear the greatest burden of this disease while possessing the least amount of control over their risk factors. According to the United States Department of Health, in 1990 only 11% of new AIDS cases were diagnosed in women. By the end of 2004, that number had leaped to 27%, with 78% of those cases originating in heterosexual relations. Currently, UNAIDS estimates that women represent nearly 50% of all AIDS cases globally. Compounding this frightful trend are the biological factors that make women two to four times more vulnerable than men to sexually transmitted HIV infection. Pivotally, many women who become infected with HIV have only one partner – their husbands. Gender dynamics, limited autonomy, fertility pressures, poverty, and a woman’s socio-economic status have additionally contributed to the state of this worrisome trend. Powerless to enforce mutual monogamy, it is imperative that a female controlled sexual barrier becomes available for widespread use.
Microbicides, a class of pharmaceutical product that is applied topically, is currently under development and will eventually help women prevent the transmission of the HIV virus. This product could come in a variety of forms, including gels, creams or rings that would release the drug slowly over days or weeks, and, most importantly, would empower women to control their destinies. They are also being developed with a non-spermicidal agent that will allow for the conception of children while providing protection.
Not only is the development and distribution of microbicides Pareto Efficient, it satisfies the concept of minimal benevolence. If we can make these women better off, without harming anyone else, we morally ought to do so. And if by making these women better off, we can also improve the lives of others and society at large, we economically ought to do so.
Additionally, scientists estimate that a mere 60% effective microbicide has the potential to prevent 2.5 million HIV infections in three years among women, men and children, and the costs associated with their treatment and death. A simple application of Bayes Theorem illustrates that a 95% efficacious method, such as the male condom, used in 20% of sexual encounters provides far less protection than a 60% efficacious method used in 40% of sexual encounters. Although this fact may seem counter-intuitive on the surface, the clarity of its truth and strength supports the argument for putting risk control into the hands of women.
Junior League of Los Angeles Position on Microbicides
The Junior League of Los Angeles supports SJR 22 as women need HIV-prevention tools that they control in order to safeguard their health and that of their families and communities. Current HIV prevention options are not enough, and Microbicides can put the power of prevention into women’s hands. Since leading scientists conclude that a HIV vaccine is at minimum 10-years away, it is time to make a strong commitment to the development of microbicides.
All data provided by The Global Campaign for Microbicides