The International AIDS Conference, Vienna 2010, has represented a series of major successes for women. First and foremost, we had the announcement today of the first microbicide ever shown to convincingly prevent HIV in women. Tenofovir Gel, applied by a woman anytime in the 12 hours before sex and then again anytime up till 12 hours after sex, reduces HIV transmission to women by at least 39%. In the International Conference at Durban in 2000, there was a plenary announcement of microbicide trials which did not work. Now, ten years later, it is very fitting that two of the scientific organizers of IAS Durban 2000, Quarraisha Abdool Karim and Salim Abdool Karim have announced the success of their research.
Microbicides were the dream of Zena Stein and promoted with Anke Ehrhardt by the Columbia University HIV Center which has focused on women since its inception in the 1980s. It was the product of feminist visions and carried through by many more feminists over the last 25years. Advocates for women pushed for microbicides when scientists working on AIDS vaccines and treatment had not even envisioned the problem of “methods women can use.”
This example illustrates that scientific research is only as good as the concepts which drive it. No scientific method is the gold standard, no matter how much it is randomized and controlled, if there is no vision behind it that reflects the needs of the affected community. Feminists have struggled with AIDS research for a generation, trying to frame questions that address women’s prevention, safe fertility and breastfeeding. A central aspect of good science is generating the questions that make sense in people’s lives. As documented in my recent book, feminists have had to fight continuously to frame the right scientific questions for women in AIDS. Once we have the questions, we have to generate the best methods to answer them – whether that be a controlled, randomized trial or a qualitative ethnographic case study.
In this respect, as the Town Hall Meeting at the Women’s Networking Zone amply demonstrated, “evidence-based” research has to reflect thoughtful concepts and a variety of appropriate methodologies, both quantitative and qualitative.
There have been many victories for women at this conference. The request for a gender breakdown in the abstracts has become routinized, and this request has also been added to the request for papers in the Journal of the International AIDS Society. The opening plenary on Monday morning featured two women who have long been active in AIDS advocacy, Vuyiseke Dubula, General Secretary of the Treatment Action Campaign in South Africa and Anya Sarang, President of the Andrey Rylkov Foundation for Health and Social Justice in Moscow, Russia. Such changes were the result of over twenty years of organizing for the recognition of women’s agency and women’s collective rights in the treatment and prevention of AIDS.
Now, we cannot rest on our laurels – we have to do better than 39% protection!! However, from now on, no woman should get less! The next challenge will be to ensure that the results of the microbicide trials are transformed into practical benefit for women, both in South Africa and beyond. If Tenofovir gel does reduce HIV transmission in women, it needs to be produced and distributed as soon as possible. As we all know, feminists and health advocates have the next struggle ahead and we need to educate ourselves and prepare to mobilize to implement the findings, imperfect as they may be.
The South African government, not Gilead, owns this patent – will they begin to plan to use this first microbicide that works ? Perhaps they will protect only 40% of women or maybe 50% of those who use the gel – but women should be given the choice to use it - and that is the challenge – will it be available by the next international AIDS Conference in Washington DC in 2012? – will it save lives now?
To read openDemocracy's multi-authored blog from the Conference click here