Jim Pickett
July 2008

International Rectal Microbicide Advocates (IRMA) Does Delhi

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As chair of IRMA, you may say I have a certain booty bias in my perceptions -- and I won't argue. But let me say, I think our burgeoning advocacy network really took the Microbicides 2008 conference in New Delhi this past February by storm.

It all started with the utterance of the melodious words -- "rectal microbicides" -- in the opening remarks given by Dr. Anbamani Ramadoss, India's Minister of Health and Family Welfare. Sure, just a mention, but so significant ... and such a huge statement on how far the rectal microbicide field has come, from laughable and obscure to, as rectal guru Dr. Ian McGowan likes to say, "almost embarrassing respectability." I was absolutely thrilled to be embarrassed.

The conference featured a Rectal Microbicide Update sponsored by amfAR, the UCLA AIDS Institute, and The University of Pittsburgh School of Medicine and was, in my opinion, the best attended Rectal Update compared to similar ones held in London (2004) and Cape Town (2006). Of all the great presentations, Dr. Peter Anton, the principal investigator of the MDP U19 study (the "rectal microbicide flagship") delivered some of the most tantalizing science. While the group's Phase I trial, looking at rectal safety of the topical vaginal formulation of the NNRTI UC 781is still wrapping up and data is still blinded, Anton and his group detected potential signals of efficacy. Efficacy! Needless to say, extremely exciting. We should know more soon once the final data is in. The slides from the Update presenters and all of Anton's slides from the Update and the general conference are available on IRMA's lovely new website -- www.rectalmicrobicides.org -- under the Community Presentation section in Resources.

One of the best aspects of the conference was the Advocacy Corner headed up by the Global Campaign for Microbicides in collaboration with other international groups such as IRMA. The space was always buzzing with activity and allowed for an enormous amount of information sharing and networking. We were thrilled to pass out hard copies of our new report, "Less Silence, More Science -- Advocacy to Make Rectal Microbicides a Reality (PDF)," in the cozy space and to sign on well over 100 new advocates to our group -- most of whom were from India and Africa.

You can find a copy of our report on our site, under IRMA Materials, by the way.

I have never seen so many people so revved up around rectal microbicides in one place ... I am still high from the experience! Please visit our brand new blog at www.irma-rectalmicrobicides.blogspot.com to read the personal accounts of some of our "Delhi Dynamos," particularly a number of very motivated advocates from Nigeria who have already birthed IRMA-Lagos and others who are planning community mobilization and education activities in their regions. There are also links there to fun Flickr photos ...

We have a long ways to go. We need more resources from a more diverse stream of funders. We need more research on the incidence and prevalence of anal intercourse globally, including better and more accurate information on the populations and contexts in which it occurs. And, quite simply, we need the rest of the field to adopt language that does not negate or obscure the rectal "compartment," or hide the fact that men, as well as women, will also be end-users of safe, effective and acceptable microbicides. Receptive partners of both genders need prevention options they can control -- pretending otherwise is no longer an option.

And I could go on ... but in a nutshell, with less silence and more science, we can save millions of HUMAN lives. Will you be part of the solution?

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