We need to put the power of HIV prevention in the hands of women

Bill and Melinda Gates has called upon world leaders to "put the power to prevent HIV in the hands of women" by accelerating the search for microbicides and other new HIV prevention tools.

Bill Gates said he thought the discovery of an effective microbicide or oral prevention drug to reduce HIV transmission could be "the next big breakthrough in the fight against AIDS." They also called for increased global access to HIV prevention and treatment, and greater advocacy to break the stigma of AIDS.

Mr. and Mrs. Gates, co-chairs of the Bill & Melinda Gates Foundation, addressed the opening ceremony of the 16th International AIDS Conference, a gathering of more than 24,000 scientists, advocates, and health workers from around the world.

Bill Gates said there is "a new sense of optimism" in Africa because "the world is doing far more than ever before to fight AIDS." He commended the progress of initiatives such as the Global Fund to Fight AIDS, TB, and Malaria, which he called "a fantastic vehicle for scaling up the treatments and preventive tools we have today." Last week, the Gates Foundation pledged $500 million to the Global Fund, and encouraged other donors to step up their contributions.

Noting that "stopping AIDS" is the Gates Foundation's "top priority," Mr. Gates emphasized that "we have to do a much better job on prevention" to avert millions of new HIV infections and keep pace with the rapidly-growing demand for treatment. "Treatment without prevention is simply unsustainable," he said.

Melinda Gates reinforced the importance of increasing access to effective HIV prevention. "We need to be much more aggressive about getting all of today's prevention tools to everyone who needs them," she said. "Today, fewer than one in five of the people at greatest risk of HIV infection have access to proven approaches like condoms, clean needles, education, and testing. That's a big reason why we have more than four million new infections every year."

HIV Prevention Research an "Urgent Priority"

Bill Gates said it should be an "urgent priority" to accelerate research on promising new HIV prevention methods, and that he hoped that the discovery and development of an effective microbicide or oral prevention drug could "mark a turning point in the epidemic." The Gates Foundation has provided significant funding to support research on new HIV prevention tools, including $287 million announced last month to advance HIV vaccine development.

"We need tools that will allow women to protect themselves," said Mr. Gates. "This is true whether the woman is a faithful married mother of small children, or a sex worker trying to scrape out a living in a slum. No matter where she lives, who she is, or what she does -- a woman should never need her partner's permission to save her own life."

Mr. Gates also said that the pace of research on new HIV prevention methods has not been fast enough, given the urgent need.

"While there is promising research to report, the world, in my view, has not done nearly enough to discover these new tools," he said. "All of us who care about this issue should have focused more attention on these tools, funded more research, and worked harder to overcome the obstacles that make it difficult to run clinical trials. Now we need to make up for lost time."

Melinda Gates noted that "we all have a role to play" in advancing the development of new HIV prevention tools. For example:

• Governments can increase funding for research and development
• Pharmaceutical companies can devote more time, energy, and funding to research and development on HIV prevention, and share their compounds and technologies with prevention researchers
• AIDS advocates can push for more HIV prevention research and for rapid access to effective prevention approaches
• Researchers can conduct studies more quickly by developing novel trial designs and finding more efficient ways to analyze data
• WHO, UNAIDS, and other major organizations can develop shared ethical standards for clinical trials

Melinda Gates also called for more aggressive advocacy and stronger leadership to break the "cruel" stigma associated with HIV/AIDS and at-risk groups, which has made the disease "much harder to fight."

"When Bill and I visit other countries, we are enthusiastically accompanied by government officials on all our stops -- until we go meet with sex workers," said Mrs. Gates. "At that point, it can become too politically difficult to stay with us, and our official hosts often leave."

"That is senseless," she continued. "People involved in sex work are crucial allies in the fight to end AIDS. We should be reaching out to them, enlisting them in our efforts, helping them protect themselves from infection, and keeping them from passing the virus along to others."