Original content from our Mapping Pathways blog team
"We have to continue to advocate and do the implementation science so that we can show policymakers what is feasible."
In the third of this five-part series, Linda-Gail
Bekker of the Desmond Tutu HIV Centre, a Mapping Pathways partner organisation,
speaks about the AIDS 2012 conference and her thoughts on the FDA approval of Truvada for PrEP. Read parts one and two
MP: What were
some of the conversations around the AIDS 2012 conference?
LGB: AIDS 2012 confirmed
that the prevention revolution is currently underway. The energy around
prevention was palpable. AIDS 2012 had me running around between presentations
on microbicides to PrEP to treatment as prevention (TasP) and back again to
microbicides. Since I am involved in both treatment and prevention, I am
usually very torn in conferences on what to attend. This time, I did one talk
on treatment of HIV-infected adolescents but everything else was related to
prevention, PrEP and microbicides. This is great because this is where the
science is at the moment.
I also participated in some very important and in-depth
conversations about some of the studies where the results have looked less than
ideal. There were conversations about what actually happened in the FEM-PrEP
trial and the VOICE trial.
Those conversations are ongoing and data is beginning to filter through and things
are becoming clearer.
MP: The U.S. Food and Drug Administration (FDA) approval
of Truvada for PrEP was another major
event this year. What is your reaction to that and how does that change
things?
LGB: I attended
this FDA meeting and it was absolutely thrilling. Gilead and the key scientists
did a great job presenting the science and I thought the discussions were very
robust and thorough. I came away from the process very impressed with the way
drugs are reviewed. I also subsequently read the statements from people on the
panel about why they voted the way they did and felt their opinions were
informed, valid and thoughtful.
However, we are now in an era where we need to be practical
while still doing the science. In that sense, I’m not sure how much the FDA
approval changes things in the South African context. I would be delighted if
Gilead takes this forward locally (in terms of an application to the SA
Medicines Control Council) because I think it would give us impetus to move
forward with prevention, but clearly much will depend on our policymakers and
their thoughts about cost and and further decisions of key population
implementation versus a generalised population implementation.
We have to continue to advocate and do the implementation
science so that we can show policymakers what is feasible and what the impact
in the public sector may be so that they can understand what the logistics are.
Linda-Gail Bekker is deputy director of the Desmond Tutu HIV Centre at the Institute of Infectious Disease and Molecular Medicine, University of Cape Town. She also serves as the chief operating officer of the Desmond Tutu HIV Foundation, a Mapping Pathways partner organisation.
Stay tuned to the blog as we bring you part four of our
conversation with Linda-Gail, where she speaks about her involvement in the HPTN 067 study and
about issues that make HIV the complicated problem that it is.
Stay tuned for the Mapping Pathways monograph, coming in early 2013
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