Bringing Multi-Purpose Prevention Technology Development into the Global Spotlight

Bringing Multi-Purpose Prevention Technology Development into the Global Spotlight

Multi-purpose prevention technologies (MPTs) are the future for female-driven sexually transmitted infection (STI) and unplanned pregnancy prevention. Although dozens of products are in the MPT development pipeline, including several at the final stages of clinical trials, progress in development has been slow, and investment paltry. In my last post, I discussed the technical and scientific barriers that are slowing down MPT research. Today I will highlight the comparable societal barriers, namely: lack of government willpower, widespread poor understanding of the depth and breadth of these health issues, and funding troubles. First, though HIV and unplanned pregnancies receive substantial attention in the fields of global health and development, other STIs tend to be much more overlooked. Fewer global health organizations conduct regular surveillance of non-HIV STIs, preventing more funding from going to their prevention. For instance, the World Health Organization’s (WHO) 2015 Report on global sexually transmitted infection surveillance reported an estimated 357.4 million new infections worldwide (roughly 1 million per...
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What We’ve Been Up To and What’s Next

What We’ve Been Up To and What’s Next

It’s been a busy spring semester here at the Center for Global Reproductive Health. We opened the semester with the inaugural Global Reproductive Health Leadership Symposium which brought together ten east African researchers and over 25 Duke fellows, researchers and students for a three-day hands-on meeting at Duke. Attendees shared areas of research, participated in grant writing workshops, and received in-depth training on leadership and mentorship. One of the key events from the Symposium was a lunch session “How Gender, Race, and Ethnicity Can Impact Leadership Opportunities”. With a standing room only crowd, Lola Fayanju from general surgery, Nimmi Ramanujam from Pratt, and Provost Sally Kornbluth engaged in a lively discussion moderated by Kathy Sikkema on their career paths, decision points, and how they have defined themselves as leaders. They also shared key insights on what it felt like to be trailblazers in their respective fields. It was an incredible panel that brought together multiple different sectors and provided real-life context...
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Why don’t we have more MPTs already?

Why don’t we have more MPTs already?

The term “multi-purpose prevention technologies” (MPTs) refers to any single technology that simultaneously protects users against sexually transmitted infections (STIs) and unintended pregnancy. As I discussed earlier this month, MPTs have recently garnered substantial attention and devotion from researchers, as well as a major increase in financial backing from donors. MPTs hold a tremendous potential to transform the lives of women everywhere, especially those in low- and middle-income countries (LMICs), where access to family planning and condoms for STI prevention can be a major challenge. Yet, despite innovative research and vast potential, the only MPTs currently on the market are still internal and external condoms. So, why haven’t more MPTs become available? At first glance, MPTs seem like a pretty simple concept—if a woman is already using a ring that emits drugs to prevent pregnancy, why not add in some prophylactic drugs that prevent HIV transmission as well? Yet, MPT research and development face a multitude of complex hurdles that need...
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Thoughts from the Global Reproductive Health Leadership Symposium

Thoughts from the Global Reproductive Health Leadership Symposium

Godfrey Kisigo participated in our Global Reproductive Health Leadership Symposium in February. Godfrey is currently a study coordinator for Center core member Dr. Melissa Watt's Implementation science study on PMTCT care in Tanzania. "Attending the Global Reproductive Health Leadership symposium presented a unique experience to interact with notable researchers from East Africa and Duke University. I enjoyed the mentorship session the most, as it was featured with the presence of my mentor. I believe we have created potential collaborations in reproductive health research across East Africa and Duke University at large. I should not forget to mention that food was amazing, and the organizing committee was rocking." Read more about his experiences here!    ...
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The Future (of STI Prevention) is Female

The Future (of STI Prevention) is Female

Currently, condoms are the only product on the market that provide individuals with dual protection against pregnancy and sexually transmitted infections (STIs), including HIV. The United Nations (UN) Department of Economic and Social Affairs recently reported a worldwide increase in condom use from 1994 to 2015. During this time, the percentage share of male condoms of all contraceptives used globally among married or in-union women aged 15 to 49 increased from 8% to 12%. In addition to condom prevalence, contraceptive use overall has increased rapidly since the creation of various modern methods (such as the pill and IUD) in the 1960s and 1970s. More women are using contraceptives now than ever before. Nonetheless, the UN also reported, “in at least one of out every four countries or areas with data, a single method accounts for 50 per cent or more of all contraceptive use among married or in-union women.” The most commonly used methods included the pill, injectables or IUDs—none of...
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Nimmi Ramanujam

Faculty Profile: Nimmi Ramanujam Dr. Nimmi Ramanujam serves as the Robert W. Carr, Jr., Professor of Biomedical Engineering, a Professor of Pharmacology and Cancer Biology, and a Research Professor of Global Health at Duke University. Since arriving at Duke twelve years ago, Dr. Ramanujam has founded the Global Women’s Health Technologies Center and the Tissue Optical Spectroscopy Laboratory, through which she researches cervical and breast cancers, women’s health disparities, and the development of diagnostic tools for implementation in low-resource settings. Her team is currently developing a Point of Care Tampon (POCkeT) Colposcope, which will allow women to screen themselves for cervical cancer.   Dr. Ramanujam took a break from her work to discuss cancer research, technology uptake, and the importance of focusing on the horizon of global health innovation.   How did you decide what technologies to work on?   For Dr. Ramanujam, who had already conducted research on cervical and breast cancers, choosing to concentrate on cervical cancer was about prioritizing the “next generation of problems”...
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Harnessing Culture for Change

Harnessing Culture for Change

Today is International Day of Zero Tolerance for female genital mutilation (FGM). FGM is comprised of all procedures which alter or injure female genitalia for non-medical reasons. It is internationally recognized as a violation of human rights, and eliminating this practice is one of the Sustainable Development Goals and a key focus area for many governments around the world. It is estimated that at least 200 million women and girls have undergone FGM and almost 40% of girls between the ages of 15 and 19 are currently affected. In order to make lasting change on this issue, more is needed than national legislation. FGM is deeply rooted in culture and religion, and local traditions need to be taken into account and understood to advocate for change. Read the latest editorial from The Lancet addressing this issue, and offering solutions for how we can harness culture for change....
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Ireland to Vote on Abortion Law Reform

Ireland to Vote on Abortion Law Reform

At the end of May, the Irish government will hold a referendum to decide if their long-standing constitutional ban on abortion should be repealed. Currently, unborn fetuses have a right to life equal to living humans, which has been interpreted as a ban on abortion in almost every single circumstance. If the referendum passes, the Irish Parliament will have the power to enact laws regulating abortion. Read the New York Times article for more information on the potential new regulations and Christine Ryan's blog to learn more about abortion law reform. Photo courtesy of: Clodagh Kilcoyne/Reuters  ...
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Cervical Health Awareness Month

Cervical Health Awareness Month

People across the U.S. are kicking off 2018 right with health-conscious resolutions. According to Statista, 45% of Americans hope to “lose weight or get in shape” in 2018. But January offers another opportunity to celebrate and jump-start health awareness: it’s Cervical Health Awareness Month. In the U.S. there are between 11,000 and 13,000 new cases of cervical cancer annually, and cervical cancer is the fourth most prevalent form of cancer among women globally. While patients diagnosed with early-stage cervical cancer have 5-year survival rates of up to 91%, the disease becomes far more deadly as cancerous cells spread to other parts of the body. Fortunately, proactive methods like HPV vaccinations and screenings can keep cervical cancer at bay, and mitigate almost all deaths related to cervical cancer. However, access to such healthcare often depends on a woman’s geographic location and socioeconomic status. According to the WHO, “approximately 90% [of] the 270,000 deaths from cervical cancer in 2015 occurred in low- and middle-income countries.” Duke...
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Human Rights, Feminism, and Abortion Law Reform

Human Rights, Feminism, and Abortion Law Reform

In the seminal international human rights treaties there is no express legal guarantee for abortion rights. Nevertheless, since the 1990s, women’s rights activists have used international human rights forums and mechanisms to advance abortion rights. Cumulatively, human rights law can now be said to call for the decriminalization of abortion and the legalization of abortion in cases where the pregnancy threatens the life or health of the woman, is the result of rape or incest, or there is severe fetal impairment. Despite this promising trajectory, international human rights law does not recognize a woman’s right to decide whether to carry a pregnancy to term as a matter of her autonomy, equality or self-determination. One reason for this is advocates have attempted to follow the path of least resistance for abortion rights and focused instead on the right to health, the right to be free from cruel, inhuman and degrading treatment, and the right to privacy. Recognizing unsafe abortion as a major public...
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