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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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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The Value of Big Data for Family Planning

The Value of Big Data for Family Planning

While the use of modern methods of contraception are now commonplace in many countries, one-third of women in developing countries who begin using a modern method of contraception quit within the first year and half quit within two years[i]. Most discontinuation occurs among women who want to avoid pregnancy putting them at risk for unwanted pregnancies, maternal morbidity and mortality[ii]. Traditional measures of contraceptive use are collected retrospectively from population representative surveys conducted only every five years which are not well-suited to measuring contemporary trends in contraceptive discontinuation. This is problematic because advocates and health ministries cannot address concerns in a reasonable amount of time to impact widespread change. "Big Data" can supplement these static sources by providing dynamic, real time tracking of the reasons women discontinue using contraceptives and open up possibilities to prevent discontinuation or help facilitate switching between methods. So what exactly is "Big Data" and how can it supplement traditional reproductive health data? Big data is commonly thought...
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Big Data for Reproductive Health

Big Data for Reproductive Health

"Curious about contraceptive discontinuation?  Intrigued by intersections of technology and sexual health?  Apply to join the Data+ “Big Data for Reproductive Health” team! This summer, participants will collaborate with Duke Global Health Institute reproductive health investigators, producing a digital resource that repackages basic Demographic and Health Surveys (DHS) information on contraceptive discontinuation as actionable intelligence for family planning organizations. During the 10-week program, students will also seek feedback from RTI researchers and determine appropriate distribution tactics for their social media-integrated platform. Like other Data+ programs, this project is interdisciplinary, combining the fields of computer science, global health, gender, sexuality and feminist studies, public policy and, of course, data.  To find out more and apply, click here."...
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Photo Essays: HIV/AIDS

Photo Essays: HIV/AIDS

While a stream of statistics sheds valuable light on global impacts of HIV/AIDS, evaluations of programs and populations can make it easy to forget the epidemic, at its core, is about individuals.  Though words are among humanity's most powerful tools, they may fail to convey the full narrative.  In a world divided by a plethora of languages, sometimes photographs--a universal form of communication--tell the best stories. In preparation for #WorldAIDSDay2017 tomorrow, we've compiled a list of photo essays that document the impacts of HIV/AIDS over time and across the world.  Keep scrolling to check them out and learn about efforts to combat this issue around the globe. "Life on London's First AIDS Ward" (photo courtesy Gideon Mendel) "26 Powerful Photos Of The US AIDS Crisis In The '80s" (photo courtesy Barbara Alper/Getty Images) "Namibia's HIV/AIDS and Poverty Crisis" (photo courtesy UNICEF) "Sex and Drugs in an HIV-Infected Paradise" (photo courtesy Mia Collis/PBS NewsHour) "HIV/AIDS in Eastern Europe" (photo courtesy Malcolm Linton) "World AIDS Day 2012: Imagine being...
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