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-GailBekker 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 twoMP: What weresome of the conversations around the AIDS 2012 conference?
LGB: AIDS 2012 confirmedthat the prevention revolution is currently underway. The energy aroundprevention was palpable. AIDS 2012 had me running around between presentationson microbicides to PrEP to treatment as prevention (TasP) and back again tomicrobicides. Since I am involved in both treatment and prevention, I amusually very torn in conferences on what to attend. This time, I did one talkon treatment of HIV-infected adolescents but everything else was related toprevention, PrEP and microbicides. This is great because this is where thescience is at the moment.
I also participated in some very important and in-depthconversations about some of the studies where the results have looked less thanideal. There were conversations about what actually happened in the FEM-PrEPtrial and the VOICE trial.Those conversations are ongoing and data is beginning to filter through and thingsare becoming clearer.
MP: The U.S. Food and Drug Administration (FDA) approvalof Truvada for PrEP was another majorevent this year. What is your reaction to that and how does that changethings?
LGB: I attendedthis FDA meeting and it was absolutely thrilling. Gilead and the key scientistsdid a great job presenting the science and I thought the discussions were veryrobust and thorough. I came away from the process very impressed with the waydrugs are reviewed. I also subsequently read the statements from people on thepanel about why they voted the way they did and felt their opinions wereinformed, valid and thoughtful.
However, we are now in an era where we need to be practicalwhile still doing the science. In that sense, I’m not sure how much the FDAapproval changes things in the South African context. I would be delighted ifGilead takes this forward locally (in terms of an application to the SAMedicines Control Council) because I think it would give us impetus to moveforward with prevention, but clearly much will depend on our policymakers andtheir thoughts about cost and and further decisions of key populationimplementation versus a generalised population implementation.
We have to continue to advocate and do the implementationscience so that we can show policymakers what is feasible and what the impactin 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 ourconversation with Linda-Gail, where she speaks about her involvement in the HPTN 067 study andabout 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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