Sexually active women around the world, and especially in countries with high rates of HIV infection and pregnancy-related deaths, need more and better options to protect themselves against both pregnancy and sexually transmitted infections (STIs). However, some of the most promising new technologies to achieve that goal, known as multipurpose prevention technologies (MPTs), are vastly underfunded, according to a new analysis published in the Guttmacher Policy Review.

MPTs are products that simultaneously protect against multiple risks, such as unintended pregnancy, HIV and other STIs. MPTs currently under development include vaginal rings that protect against HIV and pregnancy, as well as vaginal gels that protect against HIV and other STIs, such as herpes.

"The great advantage of MPTs is that they approach health challenges from the woman’s perspective," says Heather Boonstra, author of the new analysis. "A woman may want to prevent pregnancy and also protect herself against HIV, but right now her only option for doing so—the condom—depends on the cooperation of her male partner. A vaginal ring that dispenses both hormonal contraception and medication to prevent HIV infection could be a simple, effective solution."

Boonstra extensively documents the need for preventing unintended pregnancy and infection with HIV and other STIs. Most critically, for many women, these health challenges are not independent problems. For example, in Sub-Saharan Africa, 12 million women aged 15–49 are living with HIV, and more than half of the women of reproductive age who want to avoid a pregnancy—55 million—are not using an effective contraceptive method.

Despite the compelling need for MPTs, their development has been hampered by insufficient private and public funding, combined with the inherent complexity of developing such innovative technologies. In particular, the lack of profit potential of drugs for use primarily in poor countries has meant that pharmaceutical companies are not actively participating in MPT development.

"Supporting and adequately funding the development of MPTs should be a higher priority for the U.S. government, especially at a time when private sector support is missing," says Boonstra. "Unfortunately, current funding—while critical in advancing this important work to date—has not been sufficient. This inadequate funding may significantly hamper the timely development of MPTs that could be a huge boost to achieving U.S. global health priorities."

Boonstra points out that, according to one analysis, investment in MPT research and development totaled just $6.5 million for the developing world in 2013, including $5.8 million from the U.S. government. This compares to $63 million for contraceptive research and development, $119 million for malaria vaccines and $642 million for HIV vaccines.

Full article: "Multipurpose Prevention Technologies for the Developing World: U.S. Investment Is Critical," by Heather D. Boonstra.