2 July 2014 Felicia Stewart Center at UCSF ANSIRH Oakland, California, USA Women s Health in Women s Hands: The Promise of MPTs Special Guests: Manjula Lusti-Narasimhan (WHO) Ina Park (CDPH) Bethany Young Holt (CAMI/IMPT)
Multipurpose Prevention Technologies MPTs prevent a combination of unintended pregnancy, STIs, HIV/AIDS Should be safe & easily available Are designed with key input from women for their specific needs & preferences
What s in the pipeline? Small Organic Molecules Broad Spectrum Natural Products Proteins/Peptides Non-Hormonal Contraceptives
WHO Global Reproductive Health Strategy Promote and strengthen SRH services through: improving antenatal, delivery, postpartum and newborn care; providing family planning, including infertility services; eliminating unsafe abortion; combating STIs, including HIV, RTIs, cervical cancer and other gynaecological morbidities; promoting sexual health.
Global Need 222 million women have an unmet need for modern contraception. Each day, close to 800 women in developing countries die from complications related to pregnancy and childbirth. Each year 1.7 million people die from AIDS related causes and 2.5 million become newly infected with HIV. 1 million people contract a sexually transmitted infection every day.
WHO/RHR/HRP Core Functions Identifying gaps and priorities and shaping the global SRH research agenda Providing leadership on matters critical to improving SRH through knowledge generation, synthesis and management Supporting national research, technical capacity strengthening and engaging in relevant partnerships Articulating ethical and evidence-based options for policy formulation and programme development to improve SRH, in collaboration with regional and country offices Monitoring and evaluation of SRH situations and trends, advocacy, catalysing change and supporting intervention delivery Developing of WHO guidelines: clinical standards, norms and related policy and technical guidance documents Developing pre-qualification of products
Case Study: Kajiata Age 33, married Lives in region with high rates of HIV and HSV-1 Already has 6 children Currently gets the Depo injection Husband spends a significant amount of time out of the village and she accepts he is unfaithful Husband will not wear a condom
Case Study: Angie Age 19 Lives in region of the US with high incidence of chlamydia Currently using long acting reversible contraception No longer in a committed relationship Doesn t always use a condom
Consequences of STIs STIs enhance the biological risk for HIV infection and transmission and can impact how the disease progresses. Long-term health consequences of STIs include: Cervical cancer Pelvic inflammatory disease Infertility Tubal or ectopic pregnancy Infants born to infected mothers can suffer from perinatal or congenital infections.
In the United States Nearly half of all pregnancies among American women are unintended. STIs are the most commonly reported communicable diseases in the US. There are18.9 million new cases of STIs each year in the US, half of them among 15-24 year olds. Source: Guttmacher Institute
Selected STIs in California Chlamydia, Gonorrhea, and Primary & Secondary Syphilis California Rates, 1990 2012 Rate per 100,000 population 500 400 300 200 100 0 1990 '92 '94 '96 '98 2000 '02 '04 '06 '08 2010 '12 Year Chlamydia >206,000 cases of bacterial STIs reported in California Gonorrhea P&S Syphilis 448.9 (N=169,797) 89.3 (N=33,780) 7.8 (N=2,936)
Mistimed or Unwanted Pregnancy MIHA 2011 Nearly 1/3 of pregnancies in CA are unplanned
Chlamydia Among Females, 2012 Ages 15-24, By County
Chlamydia among females (2012) vs Unplanned Pregnancy (2011) 1) LA County 2) Southeastern CA 3) San Joaquin Valley
Genital Herpes Initial Visits to Physicians Offices, 1966 2012 NOTE: The relative standard errors for genital herpes estimates of more than 100,000 range from 18% to 30%. SOURCE: IMS Health, Integrated Promotional Services. IMS Health Report, 1966 2012. 2012-Fig 48. SR, Pg 45
STIs in Women Women are disproportionately affected by genital herpes 1 in 5 women 1 in 9 men Source: CDC MMWR April 23, 2010 / 59(15);456-459
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Collaboration, advocacy & research to advance MPTs
Collective Impact Approach
Questions?
Acknowledgements Bill & Melinda Gates Foundation Mary Wohlford Foundation USAID World Health Organization The generous support from individual donors like you!
Thank You! Support for this project is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of the HealthTech Cooperative Agreement #AID-OAA-A-11-00051, managed by PATH. The contents are the responsibility of CAMI/PHI and its partners and do not necessarily reflect the views of USAID or the US Government.