Dear Forum Members
(Brian Haill response follows this posting)
The lemon/lime juice debate continues! Brian Haill's recent
posting reflects at least one serious misrepresentation of the
current microbicide development field when he says that "the
search for a man-made microbicide will reap hundreds of millions
of dollars in profits. for their producers."
While small biotech companies may discover a compound that
holds promise as a microbicide, virtually all of the investment
in the actual research and development of microbicides comes
from public funding from governments of the US and Europe, or
from charitable donors such as > the Bill and Melinda Gates
Foundation. A few large pharmaceutical companies have donated
compounds to non-profit entities to develop, waiving their right
to profit from the sale of any resulting microbicide.
Everyone from advocates to donors to researchers to product
sponsors recognize that any successful microbicide must be affordable
or free for the people who need it. Collective efforts to establish
public-private partnerships and guaranteed purchase funds are
a significant part of the > microbicides development agenda.
We therefore disagree with Mr. Haill's characterization of
the microbicide community's caution around lemon and lime juice
as a reluctance to consider a straightforward, inexpensive,
and "natural" solution to the pressing need to help
women protect themselves from HIV and AIDS.
As advocates who became involved in microbicides out of an
interest in protecting our health and our rights, we are not
enamored of technology for technology's sake. Our caution in
response to generalized statements about the anti-HIV potential
of lemon or lime juice before we have answers to the many unknowns
is founded in other concerns.
It may appear to be a contradiction that advocates actively
"promote"
research into experimental microbicides of unknown safety and
efficacy, > and yet hesitate to promote lemon or lime juice.
The difference is not in the product- lime juice versus chemical
gel- but in the process.
Research on manufactured microbicides occurs in a step-wise
fashion under highly controlled conditions. It starts with pre-clinical
and animal > testing to determine appropriate dosages that
are likely to be safe and effective for human use. Only then
does the product go for trials with human participants. The
results of trials are reviewed by independent > analysts
before products move to the next stage of testing.
Women who volunteer to participate in a trial receive detailed
education, counseling and support to help them understand the
risks and benefits of using the product, to use the product
correctly at the established dosage and frequency, and to continue
to use known strategies of prevention (such as condoms).
They also have regular assessment, care and follow-up should
they experience any side effects. Since microbicides of unknown
safety and efficacy are only available through trials, it's
impossible for women to use them without also having these precautions
and protections in place.
In contrast, women who are currently using or would consider
using lemon or lime juice as a microbicide generally do not
have access to this sort of
safety net. The impact on human tissue of variability in concentration,
dosage and frequency of use of lemon or lime juice has yet to
be established.
Even if this information were known, we have no way to help
women control these factors, since the characteristics of the
fruit and its juice could vary widely, and accurate measurement
and application would be difficult.
We are deeply concerned by unqualified statements about the
use of lemon or lime juice as a microbicide- such as the following
that appears on the Lemons & AIDS website: "It is proposed
that lemon or lime juice could be used as a natural microbicide
by using the juice either as a douche (or
wash) directly after sex or by using it directly in the vagina
during sex. > Approximately a teaspoon of lemon juice in
a saturated cotton ball or sea sponge inserted into the vagina
and removed after sex could be all that is needed."
While some may defend this is a conditional, forward-looking
statement similar to what advocates say about experimental microbicides,
we see this as frighteningly close to advising women to try
an untested, unproven, and potentially harmful intervention
to protect themselves from HIV.
We therefore urge the advocates of lemon and lime juice to introduce
greater caution into their awareness-raising efforts, and to
absolutely desist from providing what seem to be instructions
for use of lemon or lime juice as a microbicide. Similarly,
we call upon those entities currently evaluating the potential
safety and efficacy of lime juice to accelerate the release
of their data and analysis.
While we welcome open debate about the pros and cons of different
approaches to microbicide development, such debate must be undertaken
in ways that are mindful of the broader consequences for people
at risk.
Megan Gottemoeller
Global Campaign for Microbicides
============================
BRIAN HAILL'S RESPONSE....posted to Gender-AIDS 14/1/2006
The Global Campaign for Microbicides is clearly and unfortunately
unaware of the scientific evidence for the microbicidal effect
of limes or lemons on HIV as presented in proceedings at the
International AIDS Conference in Bangkok in 2004 and also published
on our www.aids.net.au website and variously throughout the
world.The most recently published paper appeared in the (Australian)
CSIRO publication "Sexual Health" last year and is
carried on the www.aids.net.au website
There is a full length paper due to appear within the next
few weeks in the
(London) Philosophical Transactions of the Royal Society and
another paper is due to appear in Fertility and Sterility in
May, 2006.Other papers have been submitted for publication.Due
to the intense interest in this debate, we will be posting this
eforum article of the Global Campaign for Microbicides onto
our www.aids.net.au website together with this response.
We urge all Forum members to stay tuned as we have no secrets
to hide and no patents to protect!
Brian Haill,
President,
The Australian AIDS Fund Incorporated,
Melbourne, AUSTRALIA
