Text of LHHS Letter
March XX, 2019
The Honorable Rosa D. DeLauro
Chairwoman
Subcommittee on Labor, Health and Human Services, Education, and Related Agencies
Committee on Appropriations
U.S. House of Representatives
Washington, DC 20515
The Honorable Tom Cole
Ranking Member
Subcommittee on Labor, Health and Human Services, Education, and Related Agencies
Committee on Appropriations
U.S. House of Representatives
Washington, DC 20515
Dear Chairwoman DeLauro and Ranking Member Cole:
As your Subcommittee prepares to consider its Fiscal Year (FY) 2020 Labor, Health and Human Services, Education, and Related Agencies Appropriations bill, we request that you include language to encourage coordination amongst the National Institutes of Health (NIH), the Department of State (State), including the Office of U.S. Global AIDS Coordinator and U.S. Agency for International Development (USAID), and other partners in order to advance microbicide development and implementation efforts.
The number of new HIV infections among young women is 44 percent higher worldwide than among young men. Given the fact that women, and especially young women, continue to be infected with HIV at alarming rates, new HIV prevention technologies such as microbicides for women are urgently needed. In 2016, a microbicide known as the dapivirine ring (a long-acting, monthly vaginal ring containing the antiretroviral drug dapivirine) was shown to safely reduce the risk of HIV infection for in women ages 18-45. Additional open label extension studies on the ring (which ended in 2018) have shown even further reduction of HIV risk among women. The dapivirine ring is currently under regulatory review to determine if the product will be licensed for use. If approved, the dapivirine ring would be the first biomedical HIV prevention method developed specifically for women and an important scientific breakthrough for women’s health. There are also a number of promising microbicide products currently in earlier stages of the development pipeline to ensure next generation products with more advanced technology are available for improved protection against HIV.
Effective microbicides are needed to combat HIV because existing prevention methods (primarily condoms) are not always feasible for millions of women around the world. Power imbalances in many relationships do not allow women to make the decision to practice safe sex. In addition, gender inequities—including socioeconomic disparities, gender-based violence, and intimate partner violence—have been identified as key drivers of HIV transmission in Sub-Saharan Africa. Given this reality, women need a broader range of HIV prevention options so they can choose which HIV prevention product they like and can use consistently on their own terms. Microbicides are designed as discreet, female-initiated products that have the potential to empower women to protect their health. These products have the potential to significantly contribute to the achievement of the UN’s Sustainable Development Goals that seek to eliminate HIV/AIDS (Goal 3) and to achieve gender equality and women’s empowerment (Goal 5) by 2030.
Successfully confronting the AIDS pandemic requires a multi-faceted global HIV prevention strategy, and microbicides have the potential to be a new resource in the fight against HIV/AIDS. We ask that you support the Committee language below encouraging coordination between NIH and State, including USAID and OGAC, in the Committee Report accompanying the FY 2020 Labor, Health and Human Services, Education, and Related Agencies Appropriations bill.
Department of Health and Human Services, National Institutes of Health (NIH), National Institute of Allergy and Infectious Disease (NIAID)
Microbicides. The Committee recognizes that with NIH and USAID leadership, research has shown the potential for antiretroviral (ARV) drugs to prevent HIV infection in women. The Committee encourages NIAID to continue coordination with USAID, the State Department, and others to advance ARV-based microbicide development efforts with the goal of enabling regulatory approval of the first safe and effective microbicide for women and supporting an active ARV-based microbicide pipeline to produce additional solutions to prevent HIV and to help end the epidemic.
Given the investments that have been made to date by the Federal government, including USAID and NIH, and the scientific progress made in developing the dapivirine ring as a new HIV prevention product; it is critical that Congress continues to support funding for microbicide research, development, and implementation.
Thank you for your attention to this request.
Sincerely,
JAN SCHAKOWSKY
Member of Congress
