Issues
Microbicide, Solution To Female HIV Infection?
Since the Human Immune Virus and the Acquired Immune Deficiency Syndrome (HIV/AIDS) pandemic became known in Nigeria in the mid eighties, no illness has caused more commotion and separated families and friends alike.
From being a rumour initially, it became a cruel reality which raised so much pandemonium that how it is transmitted from person to person became more horrifying and confusing almost by the day.
However, from the mid eighties to now, so much water had passed under the bridge. Form being regarded as the most dreaded diseases, which had no cure, HIV/AIDS is now manageable.
In fact, research has proved that an infected person can live a normal life like every other person. All it requires is awareness in the part of the infected person.
In spite of this encouraging development, however, research has also shown that the virus is still spreading and fastly too, for various reasons, which include the fact that people, mostly out of fear of being discriminated upon, prefer to keep their infection to themselves, or refuse to know their status.
Research has alo showed that majority of those infected are women, thus raising questions regarding why it is so.
It did not take long for researchers to reason that perharps this will not be far from the fact that women seem to be the most vulnerable when it comes to adopting preventive measures during heterosexual intercourse.
This is because the presumed efficacy of such preventive measures as abstinence, use of condoms and being faithful to a partner could not stop more women from being infected. Hence the decision to come up with a preventive measure strictly to be controlled by women.
In the words of Dr. Orikomaba Korifama Obunge, consultant clinical microbiologist and Head of Medical Microbiology department, University of Port Harcourt Teaching Hospital (UPTH) ‘‘a lot of them (women) are still being infected, not because their partners are a little bit more adventurous, and the ability of them negotiating for the use of preventive measures such as condoms is not working much as it should.
‘‘The issue is that, can we not provide a preventive measure that is controlled by the women, that is capable of forming a barrier during heterosexual intercourse?’’
It is the search for this measure, according to Dr Obunge, that resulted in the emergence of a concept of a microbiocide by a group of researchers and activities, which also include Dr Obunge.
According to a recent UNAIDS estimates, in 2009 more than 33 million people were living with HIV and approximately 2.5 million people were newly infected.
The estimates also showed that worldwide, nearly half of all individuals living with HIV are now women, who acquired the virus largely by heterosexual exposure.
Further more, many women, because of limited economic options and gender inequality, cannot reliably negotiate sexual encounters, leaving them vulnerable to unwanted pregnancies and sexually transmitted infections (STIs), including HIV.
Thus, with clinical deployment of safe and effective HIV Vaccine still likely to be years away, topical microbicide formulations that are applied vaginally or rectally are receiving increasing attention as another strategy for HIV prevention.
The microbicide is a product in the form of a gel which could be infected intraveinously with the sole objective of preventing the transmission of the virus during heterosexual intercourse to the woman.
According to the researchers, a review of preclinical and clinical research on the development of microbicides formulated to prevent vaginal HIV transmission yielded 118 studies globally.
Presently, mathematical modeling has shown that if there is such a preventive measure that is workable, then millions of new infections could be prevented and it would be an encouragement for donor agencies to start working on it. Hence the emergence of research on microbicides.
In the words of Dr. Alan Stone of the Medical Research Council in the United Kingdom, ‘‘the development of an effective microbicide is a global priority of the highest order… The question is not whether the microbicide approach will prevent HIV infection but, rather, what proportion of HIV infections it will prevent.’’
Towards coming up with such a microbicide, two research organizations, FHI and Vera Halpen using collaborators in various countries embarked on research for the purpose. In Nigeria the collaborators were Dr. Orikomaba Korifama Obunge and Dr F.S.Ogusola of the university of Lagos.
The research went through the first and second phases, which are smaller studies that look at safety at does and at efficacy before this third phase which entailed randomized clinical/controlled trails on large groups of participants to look at the efficacy of the microbicide.
The products of the investigation were 6% Sodium Cellulose Sulphate (CS), which is a gel that was tested as a possible topical microbicide, but in 2007 was found to be in effective. Researchers thought that CS could potentially block HIV infection (and possibly others STIs) by creating a barrier between the virus and the woman’s cells in the vagina which the virus targets for infection. This would make it more difficult for the virus to enter the woman’s cell.
The other products of investigation are vaginal gel, single use applicator, and 3.5ml of gel.
According to the researchers, the study design at this phase III entailed randomized placebo controlled trail, in which a total of 2160 women at high risk of HIV/STI were in Lagos while the other half were in Port Harcourt.
The placebo is not the treatment being tested, but looks exactly like the treatment. For topical microbicides trails, the control group received a gel that looked and was used the same day as the gel given to the intervention group, except that it did not contain the microbicide.
Placebos are used in blinded clinical trails so that participants for twelve months, while tests were carried out for HIV, gonnorhoea and Chlamydia at baseline and at each monthly follow up visits.
A summary of the research showed that the duration of the study was 12 months of participants recruitment, 12 months of product used for each participants and 26 total months in the fields including screening and close-down, while the primary objective of the study was to determine the effectiveness of CS gel in preventing male-female vaginal transmission of HIV infection among women of high risk.
The primary endpoint is the incidence of HIV-1 and HIV-2 infection as determined by detection of HIV antibodies from all Mucosal Transudate (OMT) specimens, while the secondary objective is to determine the effectiveness of CS gel in preventing malae-female transmission of gonnorrhoea and chlamydial infection among women at high risk.
The secondary end point is the incidence of the genital gonorrhea or chlamydial infections as determined by DNA probe technology from self-administered vaginal swabs .
At the end of the study, it was found that the CS gel (this microbicide) did not protect against HIV and canot be used, “there were more infection in CS group compared to the placebo group from other studies outside Nigeria resulting in the stoppage of the study on CS3, and the preventive measure (HIV risk reduction messages works)”
It was thus agreed that community/scientist rapport must recognize that community involvement is an essential component in microbicide trail; that the approach to such involvement must consider the local setting (community politics and environment) that the relationship is a dynamic one.
Others are that it is clear the development of a topical microbicide to prevent the sexual transmission of HIV is scientifically, ethically and culturally complicated; and that in spite of these the benefit in lives protected may far exceed those risks seen and, as yet, unforeseen.
The implication of the foregoing is as encouraging as it is dreadful. Encouraging because by this and other researches carried out, all in pursuit of a solution to the HIV/AIDS pandemic show that there is a relentless quest to get a solution .
However, the situation looks dreadful considering that such solution seem to have remained evasive and hence almost impossible to come by.
This, therefore, is an indicator that a lot of work still needs to be done to thoroughly put the transmission of HIV under check, particularly as it concerns the most vulnerable groups.
Such areas that require more job to be done include community sensitization/involvement, capacity building programmes for various stakeholders, including families.
The question that should thus be on every bodies mind is “which way forward in HIV prevention.”
Sogbeba Dokubo
This is an open letter to the Minister of the Federal Capital Territory, Chief Nyesom Wike.
Your Excellency,
Sir, ordinarily, I would not be writing an open letter to you, but like a wise man once said, “Silence would be Treason.” So I prefer to stay alive than face the consequences of silence in the face of crime. With each passing day, and as the socio-political tides continue to turn, it has become more pertinent that more people speak up in a concerted MANNER to prevent the death of our party, the Peoples Democratic Party (PDP), as we appear to be, in the words of W. B. Yeats, “turning and turning in the widening gyre” heading for an end where the falcon will no longer hear the falconer
It is unfortunate that since losing control of the Federal Government, with the loss of President Goodluck Jonathan at the poll in 2015, our party, the Peoples Democratic Party (PDP), has continued on a downward spiral. It is much more painful, that where it is expected that leaders within the party should rise to the challenge and put an end to this decline of our great party, some have instead taken up roles as its undertaker.
It will be hypocritical to claim aloofness to what I believe is your grouse with the PDP and I am not a hypocrite. It will be uncharitable on my part to discountenance the role you have played in strengthening the PDP from 2015 up until the last Presidential primaries of the party. It is my belief that your grouse against certain members of the party who you perceived worked against the party and abandoned it in 2015 and then came around much later to take control of the party, is justified. Also know that your decision to remain in the Party and stifle its progress on the other hand, as a sort of payback, stands condemned. For a man of your pedigree and stature, it is a dishonorable act, highly dishonorable and stands as testimony against all you claim to stand for.
At least, it can be argued that those who you hold this grudge against, abandoned the party completely and did not sit back while actively working to destroy it from within. But what then can be the argument on your own part, seeing that those you are currently working with against your party are the same people who set in motion, and executed surgically, the plans that not only ended our Party’s leadership at the centre, but ended up dislodging the first Niger Deltan to occupy Aso Rock as Commander in Chief of the Armed Forces. Is this not akin to “cutting off one’s nose to spite one’s face?” That will be worse than folly. Let us not throw away the baby with the bath water because we do not like the soap used in bathing the baby. It will be a grave mistake.
Honourable Minister, sir, it is rather unfortunate that of all people, you have also decided to play the role of an undertaker not only for our party, but for our dear Rivers State.
I will like to take you down memory lane a little. Let me remind you of your emergence as Guber candidate of the PDP in Rivers State, against all fairness and justice in 2014. You will remember that despite the reality being that you as an Ikwerre man was poised to replace a fellow Ikwerre man in Governor Chibuike Rotimi Amaechi in our multiethnic state, Rivers people overwhelmingly stood by you and pushed for your emergence as Executive Governor of Rivers State in 2015. I dare say that your popularity in the entire Niger Delta region was at an all-time high at this point.
I want you to understand why you were loved across board leading to your eventual emergence as Governor of Rivers State in 2015; it was because when it looked like all were against the second term ambitions of the first Niger Delta man to emerge as President of Nigeria, you became not just a pillar but a beacon of resistance by standing for Goodluck Jonathan. Rivers people, as grateful and rewarding as they can be, paid you back by ensuring your electoral victory against the incumbent All Progressives Congress (APC) led by your predecessor. On your emergence, where there were second term Governors in the region, you, a first term Governor, was seen by the people as not just the leader of the PDP, but the leader of the entire Niger Delta region. You earned it, and no one could dispute it.
In 2019, when your re-election bid was being challenged ferociously, Rivers people once again stood solidly behind you. Many were killed in the process of defending your votes. Do you remember Dr. Ferry Gberegbe that was shot and killed while trying to protect your votes in Khana Local Government Area? There are many more unnamed and unrecognised sons and daughters of Rivers State who sacrificed their lives so that you could emerge as a second term Governor of Rivers State.
In 2022/23, Honourable Minister, you oversaw a party primary across board that saw some candidates imprisoned and internal party democracy jettisoned for your wishes, leading to the emergence of flag bearers of our party all singlehandedly picked by you. You have on more than one occasion publicly stated that you paid for all their forms. Even those shortchanged in this process licked their wounds and continued to play their roles as party members to ensure the success of the party at all levels. In what will go down as one of the most keenly contested elections in recent Rivers history, with formidable candidates like Senator Magnus Abe of the Social Democratic Party (SDP), Mr Tonye Cole of the All Progressives Congress (APC), and the vibrant youth driven Labour Party (LP), PDP emerged victorious across board except for Phalga Constituency 1 that was lost to the Labour Party. (Not that you did not loose in some other LGA’s but let’s stick to the official figures declared by INEC).
It begs the question, why then do you want to burn down Rivers State, when everyone who now holds political office emerged through a process designed and endorsed by you? Is it that you do not care about Rivers people and you are all about yourself? If so, I am forced to believe that those around you are not telling you the truth. The truth being that in a state where your words were law; where houses and businesses could be demolished or closed down without any recourse to legalities, where Executive Orders could be deployed to stifle the opposition, that your popularity is now at an all-time low. Probably because they are afraid of you, or of losing the benefits they gain from you, they fail to tell you that what you might perceive as a battle against your successor, has slowly but gradually degenerating into a battle against Rivers State and Rivers people. You know, there is a popular saying that, a man can cook for the community and the community will finish the food, but when a community decides to cook for one man, the reverse is the case.
LEAVE FUBARA ALONE
You have gone on and on about being betrayed by Governor Siminalayi Fubara. You point fingers forgetting that some of those same fingers quick to spot betrayals point straight back at you. It is not Governor Fubara that has betrayed the PDP by working against it in the just concluded General Election, and working with the opposition at the State and Federal level to destabilise the party. It is you, Honourable Minister. It is not Governor Fubara that betrayed Rivers people by instigating a political crisis with propensity to escalate ethnic tensions in Rivers State. It is you Honourable Minister. It is not Governor Fubara that has declared himself God over all in Rivers State and has no qualms with burning the state to the ground to prove a point. It is you Honourable Minister. It is you Honourable Minister who told the world that the APC was a cancer and you can never support a cancerous party. It is you Honourable Minister who ended up facilitating the emergence of the same “cancerous” APC that has accelerated the economic decline of this country and further impoverished our people with no remorse. All so you can be a Minister of the Federal Capital Territory? The lack of self awareness is gobsmacking.
Some days back I came across a video where you talked about death and how you do not cry when you hear about the death of some people because you have no idea what might have caused it considering many a politician swear “over dead bodies” and still go back on their words. Those words made me think, and I could see the reason behind them. You see, in chosing to be God in the affairs of Rivers people, you have closed your eyes and ears to reason; you see nothing and hear nothing that can cause you to rethink on the path you have chosen. In your quest to “show Fubara” you have unwittingly united a vast majority of Rivers people behind him, so much that even those who despised him because of you, now like or love him, because of you too. In your scheming, I will advise you not to forget that “the voice of the people is the voice of God”.
Note that the war which you have or are waging against Governor Fubara, has gone beyond being merely political as you might see in your minds eye. It is now one that, fortunately for some and unfortunately for others, has evolved into a war against Rivers people. It is good to point out that no one has taken a stand against Rivers people and won. No one has gone against God and won. In your defiant characteristic manner, it will be unfortunate if you believe your own hubris and that of those around you on the possibility of you being the first to successfully go against Rivers people. It will be a needless gamble; one where if you win you create more enemies for yourself than you can withstand on your political journey, and if you lose, your legacy becomes an inglorious and irredeemable one in Rivers State, the Niger Delta, and Nigeria at large. For your sake as regards posterity, it is my greatest wish that you have a moment of sobriety and a deep reflection and introspection on this path you have chosen.
Honourable Minister, sir, what is left of your legacy is on the brink of being completely desecrated and relegated to the dustbin of our political history, and it will be a sad end to what I will say has been a wonderful political career that many can only dream of. The ball is in your court, and may God Almighty have mercy on us all and forgive us for our shortcomings.
Gabriel Baritulem Pidomson
Dr Pidomson is former Chief of Staff, Government House, Port Harcourt and former member, Rivers State House of Assembly.
In 2015, I made a conscious decision to invest my financial resources, my time, and energy into supporting Nyesom Wike’s gubernatorial campaign. I poured my heart and soul into ensuring Nyesom Wike emerged victorious even at the risk of my personal safety.
Again in 2019, I doubled down on my commitment. I invested a significant amount of money to procure campaign outfits for all twenty-three Local Governments Areas of Rivers State. I spared no expense in supplementing Wike’s election efforts in my own local government, and once again putting myself at great risk to safeguard the fairness and transparency of the electoral process.
However, despite my unwavering loyalty and sacrifices, I found myself abandoned and forgotten by Wike. Throughout his eight-year tenure, he failed to acknowledge my contributions or fulfill his promises and agreements. Even as a former Deputy Governor, Wike denied me my severance benefit.
My investment in Wike’s governorship was not just financial – it was a commitment of passion, dedication, and belief in a better future for Rivers State. Yet, his leadership style of dishonesty, greed, drunkenness and rash abuse of senior citizens brought me nothing but disappointment, misery and losses.
By the grace of God, today I speak not as a victim, but as a hero. I have accepted my losses, and I have moved on. And as I reflect on my experience, I cannot help but urge Wike to do the same and allow peace and development to reign in Rivers State.
Nyesom Wike, when you speak of investing in Governor Sim Fubara’s election, remember those like me who also invested in you. Remember the sacrifices I made, the risks I took, and the promises and agreements you left unfulfilled.
It is time for you, Wike, to let go of the past and allow Governor Sim Fubara the breathing space he needs to lead Rivers State forward. Allow him to focus on the challenges of good governance and the aspirations of the people. Spare him these unwarranted and ill-conceived political manoeuvrings founded on personal agenda and not for general good of Rivers State and her people.
I may have lost my investment on Wike, but I have not lost hope in the future of Rivers State. And together, we will continue to strive for a brighter tomorrow.
Long Live the Governor to Rivers State, Sir Siminialayi Fubara!
Long Live the Good People of Rivers State!!
Long Live the Federal Republic of Nigeria!!!
Engr Ikuru is former Deputy Governor of Rivers State.
Tele Ikuru
