Women’s Health in Women’s Hands: The Promise of MPTs

1. 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: ManjulaLusti-Narasimhan (WHO) Ina Park (CDPH) Bethany Young Holt (CAMI/IMPT)

2. 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

4. What’s in the pipeline? • Small Organic Molecules • Broad Spectrum Natural Products • Proteins/Peptides • Non-Hormonal Contraceptives

5. 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. WHO Global Reproductive Health Strategy

6. 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.

7. 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

8. 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

9. 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

10. 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.

11. 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

12. Selected STIs in California Chlamydia, Gonorrhea, and Primary & Secondary SyphilisCalifornia Rates, 1990–2012 Chlamydia 448.9 (N=169,797) 89.3 (N=33,780) Gonorrhea 7.8 (N=2,936) P&S Syphilis >206,000 cases of bacterial STIs reported in California

13. Mistimed or Unwanted PregnancyMIHA 2011 Nearly 1/3 of pregnancies in CA are unplanned

14. Chlamydia Among Females, 2012 Ages 15-24, By County

15. Chlamydia among females (2012) vs Unplanned Pregnancy (2011) LA County Southeastern CA San Joaquin Valley

16. 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

17. 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

18. What you can do? SHARE Spread the news about life saving MPTs with your colleagues and networks. Visit our website to access factsheets, PowerPoint presentations, MPT meeting reports and other resources. COLLABORATE Join the IMPT and help move the research, policy, funding and education efforts forward to save lives – learn more on our website. CONTRIBUTE Your financial and in-kind support can accelerate MPT education, research and introduction. Visit www.cami-health.org or www.MPTs101.org to learn more!

19. Collaboration, advocacy & research to advance MPTs

20. Collective Impact Approach

21. Questions?

22. Acknowledgements • Bill & Melinda Gates Foundation • Mary Wohlford Foundation • USAID • World Health Organization • The generous support from individual donors like you!

23. 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.