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| Comment: Issues around lime/lemon juice as possible microbicides |
2006-01-13 16:00:00 <GENDER-AIDS> |
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Comment: Issues around lime/lemon juice as possible microbicides
Megan Gottemoeller
Global Campaign for Microbicides
12 January 2006
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[Mods Note: The following posting relates to a previous message on Gender-AIDS during November 2005 concerning lime/lemon juice douches - article can be read at: http://www.healthdev.org/eforums/cms/showMessage.asp?msgid=8753
from the Gender-AIDS forum archives.
The topic of lime/lemon juice as possible microbicides has also been aired on the AF-AIDS eForum and the following message is posted for members information. The original articles which relate to this topic, can be accessed via the AF-AIDS forum archives -
http://www.healthdev.org/eforums/cms/showMessage.asp?msgid=9383
http://www.healthdev.org/eforums/cms/showMessage.asp?msgid=9125 ]
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Dear Forum Members
The lemon/lime juice debate continues! Brian Haills 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. Haills characterization of the microbicide communitys 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 technologys 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, its 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
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