%0 Journal Article
%T Developing Multipurpose Reproductive Health Technologies: An Integrated Strategy
%A P. F. Harrison
%A A. Hemmerling
%A J. Romano
%A K. J. Whaley
%A B. Young Holt
%J AIDS Research and Treatment
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/790154
%X Women worldwide confront two frequently concurrent reproductive health challenges: the need for contraception and for protection from sexually transmitted infections, importantly HIV/AIDS. While conception and infection share the same anatomical site and mode of transmission, there are no reproductive health technologies to date that simultaneously address that reality. Relevant available technologies are either contraceptive or anti-infective, are limited in number, and require different modes of administration and management. These ¡°single-indication¡± technologies do not therefore fully respond to what is a substantial reproductive health need intimately linked to pivotal events in many women's lives. This paper reviews an integrated attempt to develop multipurpose prevention technologies¡ª¡°MPTs¡±¡ªproducts explicitly designed to simultaneously address the need for both contraception and protection from sexually transmitted infections. It describes an innovative and iterative MPT product development strategy with the following components: identifying different needs for such technologies and global variations in reproductive health priorities, defining ¡°Target Product Profiles¡± as the framework for a research and development ¡°roadmap,¡± collating an integrated MPT pipeline and characterizing significant pipeline gaps, exploring anticipated regulatory requirements, prioritizing candidates for problem-solving and resource investments, and implementing an ancillary advocacy agenda to support this breadth of effort. 1. Introduction The combined burden of maternal and infant mortality and morbidity produced by unintended pregnancies and sexually transmitted infections¡ªindividually and as a consequence of their multiple interactions¡ªis compelling in its volume, extent, and complexity. For an array of behavioral, biological, physiological, and sociocultural and political reasons, most of that burden falls on women in developing countries. In those countries, of the 80 million unintended pregnancies estimated for 2012, 63 million will occur among the 222 million women defined as having an ¡°unmet need¡± for modern contraception [1]. Those unintended pregnancies will, in turn, result in 30 million unplanned births; 10 million miscarriages, including stillbirths; and 40 million abortions, of which one-third to one-half will be unsafe. Women aged 15¨C19 are at particular risk of these events [2]. Sexually transmitted infections (STIs) further compound these burdens, with which they are relentlessly intertwined. The World Health Organization estimates that 448 million
%U http://www.hindawi.com/journals/art/2013/790154/