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Microbicide, Solution To Female HIV Infection?

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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

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Issues

Checking Sex Trafficking Of African Women

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For thousands of years and even up to the present, African women have been subjected to acts of slavery, including sex trafficking, forced labour and domestic servitude.
Slavery has, therefore, become a daily happening each and every year, particularly among Africans. Now it seems some persons have turned it into a huge business from which they make large sums of money with no intention to let go any soon. This criminal act towards these victims is mostly perpetrated by their relatives, friends, men or women who pretend to mean well but who harbour evil intentions toward their unsuspecting victims.
The world is increasingly being blinded by the truth so much so that we don’t get to face the reality when a young girl is being trafficked. During the invasion of slave traders, women were used to satisfy their sex needs because such females were deemed to be of little or no importance unlike the men who were forced to perform the harder duties. These ladies were used anytime, any day thereby robbing them of their dignity and self esteem. Unfortunately, this trend has endured till date, more especially among African women.
Let me share the story of a young lady who was once a sex traffic victim. Her name is Ngozi (not real name). I met her in Moscow, the Russian capital, four years ago. She and her baby caught my attention. I was so curious to know who she was because, from every indication, she didn’t strike me as a student.
We started off by exchanging pleasantries after which she asked to know if I was a student, to which I responded in the affirmative. When she said she wasn’t a student, I then realised that my instinct was right, after all.
She was like, I need to tell you about myself unashamedly; an experience that has become a lesson to me and which might serve as a warning to any young girl who clamours to travel out of Nigeria in search of a better life.
Ngozi started narrating the story of how she was taken from Delta State, lured with the offer of travelling to Russia to assist a certain nursing mother from Uganda who was resident in Moscow. Her duty would entail taking care of the lady’s children in her absence.
The woman who travelled down to pick her from Nigeria happened to be a friend to her aunty whom she was staying with then. The two friends had a lengthy discussion together during which the woman assured Ngozi’s aunty that her niece would be well paid and have a good life. In turn, the aunty pleaded that Ngozi be properly taken care of and given the best of life as promised.
Fast forwarding a little, she narrated how her travel documents were processed based on the understanding that she was going for study as claimed by her lady companion in order to avert suspicion.
Ngozi said she was barely 17 years old as at when the woman came to pick her up. Everything sailed through for her at the entry points and they were able to arrive Moscow. But life took a different turn for her in a space of three days. The woman really made her feel comfortable in those few days, but on the fourth day, two hefty men wearing masks came into the apartment at night and whisked her away.
According to the lady, she was not the only one in such a mess as she could hear other girls crying and pleading for help from another cage where they were held. All she did was to cry quietly knowing the uselessness of any loud wailing. Soon, they were given new clothes by the masked men and told to get ready for work.
A new but harsh life began for Ngozi such that she got thoroughly beaten and starved whenever she declined sleeping with her assigned clients. She was forced to sleep with an average of 10 men each day and the money paid directly to the madam in charge of them. All her attempts to escape proved futile. Ngozi’s child came from a Russian man who bought her off from her madam. On the possibility of returning to Nigerian, Ngozi vehemently rejected the idea, claiming that she was ashamed of herself and nothing good could come of her life anymore.
After hearing Ngozi’s story and comparing with other accounts I had heard previously in the media, I was so broken and asked myself questions that might appear unexplainable but which definitely have answers: Why are young ladies in their early ages of 15-40 years, still being trafficked every year? What measures are being applied to stop the rise in sex trafficking cases in Africa? Why is the government not paying adequate attention to human trafficking? Why are there no seminars or platforms created to educate and possibly discourage the average young lady who wants to risk her life by travelling to such countries? And lastly, why are they mostly trafficked to Middle East countries?
Now, let’s start with the first question. Like stated in the first paragraph of this article, young ladies have always been victims of sex traffickers and also major targets because they are young and energetic.
Also, most of the girls trafficked are either orphans, people from poor homes or those who are desperate to have a better life by all means and who do not care about what happens to them afterwards.
On the second question, it can be said that the men and women who take these women overseas from Africa are most likely to have connections with a human trafficking syndicate. Just like the narcotics business, it is extremely difficult to identify those in charge. In the event that something goes wrong and a leader is apprehended, a fresh link is created immediately for the business to continue.
For the third question, we understand the fact that the government has a lot of responsibilities to handle; but regardless, women trafficking is an important issue too. It is a threat to society, trafficking is an important issue too. It is a threat to society, a threat to Africa and also to the girl-child. We appreciate the role being played by the Nation’s Agency for the Prohibition of Trafficking In Persons (NAPTIP) but such monster as this deserves utmost attention and should be critically followed with all amount of seriousness.
The fourth question harps on the need for platforms to be created to discuss and enlighten potential victims of such illicit trade. We now live in a world that has gone digital and where information on any topic is readily accessible. But unfortunately, most of the less privileged young women still need to be properly taught about the so-called ‘countries with great opportunities’ which they hope to travel to and make quick money.
They should also be schooled on how to easily identify any person(s) who is coming around with the aim of deceiving them into travelling abroad for good jobs and better living standards.
On the frequency of trafficking women for sex in Middle East countries, I want to believe that it is as a result of the handsome monetary reward. Ladies who are trafficked to Arab countries often end up in wealthy families where they are mostly maltreated by their bosses and the entire household. These young women are usually placed on faulty contracts which subjected them to such households for life. They are bought from their traffickers with huge sums of money and forever remain as slaves or sex objects in which ease they are sometimes used to also generate revenue from pornographic video productions. And whenever these girls attempt to escape, having had enough, they are either killed or some other tragic fate befalls them.
Some of the effects of sex trafficking on African women who had been victims include, but are not limited to: loss of self worth, misery, self pity, living in fear, hunted by past experiences, loss of confidence in society and psychological trauma.
Sex trafficking can be checked if young women look out for early danger signals as already stated. Other measures that can be taken are as follows:
Young ladies should take note of false appearances and suspicious behaviours. Most fraudsters appear to be decent while some even belong to the same religious or ethnic group with them. They may even be the people such girls see daily who usually look harmless.
Parents and guardians should not just give out their daughters to people they barely know on the claim of providing them a better life elsewhere.
Government should ensure that once caught, tried and sentenced, any perpetrators are adequately punished if only to serve as deterrent to others.
And finally, the country’s borders should be under constant watch because these traffickers can always improvise means of transporting their victims out of the country or locally without the awareness of security officials. Some even pay their way through.

By: Osepken Muzan
Miss Muzan is a Nigerian medical student in Russia.

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Customs And Dynamism At Seme Border

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The pains cum hardship believed to have been occasioned by the Nigeria‘s international land border closure seemed incomparable to the dynamism and operational progress that have characterised the reopening of the borders.
Enlightening Nigerians, through the media, on the positive exploits of his leadership team associated with border reopening to their progress, the Nigeria Customs Service (NCS) Seme border area boss, Comptroller Bello Mohammed Jibo, stated that his area command situated at the ECOWAS Joint Border Post, Seme-Krake Borders, has since the pronouncement of the reopening of land borders to date by the Federal Government, performed creditably.
He maintained that during the course of its sustained tempo in the fight against smuggling, the Command intercepted a total of 232 (Two Hundred and Thirty Two) parcels of cannabis sativa. In line with the dictates of the Service towards promoting inter-agency collaboration, cooperation and its unequivocal zeal towards the fight against drug trafficking, the Command  handed over the aforementioned seized drugs with duty paid value of N2,933,358.40 (Two million, Nine Hundred and Thirty Three Thousand, Three Hundred and Fifty Eight Naira, Forty Kobo) only to the Commander, NDLEA Special Command Seme.
According to Jibo, officers and men of the Command had in their various operations taken the full advantage of the Service’s renewed strategies to continue the fight against smuggling, leading to remarkable interception of 705 (Seven Hundred and Five) items, with a duty paid value of N409,851,533.14 (Four Hundred and Nine Million, Eight Hundred and Fifty One Thousand, Five Hundred and Thirty Three Naira, Fourteen kobo).
The Area Controller itemised the seizures as 5,568 bags of foreign parboiled rice (50kg each); 3208 jerry cans of Premium Motor Spirit (25 liters each); 79 units of smuggled vehicles; 294 cartons of frozen poultry products; 131 parcels of cannabis sativa; 798 cartons of tomato paste; 3 cartons of sugar; 6 cartons of slippers; 305 pairs of used shoes; 30 cartons of Nescafe; 19 cartons of non-alcoholic wine; 10 cartons of cigarettes; 12 cartons of herbal soap; and 2 sacks of condoms; adding that the  landmark achievement was an indication that officers and men of the Command were not losing their guard in detecting and streaming the tide of the nefarious activities being perpetuated by daredevil smugglers.
“In the wake of Federal Government pronouncement on the reopening of land borders, the Command harnessed all revenue compounds in line with the new operational guidelines with a view to projecting revenue base of the Command and facilitation of legitimate trade,” he said.
The Customs comptroller disclosed that in export, the Command recorded a trade volume of 348,827,775 (Three Hundred and Forty Eight Million, Eight Hundred and Twenty Seven Thousand, Seven Hundred and Seventy Five) metric tons of exported goods with the free on board (FOB) value of N4,277,047,153.92 (Four Billion, Two Hundred and Seventy Seven Million, Forty Seven Thousand , One Hundred and Fifty Three Naira, Ninety Two kobo) and a NESS value of N21,384,443.67 (Twenty One Million, Three Hundred and Eighty Four Thousand, Four Hundred and Forty Three Naira, Sixty Seven kobo).
Jibo explained that a whopping sum of N80,774,807.22 (Eighty Million, Seven Hundred and Seventy Four Thousand, Eight Hundred and Seven Naira, Twenty Two kobo) was raked into the Federation Account (federal government coffers) during the period under review emanating from 0.5% ETLS, 1% NESS, Baggage assessment and  reassessment of  trapped trucks;  stressing that the Command was yet to receive imports from third countries, as there are  clearance procedure disputes to settle between importers, agents from Nigeria and Benin Republic authorities, including the shipping  companies, declaring that the Grand Total for the seizures and revenue stood at N490,626,431.36 (Four Hundred And Ninety Million, Six Hundred And Twenty Six Thousand, Four Hundred And Thirty One Naira, Thirty Six Kobo).
The comptroller explained that in line with the Comptroller-General’s  reform agenda which sees the welfare of officers as paramount, the Command benefited from different welfare initiatives from the management of NCS, including the construction of 32, 30 and 16 man ranks and files barracks accommodation to cover the inadequacy of accommodation in the Command; pointing out that there was also ongoing renovation of Deputy Comptroller’s quarters as well as the new upgraded terminal to accommodate consignments, in the event that the private bonded terminal cannot handle the volume of consignments coming into Nigeria.
“In a bid to sustain the existing cordial relationship with the host communities, the Command through corporate social responsibility (CSR) initiative, constructed a modern convenience at the International Park, J4, in Seme Badagry West Local Government to assist travellers both local and international. The convenience was handed over to the Chairman of the Local Government Council for effective utilization,” he stated.
The Seme Customs boss stated that the Command was partnering with an NGO named Community Football Foundation for the establishment of a football club named Badagry United; which has already been registered with the Cooperate Affairs Commission (CAC) and Oba Akran of Badagry, De Wheno Aholu Menu-Toyi 1, was also presented with the Certificate of Grand Patron while the new team was accorded royal blessing and support.
Comptroller Jibo who personally led media practitioners on an inspection tour of some multi-million naira worth of trade facilitation equipment put in place by the NCS at the Seme Border also maintained that effective and efficient community relations was being maximally fostered by his leadership, leading to a befitting collaboration with traditional leaders as well as representatives of other sister government agencies.
On whether the Command has the operational capacity to contend with effective implementation of the new government directives that imports into the country must be fully containerised henceforth, Comptroller  Jibo explained that it was only goods imported from developed countries that were to be received in containers while ECOWAS Trade Liberalisation Scheme products generally referred to as ETLS goods were still receivable in  trailers and trucks; stressing that more uitra-moderm scanning machines have been acquired and installed for the command to boost its examination capacity and efficiency.
The well attended media briefing which was co-ordinated by the Command’s Public Relations Officer, Mr. Hussaini Abdullahi took place recently at the Seme conference room of the Service.
Ikhilae is a Lagos-based public affairs analyst.

 

By: Martins Ikhilae

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Covid-19 Vaccine And Wike’s Approach In Rivers

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I have read with dismay the misinformation peddled on social media about the Rivers State Government and its citizens on receiving the so-called Oxford AstraZeneca Covid-19 vaccine, especially as the Governor, Chief Nyesom Ezenwo Wike, was not seen on live television receiving a shot.
Some even reported that his Deputy, Dr Ipalibo Harry Banigo, allegedly received an empty syringe of a supposed Covid-19 vaccine on live TV.
As a concerned Rivers indigene who has the privilege of practising medicine in a developed country, I write in defence of the Governor’s health policies and to debunk some unfounded misconceptions about the Covid-19 vaccines at this crucial point in this pandemic.
We have seen and read about the devastating effects of the Covid-19 pandemic on the Black race, majority of whom are Africans. It, therefore, behoves every government and policy makers to prioritise their citizens, especially the ‘at-risk’ and vulnerable groups when it comes to receiving Covid-19 vaccines.
If the Deputy Governor of Rivers State got the vaccine before the Governor, it is probably because she is more at risk than the governor of which her profession as a medical doctor automatically places her up the risk ladder. The Covid vaccine is given based on risk-exposure basis.
The Federal Government of Nigeria through the National Centre for Disease Control (NCDC) and Ministry of Health, with the approval of NAFDAC, has procured about 4 million Oxford AstraZeneca vaccines and has rolled out plans to get the citizens vaccinated. The best that every state government can do, at this point, is to key into this vaccination programme and get the ball rolling, which the Rivers State Government is rightly doing.
Let us take a look at the various types of Covid-19 Vaccine;
Contextually, there are five major vaccines commercially available against Covid-19 and all have undergone clinical trials and certified to be efficacious to varying degree.
Vaccine trials are done using different criteria aimed at measuring infection load which determines their effectiveness. Every degree of vaccine efficiency offers better immunity than none.
Unfortunately, as most things are politicised in our country, people are quick to discredit the Governor solely by looking at summary figures and get swayed into propagating misconstrued and unfounded propaganda of the AstraZeneca vaccine as being substandard.
Oxford University AstraZeneca Vaccine.
This is a vector vaccine with 70.4% protection after the second dose.
It is given as 2 doses 3 months apart and can be stored in a refrigerator between + 2 to + 8 degrees Celsius for six months or till expiry date. It costs only $4 per vial.
Owing to the peculiarity of Nigeria’s erratic power supply and comparative cost advantage, this appears the best option. It is in no way substandard.
The Mordana Vaccine.
This is an mRNA vaccine developed by Madonna in partnership with Niaid.
It has 98.1% efficacy after the second dose given 28 days apart.
It can be stored in freezer between – 25 to – 15 degrees Celsius till expiry and in the fridge at +2 + 8 degrees Celsius up to 30 days before its use. It cannot be re-frozen and the cost of a vial is $15 to $25.
Pfizer BionTECH Vaccine
This vaccine was developed by Pfizer using the mRNA technology.
It provides 52% protection after the first dose and 95% effective at preventing Covid- 19 after the second dose. It consists of 2 doses given 21 days or three months apart depending on the supply availability. It can be stored frozen between -80 degrees Celsius to -60 degrees Celsius until expiry or six months afterwards. Once diluted, it has to be stored at +2 + 25 degrees Celsius used within six hours. Each vial costs $20.
Jensen (Johnson & Johnson) Vaccine.
This is a vector vaccine produced in America and found to be 72% effective at preventing moderate form of Covid-19 and 85% protective against the severe form of the virus.
It offers 100% protection from hospitalisation and death arising from Covid-19.
It is only giving in a one-off dose and can be stored in warehouses between – 20 degrees Celsius. It can remain stable at this temperature for up to two years.
Novovax
This is a protein adjuvant vaccine. It provides 89.3% protection after two doses.
It can be stored at fridge temperature making it easier to distribute.
Vaccines, just as medicines, have side effects. The side effects represent signs that the vaccine is prompting your body to mount an immune response which is a sign that the vaccine is working.
For all vaccines against Covid-19, the most commonly reported side effects are mild discomfort at the site of injection, fatigue, nausea, headache, fever and chills.
The side effect profiles were extensively explored using the clinical trials data from the US Food and Drug Administration (FDA) and other relevant bodies.
The WHO and CDC have published various data to reveal that the Black race is more at risk of mortality from Covid-19. Ironically, Black people are the lowest group to have received the vaccine so far globally. This apathy stems from propaganda, politics, conspiracy theories and statistics suggesting that the Black race is the elimination target of Covid-19.
It is interesting how data has been skewedly misinterpreted to suggest that any vaccine not up to 100% efficacy is substandard. That is not correct.
Despite the low efficacy rates of any of the vaccines, they still provide near-perfect protection against Covid-19 and prevent hospitalisation and death arising from complications of the disease.
People should be encouraged to take whichever vaccine is available to them depending on their local peculiarities and regardless of the vaccine brand.
If the Rivers State Government has procured any brand of the vaccine from the Federal Government or from any other source, despite the efficacy level, it is still optimum and will provide effective protection against the deadly Coronavirus and forestall poorer outcomes.
Let history not repeat itself. May we not forget the consequence of the apathy of the Northern leaders towards polio vaccine that gave Nigeria a herculean task in eradicating polio from the country.
The priority of the Rivers State Government in its roll-out Covid-19 vaccination plan should be to aggressively embark on public enlightenment to gain trust in our communities so as to underpin her commitment in ensuring that the health of Rivers people is prioritised.
There are various haemorrhaging concerns about the health sector both in Rivers State and nationally which will have to be addressed by the government in power, but of utmost immediate importance is to contribute meaningfully towards fighting this pandemic.
I salute the Rivers State Governor for championing this course in ensuring that Rivers people were promptly included in the Covid-19 vaccination campaign.
Dr Pepple is a fertility expert and NHS registrar in the United Kingdom.

 

By: Douglas-Iyalla Pepple

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