health check

The all-in-one solution to sexual health is on its way

Scientists are developing various products that can provide contraception and protection from sexually transmitted infections and HIV at the same time.

The current sexual and reproductive prevention methods have significantly improved the health and well-being of women and their families. But this is not enough. Worldwide each year there are still 85 million unplanned pregnancies, 21.6 million unsafe abortions, and nearly 300,000 maternal deaths from complications related to pregnancy and birth.

HIV remains the leading cause of death of women of reproductive age worldwide. Sub-Saharan Africa has the highest burden. While anti-retroviral drugs are effective treatments, half of the women living with HIV in resource-limited settings can’t access them. And women’s HIV prevention technologies remain limited. Their use is often outside a woman’s sphere of control.

Enabling women to maintain good reproductive health requires innovative and improved prevention technologies. A revolutionary class of women’s sexual and reproductive health prevention products is being developed and may prove to be the linchpin to achieve the sustainable development goals that relate to women’s health.

Multipurpose Prevention Technologies, more commonly known as MPTs, are a new class of product in development. They deliver varying method combinations to simultaneously prevent HIV, sexually transmitted infections and unplanned pregnancies.

Although these technologies are complicated to develop, they are technically feasible. Since the field was launched six years ago, it has evolved from an innovative concept. Currently there are over 20 products being developed with nearly a dozen products in clinical trials.

New methods of prevention

There are many forms of innovative technologies being developed. Some combine contraception with prevention from sexually transmitted infections while others provide women who want to get pregnant with protection from HIV and other Sexually Transmitted Infections. Many do so in discrete forms that do not require partner negotiation. Some are designed to be used just before or at the time of a sexual encounter while others are long-acting products.

The innovations currently being developed include:

*vaginal rings that release both hormonal contraception and an HIV prevention drug;

*vaginal films and tablets that prevent HIV and herpes;

*rectal suppository MPTs offering HIV and STI prevention for anyone engaging in anal sex;

*new bio materials that will feel more like skin to make better feeling condoms; and other innovative technologies.

The goal is to create an array of broad-spectrum prevention methods which a woman can choose from to best suit her circumstances. But without increased investment in the research and development of these technologies, these powerful new prevention methods may never reach women’s hands.

A benefit for all

The intersecting nature of sexual and reproductive health risks is especially apparent in areas of the world where women have the least access to modern contraception and face the highest HIV and STI risks.

In 2012, young women in sub-Saharan Africa accounted for 70% (25 million) of the 35.3 million people estimated to be infected with HIV globally.

By reducing non-HIV sexually transmitted infections at the same time as HIV and unplanned pregnancy and health costs will be cut. In addition lives can be saved. If sexually transmitted infections such as herpes, chlamydia and human papillomavirus are left untreated they can result in infertility and cancers. Herpes and human papillomavirus also put women at greater risk of acquiring HIV.

Sub-Saharan Africa has the highest burden of herpes where up to 80% of sexually active women are estimated to be infected.

It is no secret that improving women’s ability to plan and space children improves the economic well-being of families, saves millions of lives and billions of dollars. Reducing the incidence of HIV and STIs also offers clear and well documented benefits to women, families, and economies. Doing it all at the same time will magnify these benefits.

And it is key to ending poverty and fulfilling the range of interlocking sustainable development goals that shape our interconnected futures.

An all-in-one solution

Women, providers and advocates of women’s health are enthusiastic about the multipurpose prevention technology. Combining prevention benefits into one product will be more efficient and will increase the number of women covered by this umbrella of prevention.

Early market research shows an overwhelming preference for products that can address multiple sexual and reproductive health risks. And research shows that HIV stigma is a barrier that prevents many women from seeking HIV prevention. It suggests combining HIV prevention and protection from STIs with contraception delivered in family planning settings will increase HIV prevention uptake for many women.

Researchers, health care providers, and funders from around the globe, including China, India, Kenya, South Africa and the US have forged in-country collaborations to ensure multipurpose prevention technologies will be desirable and accessible to those who need it most.

The social benefits of these technologies are far reaching. It ranges from educational attainment to reducing child mortalities, improving incomes, reducing inequity and having a positive impact on the environment.

For the young women in sub-Saharan Africa who bear a disproportionate burden of HIV infection, unwanted pregnancies and sexually transmitted infections, these technologies could be life-changing.

Helen Rees, Executive Director of the Wits Reproductive Health and HIV Institute, University of the Witwatersrand

This article was originally published on The Conversation.


We welcome your comments at letters@scroll.in.
Sponsored Content BY 

Behind the garb of wealth and success, white collar criminals are hiding in plain sight

Understanding the forces that motivate leaders to become fraudsters.

Most con artists are very easy to like; the ones that belong to the corporate society, even more so. The Jordan Belforts of the world are confident, sharp and can smooth-talk their way into convincing people to bend at their will. For years, Harshad Mehta, a practiced con-artist, employed all-of-the-above to earn the sobriquet “big bull” on Dalaal Street. In 1992, the stockbroker used the pump and dump technique, explained later, to falsely inflate the Sensex from 1,194 points to 4,467. It was only after the scam that journalist Sucheta Dalal, acting on a tip-off, broke the story exposing how he fraudulently dipped into the banking system to finance a boom that manipulated the stock market.

Play

In her book ‘The confidence game’, Maria Konnikova observes that con artists are expert storytellers - “When a story is plausible, we often assume it’s true.” Harshad Mehta’s story was an endearing rags-to-riches tale in which an insurance agent turned stockbroker flourished based on his skill and knowledge of the market. For years, he gave hope to marketmen that they too could one day live in a 15,000 sq.ft. posh apartment with a swimming pool in upmarket Worli.

One such marketman was Ketan Parekh who took over Dalaal Street after the arrest of Harshad Mehta. Ketan Parekh kept a low profile and broke character only to celebrate milestones such as reaching Rs. 100 crore in net worth, for which he threw a lavish bash with a star-studded guest-list to show off his wealth and connections. Ketan Parekh, a trainee in Harshad Mehta’s company, used the same infamous pump-and-dump scheme to make his riches. In that, he first used false bank documents to buy high stakes in shares that would inflate the stock prices of certain companies. The rise in stock prices lured in other institutional investors, further increasing the price of the stock. Once the price was high, Ketan dumped these stocks making huge profits and causing the stock market to take a tumble since it was propped up on misleading share prices. Ketan Parekh was later implicated in the 2001 securities scam and is serving a 14-years SEBI ban. The tactics employed by Harshad Mehta and Ketan Parekh were similar, in that they found a loophole in the system and took advantage of it to accumulate an obscene amount of wealth.

Play

Call it greed, addiction or smarts, the 1992 and 2001 Securities Scams, for the first time, revealed the magnitude of white collar crimes in India. To fill the gaps exposed through these scams, the Securities Laws Act 1995 widened SEBI’s jurisdiction and allowed it to regulate depositories, FIIs, venture capital funds and credit-rating agencies. SEBI further received greater autonomy to penalise capital market violations with a fine of Rs 10 lakhs.

Despite an empowered regulatory body, the next white-collar crime struck India’s capital market with a massive blow. In a confession letter, Ramalinga Raju, ex-chairman of Satyam Computers convicted of criminal conspiracy and financial fraud, disclosed that Satyam’s balance sheets were cooked up to show an excess of revenues amounting to Rs. 7,000 crore. This accounting fraud allowed the chairman to keep the share prices of the company high. The deception, once revealed to unsuspecting board members and shareholders, made the company’s stock prices crash, with the investors losing as much as Rs. 14,000 crores. The crash of India’s fourth largest software services company is often likened to the bankruptcy of Enron - both companies achieved dizzying heights but collapsed to the ground taking their shareholders with them. Ramalinga Raju wrote in his letter “it was like riding a tiger, not knowing how to get off without being eaten”, implying that even after the realisation of consequences of the crime, it was impossible for him to rectify it.

It is theorised that white-collar crimes like these are highly rationalised. The motivation for the crime can be linked to the strain theory developed by Robert K Merton who stated that society puts pressure on individuals to achieve socially accepted goals (the importance of money, social status etc.). Not having the means to achieve those goals leads individuals to commit crimes.

Take the case of the executive who spent nine years in McKinsey as managing director and thereafter on the corporate and non-profit boards of Goldman Sachs, Procter & Gamble, American Airlines, and Harvard Business School. Rajat Gupta was a figure of success. Furthermore, his commitment to philanthropy added an additional layer of credibility to his image. He created the American India Foundation which brought in millions of dollars in philanthropic contributions from NRIs to development programs across the country. Rajat Gupta’s descent started during the investigation on Raj Rajaratnam, a Sri-Lankan hedge fund manager accused of insider trading. Convicted for leaking confidential information about Warren Buffet’s sizeable investment plans for Goldman Sachs to Raj Rajaratnam, Rajat Gupta was found guilty of conspiracy and three counts of securities fraud. Safe to say, Mr. Gupta’s philanthropic work did not sway the jury.

Play

The people discussed above have one thing in common - each one of them was well respected and celebrated for their industry prowess and social standing, but got sucked down a path of non-violent crime. The question remains - Why are individuals at successful positions willing to risk it all? The book Why They Do It: Inside the mind of the White-Collar Criminal based on a research by Eugene Soltes reveals a startling insight. Soltes spoke to fifty white collar criminals to understand their motivations behind the crimes. Like most of us, Soltes expected the workings of a calculated and greedy mind behind the crimes, something that could separate them from regular people. However, the results were surprisingly unnerving. According to the research, most of the executives who committed crimes made decisions the way we all do–on the basis of their intuitions and gut feelings. They often didn’t realise the consequences of their action and got caught in the flow of making more money.

Play

The arena of white collar crimes is full of commanding players with large and complex personalities. Billions, starring Damien Lewis and Paul Giamatti, captures the undercurrents of Wall Street and delivers a high-octane ‘ruthless attorney vs wealthy kingpin’ drama. The show looks at the fine line between success and fraud in the stock market. Bobby Axelrod, the hedge fund kingpin, skilfully walks on this fine line like a tightrope walker, making it difficult for Chuck Rhoades, a US attorney, to build a case against him.

If financial drama is your thing, then block your weekend for Billions. You can catch it on Hotstar Premium, a platform that offers a wide collection of popular and Emmy-winning shows such as Game of Thrones, Modern Family and This Is Us, in addition to live sports coverage, and movies. To subscribe, click here.

This article was produced by the Scroll marketing team on behalf of Hotstar and not by the Scroll editorial team.