Historically, a gin and tonic consumed daily was a means to help protect British soldiers from catching malaria in tropical environments. It was a prophylactic that helped prevent the disease from taking hold. Quinine is the active ingredient that kills malaria, and it is quite bitter. So, British soldiers began adding water, sugar, gin and lime to cover the taste. Thus was born the modern cocktail.
This same general principle of prophylaxis is being applied today to the prevention of HIV/AIDS. Since this disease cannot be cured, prevention is a primary focus of new research. This strategy is called pre-exposure prophylaxis or PrEP for short. It involves daily doses of medications known to protect against the infection. When taken consistently, it can substantially reduce the risk of catching HIV and subsequently developing AIDS.
It works much the way a gin and tonic was thought to protect against malaria. It prevents the virus from taking hold and successfully spreading throughout the body. When taken consistently, it can reduce the risk of infection with HIV from sex by upwards of 90 percent. However, missing a single dose can lower the effectiveness.
In sub-Saharan Africa, it is an unrelenting epidemic. According to statistics from 2013, there were 24.7 million people living with HIV in that part of the world. They accounted for 71 percent of all HIV cases in the world.
For a long list of reasons, consistent use of medication is a big challenge in this part of the world. Thus, a current focus of the Bill & Melinda Gates Foundation is a tiny implantable drug pump from a Boston-based company called Intarcia Therapeutics. The pump is the size of a matchstick, yet can hold either a six- or twelve-month supply of PrEP medication.
It can be implanted under the skin in a physician's office. The procedure is said to be painless. Since it is an outpatient procedure, it is also relatively quick and easy. Once done, the patient is protected for the six months or one year that it lasts.
There are still many details to work out. It will be some years before it is available on the market. The intent is to make it as easy to use as possible in order to try to curb the current epidemic, especially in less developed parts of the world. Simply containing the epidemic and preventing further spread is the best hope at this time.
The pump may eventually be used as a delivery mechanism for other drug therapies aimed at other serious medical conditions. In fact, Intarcia is currently working to get FDA approval for a variation of the pump intended to provide treatment for type 2 diabetes.
A new high tech drug pump the size of a matchstick is currently being developed as a means to consistently deliver prophylactic medication to protect against HIV. This pump would allow people to see a doctor once or twice a year to get the protection they need from this currently incurable dread disease.