Re-building distribution networks to assure future microbicide access

The first candidate topical microbicides--products designed to reduce women's risk of HIV infection--are now in the final stages of efficacy testing, and, if successful, could start to be available by the end of the decade. Advocates in public health and international development are already discussing how to expedite access to this new technology in countries where it could have the largest public health impact. The World Health Organization (WHO), World Bank, and the European Union support the integration of family planning and HIV programs. Such integration is impeded by U.S. policy, funding restrictions, and reluctance to integrate family planning and HIV/AIDS funding. This article describes how these policies weaken, rather than strengthen, the capacity of distribution networks to play an urgently needed role in microbicide roll-out when the time comes.