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The recall of defective free condoms issued by the South African government, along with last month's sudden suspension of a major vaccine trial, could have a disastrous effect on the fight against AIDS in the country, campaigners fear.
In August 20 million defective, locally manufactured condoms were recalled from circulation in South Africa, which has the world's highest burden of HIV and AIDS. The recall resulted in widespread panic and a political scandal, and then last month a second batch of millions of free condoms was also withdrawn.
Warren Parker, director of the Centre for AIDS Development, Research and Evaluation, said, “Having a second condom recall severely discredits the reputation of public sector condoms in South Africa and has the potential to bring about quite rapid declines in condom use. Whilst the government have been frank about the problems, there has been little in the way of rebuilding the confidence of condom users.
“This would seem to be a priority, alongside expanding other strategies, including intensifying promotion of the risks of multiple concurrent sexual partnerships, which lie at the centre of HIV infection risk in this country.”
The first condoms were recalled on 23 August after allegations that Sphiwe Fikizolo, a testing manager at the South African Bureau of Standards, had accepted bribes for certifying defective condoms. Mr Fikizolo has been charged with fraud and corruption, along with Jeffery Hurwitz, executive director of Latex Surgical Products, which made the condoms, and Sajeev Joseph, an employee of the company.
A health department spokesman, Sibani Mngadi, claimed that of the 20 million condoms initially recalled, only an estimated seven million would have been directly compromised by the alleged corruption. But he conceded that the recall had left people suspicious of the government's free condoms. “We are working to find the best strategy to manage the damage done to the brand's reputation and the public's confidence in the product,” he said.
David Nowitz, marketing manager of the Society for Family Health, which partners the government in branding and distributing free condoms, said, “I think those behind the scandal have done the AIDS prevention cause a huge disservice. However, it's important for people to remember that we're talking about the actions of a couple of individuals and not a whole public healthcare system.”
A second batch of defective condoms was then withdrawn last month, the same day that South Africa suddenly halted the ongoing Phambili AIDS vaccine trial, amid fears that the drug seemed to increase rather than reduce the transmission of HIV.
Mitchell Warren, director of the AIDS Vaccine Advocacy Coalition, said, “We are deeply concerned by and share the disappointment of the field regarding the 23 October announcement that the immunisations would be stopped in the Phambili trial of Merck's Ad5 [adenovirus serotype 5] candidate and that volunteers in that study would be counselled that receiving the vaccine might have increased their risk of acquiring HIV infection.
“In the next weeks and months the AIDS vaccine field will need to make carefully considered decisions about whether to move forward with planned trials of related vaccine strategies.”