Today, on World Sexual Health Day, we at the IMPT reflect on how to work with partners to improve sexual health across the globe. There are many things that could be done, many different approaches, and many people we can work with towards this goal. Here, at the IMPT, we see multipurpose prevention technologies (MPTs) to be one such promising strategy with the potential to improve the sexual health – and lives – of women and their families across the globe.

It all started with the simple realization that women seeking protection against HIV also want to prevent unintended pregnancies. In general, they also prefer a combined method. Then followed the innovation challenge: Engineer a long-acting intravaginal ring that could release two chemically diverse drugs – one for HIV and herpes simplex virus (HSV) prevention, and one for contraception – at sustained, controlled, and yet extremely different release rates (up to 1000-fold) for 3 months; make it suitable and scalable for use in resource-limited countries, such as those of sub-Saharan Africa; and design it so women would want to use it. Even now it’s a daunting task. When this project began, 10 years ago, its feasibility was questioned by many, including our collaborators and ourselves. However, if successful, this challenge had strong potential to provide a truly game-changing MPT solution to a dire unmet need for women globally.

One of the ongoing challenges in the MPT field is that, because MPT products are not yet commercially available (aside from male and female condoms), we do not have ‘real world’ data to inform product development, introduction, and investment decisions. Given this, MPT product developers, researchers, and funders must grapple with critical questions, such as: How impactful do these products need to be for me to consider funding or starting a product development program? Is that impact potential achievable, and under what conditions? How efficacious would the product need to be? What is the market for the product? How many people would need to use the product correctly and consistently? What associated costs will make a product cost-effective or cost-saving?