Cheaper drug a big step in fighting HIV and Aids

Kenya and South Africa will now be able to treat an HIV infected person for only Sh7,500 per year, the United Nations Programme on HIV and Aids (Unaids) has announced.

The pricing agreement is expected to accelerate treatment roll-out as part of global efforts to reach all 36.7 million people living with HIV and Aids with high-quality anti-retroviral (ARV) therapy.

Unaids estimates that in 2016, just over half  – 19.5 million – of all people living with HIV had access to the lifesaving medicines.

The agreement will accelerate the availability of the first affordable, generic, single pill  containing dolutegravir (DTG) to public sector purchasers in low- and middle-income countries.

This pill, a once-a-day generic fixed-dose combination of tenofovir disoproxil fumarate, lamivudine and dolutegravir (TLD) drugs, according to researchers, is safe and inhibits HIV’s integrase enzyme. The drug has been too expensive for most poor countries.

GENERIC VERSION

“This is a major breakthrough,” says Michel Sidibé, executive director Unaids in a statement.

In July, Kenya became the first country in Africa to roll out the generic version of DTG and the second after Botswana to launch the drug for routine use.

DTG, manufactured by the Indian pharmaceutical Aurobindo Pharma, is available free of charge in public hospitals and select private facilities.

For the past two years, DTG has been used in high-income countries as the drug of choice for HIV and Aids patients.

However, the high cost of the medicine has put it out of reach for most patients in Africa.

The drug has been available in local private hospitals at between Sh1,200 and Sh5,000.

AIDS PATIENTS

Unitaid, a non-governmental organisation, donated 148,000 packs of DTG worth Sh60 million for a 30-day supply.

Currently, about 1.5 million HIV and Aids patients receive ARVs from the government at no cost, costing the taxpayer an average of Sh20,000 per year per person.

Researchers recommend the drug for patients who are resistant to second-line ARVs as well as HIV positive people who inject drugs.

DTG is widely used in high-income countries and is recommended by the World Health Organisation (WHO) as an alternative first-line HIV and Aids treatment.

In 2015, WHO recommended DTG as an alternative first-line treatment for adults and adolescents.

However, until recently, people living with HIV and Aids in countries such as Kenya could not access the drug due to its high cost.

ARV TREATMENT

In July 2017, WHO issued guidance to countries on how to safely and rapidly transition to DTG-based ARV treatment.

“In addition to improving treatment quality and retention, widespread use of DTG is expected to lower the cost of first-line HIV and Aids treatment while also reducing the need for more expensive second- and third-line regimens,” said Mr Sidibe.

This agreement, announced by the two governments, takes an important step toward ensuring the availability of worldwide high-quality treatment for HIV and Aids patients.

“It will improve the quality of life for millions of people living with HIV and Aids,” he said.

“Research has shown that DTG offers better tolerability, fewer adverse drug reactions, fewer drug interactions and a higher genetic barrier to resistance. In July this year, Kenya approved its inclusion in the National ART Programme,” said Dr Mailu.

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