South Africa launches HIV prevention shot: NPR

JOHANNESBURG – South Africa on Friday introduced a new, biweekly HIV prevention drug that has the potential to drastically cut infection rates, but cuts in US aid mean access will be limited.

Lencapavir, a type of pre-exposure prophylaxis (PrEP), is injected into the stomach every six months and basically fails to prevent high-risk individuals from becoming infected with the virus.

South Africa is not the first African country to introduce lencapavir injections. The drug is becoming available across Africa faster than any HIV prevention option so far, and South Africa has become the ninth country on the continent to launch it. But in the country with the highest number of HIV cases in the world, this long-acting injection is being seen as a potential game changer.

Speaking at the launch, South African President Cyril Ramaphosa said, “Today's launch of lencapavir marks a turning point in our country's fight against HIV. For us, this incredible, incredible treatment is not just a drug or medicine, for us it represents a major turning point in South Africa's national story.”

The rollout is beginning in 360 health facilities in high-burden districts.

South Africa, which is about 8 million people According to UNAIDS, despite considerable progress in treatment, most of the population living with HIV remains dependent on antiretroviral drugs. But prevention is still an issue, with about 160,000 new infections each year.

most of them are infections Adolescents and young women Aged 15 to 24, about 1,000 people in this demographic are infected each week. Reasons for this include the unequal relationships, sometimes even transactional, that these girls and women have with older men.

South Africa already has some PrEP in the form of a daily pill, but adherence is a problem. Experts hope lencapavir could be a breakthrough that makes prevention more effective and accessible.

“Lenacapavir for HIV prevention gives us something we've never had before: a twice-yearly option that could be quite easy to fit into people's lives,” Dr. Saika Mullick, a PrEP expert at Wits RHI at the University of the Witwatersrand, told NPR.

But to truly overcome the pandemic, Mullick says South Africa will need much more than the international health financing partnership provided by the Global Fund – enough to give medicine to about 456,000 people over two years.

He said, “We have game-changing technology, but the impact will depend on implementation. A successful product changes the pandemic only when it reaches those who need it most.”

Currently, access is being hindered by two things: the fact that the Trump administration cut off U.S. President's Emergency Plan for AIDS Relief (PEPFAR) funding to South Africa last year, and the lack of an affordable generic.

Mullick said, “US funding cuts have impacted HIV prevention infrastructure, community programs, outreach, youth services, and key population services. The cuts have weakened prevention programs, because South Africa needs them for the lencapavir rollout.” “Some replacement funding is emerging but it does not fully replace the scale of PEPFAR funding.”

Linda-Gail Baker, an HIV expert who leads Desmond Tutu Health FoundationAlso noted the impact of US cuts.

He said, “If Pfeffer had been in place, I think we would have been the recipient of more lane doses, as it happens, we are getting at least some from the Global Fund, but clearly we would have been able to get the support of both the Global Fund as well as Pfeffer in this regard.”

The cost of lencapavir, currently made by the US pharmaceutical company Gilead, is prohibitive: about $28,000 per person per year in the US.

But Mullick says generic drugs are on the way following an agreement to make them available to 120 low- and middle-income countries. And sub-Saharan African countries are a priority.

“South Africa is also looking at local manufacturing capacity to improve regional access and reduce dependence on external supplies,” he said.

A generic version of lencapavir is expected to be available in 2027 at a cost of about $40 per person per year.

“Obviously once generic medicines come online, we are very hopeful that the South African government will also be able to make a big contribution in purchasing the drugs at scale,” Baker said.

Scientific modeling suggests that if one to two million HIV-negative people take the vaccine between now and 2043, AIDS may no longer be a major public health problem in South Africa.