[YAOUNDE] It is crucial to ensure the availability and optimize antiretroviral (ARV) treatments in developing countries, particularly in Africa.
This is the message widely supported by the participants, including researchers, members of international organizations, civil society actors and people living with HIV, who took part in the symposium organized as part of the 12e international conference of the French-speaking Alliance of health actors against HIV and chronic viral infections (AFRAVIH), held from April 16 to 19 in Yaoundé, Cameroon.
According to the World Health Organization (WHO), there are an estimated 39 million people living with HIV at the end of 2022, with more than two-thirds (25.6 million) in the WHO African Region.
“When there are new drugs that could have a significant impact in developing countries, we discuss and negotiate with the pharmaceutical companies that have developed these new drugs so that they can be quickly available and at a more affordable price in these countries, particularly through the manufacturing of generic products”
Esteban Burrone, Director of Policy, Medicines Patent Pool (MPP)
Central and West Africa account for 4.8 million of the 39 million people living with HIV. Furthermore, 160,000 new infections are recorded each year, including 51,000 in children under 15 years old. HIV-related deaths amount to 120,000 per year.
In view of these figures, it is “essential” to make treatments available to countries at lower costs, specifies Esteban Burrone, director of policies, strategy and market access at Medicines Patent Pool (MPP), an international organization whose goal is to reduce HIV drug prices and facilitate the development of HIV treatments, through the licensing of patents in low- and middle-income countries.
“When there are new drugs that could have a significant impact in developing countries, we discuss and negotiate with the pharmaceutical companies that have developed these new drugs so that they can be quickly available and at a more affordable price in these countries, particularly through the manufacturing of generic products,” he declares.
He continues by specifying that “ […] TLD, which is the first-line regimen in the world today, is available for less than $45 per patient per year.”
According to him, a few years ago, the best medicines were available in rich countries and cheaper medicines were available in developing countries.
“But today, we have the best possible drugs such as the fixed dose combination TLD which is the main WHO recommendation for HIV available in developing countries,” maintains Esteban Burrone.
“Revolutionary” drug
The Yaoundé symposium was devoted to 10 years of efforts for broad access to Dolutegravir (DTG), a fairly “revolutionary” drug, from the point of view of Philippe Duneton, executive director of UNITAID, an international organization responsible for centralizing drug purchases with a view to obtaining better prices.
Medicines Patent Pool And ViiV Healthcare signed, in April 2014, two licensing agreements (adult and pediatric) aimed at accelerating access to DTG, an antiretroviral intended for adults and children. Thanks to these agreements, generic manufacturers produce low-cost versions of this drug.
This is “a very effective and well-tolerated combination which helps to rapidly suppress the virus and reduce transmission”, informs MPP.
In 2019, the WHO recommended DTG “as the preferred treatment option for HIV in all populations.” Today, around 24 million people take products based on this active ingredient, says Esteban Burrone.
The deployment of this drug in Senegal since 2018 has been “a very interesting event”, testifies Eloi Kambanck, representative of the National Council to Fight AIDS in this West African country.
“The established transition plan was planned for 2019-2021 and our objectives for 2021 were to put 80% of patients on a DTG-based protocol. At the end of 2021 when we did the mid-term evaluation, we were at 84%. Today, 96% of our patients are on DTG,” he explains in an interview with SciDev.Net.
According to this expert, the success of this product and all the advantages associated with it are partly linked to the supply that could be ensured. The reduction in costs allowing the country to renew stocks.
“I am myself a person living with HIV and I had taken a therapeutic vacation because I could no longer tolerate the treatment I was taking. But when I heard about DTG, I asked my doctor to prescribe it to me and today, I am satisfied,” says Nadia Adingra, director in Ivory Coast of the NGO International Community Women Living with HIV.
For her, DTG is an “optimal” medicine used for the treatment of HIV and ensuring equitable access to this treatment is “essential” to guarantee the health and well-being of women and children affected by HIV.
According to Nadia Adingra, nearly 82% of infected breastfeeding and pregnant women are under DTG treatment in Ivory Coast. However, she regrets, the care of children living with HIV remains worrying.
“The mortality rate among children is much higher due to lack of treatment. Children represent only 4% of people living with HIV. Unfortunately, 13% of children die from HIV, and this is something that needs to be fixed. We hope that with the fixed dose, things will return to normal,” she says.
