JOHANNESBURG – Health officials are hoping that new, long-acting drugs to help prevent HIV infection will be a turning point for the fight against a global health threat that’s been eclipsed by the coronavirus pandemic.
South African President Cyril Ramaphosa highlighted the new drug in a weekly newsletter, saying the long-term acting and injectable HIV drug has “the potential to significantly strengthen our response to the epidemic.”
The region is especially hard-hit. South Africa has the biggest epidemic in the world with 7.7 million people living with HIV, according to UNAIDS.
In separate studies of men and women earlier this year, including one by the HIV Prevention Trials Network and the Reproductive Health and HIV Institute (RHI) at the University of Witwatersrand in South Africa, the drug — Cabotegravir — had successful trials. The shot given every two months has been proven to be 90% more effective than the daily pill known as PrEP.
Ramaphosa’s message noted, however, that South Africa’s battle against HIV had suffered because of the coronavirus pandemic and the resultant strain on health services, a situation repeated in many countries with a high prevalence of HIV/AIDS.
In her World AIDS Day message, UNAIDS executive director Winnie Byanyima lamented the fact that more than 12 million people are still waiting to get on HIV treatment, while 1.7 million people were infected with HIV in 2019 because of lack of access.
She called on companies to “openly share their technology and know-how and to waive their intellectual property rights” so that the world can produce vaccines, including for COVID-19, at the scale required. There is no vaccine for HIV.
She also stressed that the global AIDS response was off track even before COVID-19 and the world needed to reset its targets if it is to meet the goal of ending HIV/AIDS as a public health threat by 2030.
The response against COVID-19 has shown what can be achieved by working together, UNAIDS said.
Fears that the world is losing focus on the AIDS epidemic were reflected by figures in South Africa that showed 225,000 HIV/AIDS patients in the country’s largest province of Gauteng had discontinued their vital anti-retroviral treatment this year, partly but not only because of difficulties accessing care during the virus pandemic.
Yet, amid the stark figures, health officials and women, hold onto hope that cabotegravir could mean less visits to health centers as many look to reduce exposure to COVID-19.
Dr. Sinead Delany-Moretlwe, director of research at the Johannesburg-based RHI, said women in sub-Saharan Africa, who are disproportionately affected, were among those who will benefit significantly from the drug.
Some research suggests women may be at greater risk of getting HIV through sex than men are, but Delany-Moretlwe added that social issues also contribute significantly to their increased risk.
“Women do not always have power in relationships, and up until fairly recently, negotiated condom use was a challenge particularly in relationships where women rely on their partners for financial support or where the threat of violence is enough to keep women quiet,” said Delany-Moretlwe.
Women such as 26-year-old Khanyiswa Kwatsha, who is currently taking the daily PrEP pill and promotes it among young women, are eagerly anticipating access to the new treatment, saying it will be much easier for them to protect themselves with an injectable drug they only have to take every eight weeks.
“I am very happy because drinking a pill every day is not easy, while you know that you are not sick but you are drinking it to protect yourself,” Kwatsha said. She said that while PrEP has been pivotal, this new injectable drug will make life easier.
The clinical trials were conducted among more than 3,200 women at research sites in South Africa, Uganda, Eswatini, Kenya, Malawi, Botswana and Zimbabwe.
Cabotegravir is being developed by ViiV Healthcare, which is mostly owned by GlaxoSmithKline, with Pfizer Inc. and Shionogi Limited. The study was sponsored by the U.S. National Institutes of Health, the Bill and Melinda Gates Foundation and ViiV. The drugs were provided by ViiV and Truvada’s maker, Gilead Sciences.