Since the outbreak of the HIV and AIDS epidemic many years ago, the South African government has been pulling all the stops in efforts to prevent the scourge of infections across the country. Our government has relied on scientific intervention from leading companies such as Gilead Sciences and other reputable pharmaceutical entities that have demonstrated scientific leadership throughout the years. What we find amazing is that South Africa, a country that has been historically deemed as one of the epicenters of the virus, is now a key player at the forefront of solving the scourge of infections.
In June of 2024, Gilead Sciences made an announcement about a study that they had undertaken to trial out new medication for HIV prevention. One part of the study took place in South Africa, led by Professor Linda-Gail Bekker and the other part in Uganda. The PURPOSE 1 study enrolled over 5,300 cisgender adolescent girls and young women between the ages of 16 and 26 among the two countries in efforts to evaluate injectable Lenacapavir for pre-exposure prophylaxis (PrEP) and a daily oral pill called Truvada for pre-exposure prophylaxis (PrEP). After robust evaluation, Gilead Sciences found that the twice-yearly injections of Lenacapavir showed overwhelming efficacy for preventing HIV infections compared to standard oral preventative HIV medicines which are popularly known as PrEP. Dr. Merdad Parsey from Gilead Sciences cited that with zero infections and 100% success, lenacapavir could be a powerful new tool to prevent HIV.
Despite the success of this breakthrough, there remains concerning statistics in South Africa that need to be addressed if ever we are to beat this virus. We all know that our government’s HIV testing programme has been successful over the past decade due to rapid tests. Be that as it may, a subset of people who’ve tested positive are still not on medication. Out of the estimated 7,8 million people living with HIV in South Africa, only about 5,9 million are on treatment. This translates to treatment coverage of 75%, leaving us with a 25% treatment coverage gap to fill. Our government’s plan is to ensure that no one is left behind so there needs to be a lot of awareness raised on this matter. That is just one part of this fight against HIV and AIDS. The more recent one is the question around the affordability aspect of injectable Lenacapavir and its roll-out once it gets approval from health authorities.
UNAIDS, the joint United Nations programme on HIV and AIDS, which is the main advocate for accelerated, comprehensive and coordinated global action on the pandemic has welcomed Gilead Sciences’ exciting development. Subsequent to their nod, they have urged the company to allow generic production of Lenacapavir to all low- and middle-income countries by negotiating voluntary licensing agreements through the Medicines Patent Pool (MPP). The MPP is a United Nations backed programme with extensive experience negotiating generics agreements between originators and generic pharmaceutical companies. In response to these glaring global questions, Senior Vice-president Page 2 of 2 at Gilead, Janet Dorling, told The New York times that Gilead plans to work with other pharmaceutical manufactures to produce cheaper versions of lenacapavir by sharing its intellectual property in exchange for a licensing fee.
As a country, we should all be proud of the ladies who have volunteered to partake in this groundbreaking study. They have played their part in ensuring our government’s commitment to advancing actions to end HIV and AIDS as a public threat by 2030 is kept alive. This Mandela month we remember the words of former President Nelson Mandela when he said, “Many people suffering from AIDS and not killed by the disease itself are killed by the stigma surrounding everybody who has HIV and AIDS.” His words should serve as a clarion call for all of us to address issues of stigmatisation, the importance of testing and treatment retention. In the meantime, and between time, let us practice safe measures that will prevent the spread of HIV infections across the country. Most of us know better, let us educate one another and make our society a safe and healthy place to live in.
