An HIV-free world is finally within reach | HIV/AIDS

British health authorities recently announced that they hope to stop all new cases of HIV in England and make the country officially the first in the world to “defeat the virus” by 2030. They say they will achieve this through a series of new deals they made with pharmaceutical companies to ensure that effective new medicines are available throughout the country. This is undoubtedly good news for the people of England. Nevertheless, as we have realized since the start of the COVID-19 pandemic, no country can definitively “defeat” a virus on its own. Viruses do not recognize boundaries. The way to end a pandemic is not through local pharmaceutical agreements, but global solidarity.

Today, it is true that defeating HIV globally is indeed within reach thanks to miraculous new drugs and treatments already on the market and being developed – but only if we work together and ensure that the most effective preventive drugs and treatments available to everyone in need, anywhere in the world.

The new drug that England hopes will help “defeat” HIV for good in less than a decade is the long-acting injectable form of the established HIV drug cabotegravir. The drug is not only an excellent treatment for people who are HIV positive, but is also highly effective as a preventative treatment. In July 2022, the World Health Organization released its guidelines for the use of long-acting injectable cabotegravir (CAB-LA) as pre-exposure prophylaxis (PrEP) for HIV and called on “countries to consider the safe and highly effective prevention option this is for HIV. people at significant risk of HIV infection”.

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This drug is seen as a potential game changer in the fight against HIV, mainly because it provides adequate protection through injections every two months. According to the World Health Organization, the initial randomized trials showed that “the use of CAB-LA resulted in a 79 percent relative reduction in HIV risk compared with oral PrEP, where adherence to taking daily oral medication was often is a challenge”.

All signs point to CAB-LA having the potential to help us finally consign AIDS to the dustbin of history. However, the battle to deliver this miracle drug to all who need it is just beginning. This most effective form of HIV prevention is still out of reach for people at the highest risk of contracting HIV.

Putting profit before lives

CAB-LA is patented and manufactured by ViiV Healthcare, a branch of pharmaceutical corporations Pfizer, GlaxoSmithKline and Shionogi. Like all pharmaceutical companies, ViiV Healthcare is focused on profit.

This is why it has not yet made CAB-LA available worldwide at an affordable price.

At first, the company blocked the production of low-cost generic CAB-LA anywhere in the world by refusing to grant voluntary licenses to generic manufacturers in the developing world, citing “manufacturing complexities, regulatory requirements, capital investment needs and unpredictability. demand”.

After significant backlash from civil society organisations, activists and health organisations, the company made a U-turn and in July 2022 reached an agreement with the United Nations-backed Medicines Patent Fund to enable access to the generic formulation of CAB-LA to 90 low and lower to middle income countries.

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The news of the voluntary licensing agreement was widely celebrated, but even this commitment did not give everyone in need immediate access to this essential HIV drug. It is expected that it will take up to four to five years for generic manufacturers to develop CAB-LA, scale up manufacturing, complete all necessary testing and submit the registration. This means that affordable CAB-LA will not be available in most countries for years to come and it will still be up to ViiV Healthcare to provide the medicine to all markets.

ViiV has a stated policy of providing its medicines to low-income developing countries, including those with a very high prevalence of HIV in sub-Saharan Africa, “at cost”. However, the company has yet to officially announce what that price would be for CAB-LA. Medecins Sans Frontieres says that ViiV notified them in July 2022 that the non-profit price is $210-$240 per person per year and is “subject to change at any time”.

This number is over 10 times higher than what the Clinton Health Access Initiative (CHAI) estimates the generic price for CAB-LA could be: less than $20 per year. This delay in making the breakthrough injection available in countries that need it most will lead to thousands of new HIV infections that could and should have been prevented.

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Unfortunately, ViiV Healthcare’s actions are not unusual. Since the start of the HIV epidemic, pharmaceutical giants like ViiV have been delaying the Global South’s access to innovative medicines to protect their profits. In the 1990s, when most countries in South Africa were ravaged by AIDS with death rates from the virus far exceeding birth rates in many communities, for example, Pharmaceutical Research and Manufacturers of America, an alliance of r 100 largest drug companies in the United States, aggressively lobbied against an attempt by South Africa to manufacture and distribute to patients generic AIDS drugs at the fraction of the price charged by US patent holders. Their lobbying and resulting legal warfare significantly hampered South Africa’s efforts to control the virus and led to countless preventable deaths.

We cannot allow this sad history to continue to repeat itself. With CAB-LA, we finally have a weapon strong enough to defeat HIV forever – not just in England, but around the world. But if we are serious about ending transmissions anytime soon, we need to ensure that everyone at high risk of HIV, including those in Africa, has access to this drug at an affordable price, not in a decade or a few years, but now.

The views expressed in this article are the author’s own and do not necessarily reflect the editorial stance of Al Jazeera.


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