By George Okore
Kenya has become the first African country in Africa to offer a new first-line drug for people living with HIV, thus accelerating access to better antiretroviral (ARV) drugs
The debut of generic version of Dolutegravir (DTG) is a relief people living with HIV in Africa, where it’s needed most. Today’s launch also set the stage for large-scale introduction of new health products, thus access to better quality and more effective ARV therapy that will greatly improve quality of life of people living with HIV.
It will also usher introduction and uptake of adapted pediatric HIV drugs for children. Popular known as DTG, the drug has minimal side effects, is easier to take than currently used formulations (one small tablet taken daily), and patients are less likely to develop resistance. In 2015, the World Health Organization (WHO) recommended DTG as alternative first-line regimen for adults and adolescents.
The drug of choice, whose introduction is being supported by Unitaid, reinforces medical advances in recent years mean that ARVs have turned HIV from a death sentence into a manageable condition. With patients needing to be on lifelong treatment, the focus is now on ensuring that medication is as well-tolerated as possible.
“Until recently, people living with HIV in countries like Kenya were not able to access DTG. Through partnership with Unitaid, the drug is a relief to patients living with HIV, build healthcare worker experience, and generate the evidence needed to introduce DTG on a larger scale by early 2018,” said Dr Jackson Kioko from Kenya’s Ministry of Health.
The Kenyan government will initially provide DTG to 27,000 people living with HIV who are unable to tolerate side effects of efavirenz, the first-line HIV drug currently used in the country. DMG will be introduced in select health facilities across the country, and expected to be available countrywide at the end of the year.
Unitaid Executive Director Lelio Marmora says numerous phase 3 clinical trials have shown DTG to be superior to other first line treatments, and in 2016 Kenya included the drug into its ART treatment guidelines. “New regimens including DTG offer great potential for better and less costly HIV treatment. Through this catalytic work, we are significantly reducing the time it takes for people living with HIV in Africa to access the latest ARVs on the market. These are important developments as we move towards HIV treatment for all in need,” he says.
Speaking at the launch, Dr Gerald Macharia, African Vice President for Clinton Health Access Initiative said the drug would offer new strategies to prevent, diagnose and treat HIV/AIDS, hepatitis C, tuberculosis and malaria more quickly, affordably and effectively. “ We praise Unitaid for pioneering introduction of simpler, more affordable optimal HIV regimens and ensuring they are available sooner for those in need, so countries and partners like PEPFAR and the Global Fund can bring them to scale, ” he said
Worldwide, over 18 million people are on life-long HIV treatment, and majority of these are access to treatment yet. In Kenya, approximately 1.5 million people are living with HIV, and just over one million are currently on ARVs.
Unitaid is investing US$ 67 million to address this pressing need in an effort to avoid delays of more than 10 years before new drugs can be introduced in low- and middle-income countries. This catalytic intervention also provides key opportunity to test DTG’s use in routine treatment for the first time and prepare national distribution channels.
Besides Kenya, Nigeria and Uganda will also be introducing DTG later this year as part of the project. This will accelerate uptake of the three-in-one fixed dose combination that would be made available by 2018. The fixed dose combination, which would include tenofovir, lamivudine and DTG, is expected to significantly simplify treatment for people living with HIV.