Injectable ARVs: The new technology in the fight against HIV and AIDS
What you need to know:
- Matthew Kavanagh is the director of Georgetown University's Centre for Global Health Policy & Politics and an advisor to the United Nations.
- According to Matthew, a reduction in HIV/AIDS funding would pose significant challenges for Kenya
- Studies published in the last 18 months show that long-acting medicines could revolutionize HIV treatment and HIV prevention
The National Syndemic Disease Control Council reveals that individuals aged between 15 to 24 have recorded the highest number of new HIV/AIDS infections. While the everyday antiretroviral viral pill may take a toll on the body, among the new technologies deemed effective by a section of experts is the long-active HIV medication. Healthy Nation had a sit down with Matthew Kavanagh, the director of Georgetown University's Centre for Global Health Policy & Politics and an advisor to the United Nations on the progress and challenges in the uptake of the injectable ARVs.
What does the future hold for the Kenya-United States partnership in the fight against HIV and AIDS?
This partnership has been a remarkable global success story. Kenya, along with many other countries in the region, has collaborated with the United States and various funding programmes to achieve what once seemed impossible. Not too long ago, there was significant doubt about whether treatment levels could ever reach 90 per cent coverage for those in need. Today, we have surpassed that benchmark, reaching 95 per cent.
Is Kenya at risk of funding cuts for HIV programmes under the US President's Emergency Plan for AIDS Relief (PEPFAR)?
Right now, we are facing significant financial challenges and complex geopolitical dynamics. It would be a huge setback if, after achieving two-thirds to three-quarters of the progress needed, funding were to be cut. We are still battling a pandemic, and when dealing with a virus or an infectious disease outbreak, the reality is stark: If you are not winning, then you are losing.
This is a critical moment to double down and increase funding to push towards the goal of ending the epidemic. Once we achieve sustainability in combating HIV/AIDS, then we can have discussions on how the Kenyan government and Kenyans can take over and ensure the fight is ultimately won."
What would Kenya's future look like if HIV/AIDS funding were reduced?
A reduction in HIV/AIDS funding would pose significant challenges for Kenya. The country is already grappling with a high debt burden that surpasses its health spending, making it difficult to allocate the necessary resources for health financing. In this context, reduced donor support would strain the healthcare system further, potentially reversing gains made in combating HIV/AIDS. We need donors not to retreat at this moment.
Is Kenya prepared to achieve self-sufficiency in the fight against HIV/AIDS?
Not yet. Kenya needs debt reforms to ensure these unsustainable levels of international debt are taken away. Then, the Kenyan government will have the options and the fiscal space to be able to expand its funding into HIV.
What is the new technology in the field of HIV/AIDs?
The science of HIV is remarkable. In the last two years, we have a set of new technology that has been developed, and studies published over the last 18 months show that long-acting medicines could revolutionize HIV treatment and HIV prevention. We are talking about the move from the everyday ARV pill to injections—an ARV injection every two months or an ARV injection every six months.
How is it administered?
It is an intramuscular injection administered by a trained medical healthcare provider
What is the efficacy of the long-acting medication?
The efficacy has been tested and proven, and it could be transformative on both the treatment and preventive sides. This could soon lead to a situation where people no longer have to think about day-to-day HIV medication. Instead, they could embrace life without the constant worry of missing a pill and the associated risk of their viral load spiking. Patients on daily ARVs often report that the medication takes a toll on their bodies, and research has shown it can overpower an individual if they don’t take necessary measures like proper nutrition.
Will injectable ARVs have the same effect on the human body?
No, they are very efficient. The medication is here, and it is being rolled out globally. The two-month injectable drug is already being used in high-income countries, showing significant impact and effectiveness in suppressing HIV and preventing HIV transmission. For people who are HIV-negative, this medication can stop the virus from being transmitted to them.
A recent study published in the New England Journal of Medicine reported zero new infections among young women in the African region who took this medication once every six months—an efficacy comparable to that of a vaccine. While pre-exposure prophylaxis (PrEP) has been effective in pill form, these new injections are even more potent.
What are the challenges hindering Kenya from accessing long-acting HIV medications?
Unfortunately, long-acting HIV medications are not currently available in the Kenyan market, primarily due to their high cost. This is a challenge we’ve seen before. For instance, in 1997, when the first HIV medication became available, there was widespread excitement about its potential to combat the virus. However, it took a decade before the medication was fully accessible in Kenya. During that time, millions of people lost their lives, and new infections surged across the region. We cannot let that happen again with this new technology.
The ongoing conversations are focused on how to make these medications affordable and accessible to the people who need them. Currently, the two-month injectable medication costs around USD40 (Sh5,200) to USD 50 (Sh6,500) per patient per year, a price point that is unaffordable for many Kenyans.
What actions can African countries take to stay ahead in new advancements?
We should be producing these medicines locally to avoid waiting another decade, as we did with ARVs in the past. We are working with Africa CDC, the Global Fund, and various partners about how we can manufacture these drugs in the regions so that we can have an impact. Another crucial consideration is financing. We need to strategize on how to secure funding and ensure that development partners are buying at scale to guarantee global access. There is a company we heard from that is based in Egypt and is going to make these drugs next year. So these drugs will become available in the African region and can then be purchased by countries like Kenya, the global fund and PEPFAR.