“It takes a nice healthy question to ensure that it will be worthwhile for each of the generic businesses,” says Bekker. “We all hope that governments [across sub-Saharan Africa] Write the generic product in their budgets for the future, but the reality is that we meanwhile trust in donor funding. Even my country, South Africa, which has a good GDP and finances 80 percent of its HIV response, has been buying antiretrovirals for 6 million individuals every year. I would imagine that it would take them a few years to mobilize the money for Lenacapavir as well. “
With Pepfar that is now mainly focused on the treatment of existing patients, at the expense of prevention, clinicians such as Nomathemba Chandiwana, a physician scientist at Desmond Tutu Health Foundation in South Africa, are concerned that the infection rate will start to rise rather As a fall, something that will have a clear impact on public health across the African continent and beyond.
Chandiwana spoke last week’s NCD Alliance Forum in Kigali and explained that the effects of new infections are not just related to HIV itself. Research is increasingly showing that people living with prolonged HIV infections, even those controlled by antiretroviral treatment, are at greater risk of developing metabolic conditions such as hypertension, obesity and type 2 diabetes, a disease burden that is already on the rise is sub -Saharan Africa. “HIV itself disrupts your metabolism, just like many of the antiretroviral drugs,” says Chandiwana. “We see the same chronic illness in people living with HIV as in the general population, but at an earlier age and in an accelerated way.”
As a result, there is also a need for a new generation of HIV treatments, and one concept investigated was to use Lenacapavir as a basis of future combination therapies for those already with the virus. In addition to some of the metabolic side effects, it has been hoped that it may lead to treatment protocols that do not require HIV-infected individuals to take daily medication.
“Several ideas have been set up,” says Bekker. ‘Can you combine bi-monthly Cabothegravir with a six-month Lenacapavir injection [as a form of viral suppression]So you would only come in six times a year for treatment, and it would all be injectable? There is a weekly antiretroviral pill in the works, and can you combine it with a six-monthly injectable? It can be very liberating for people, as they always tell us how stigmatizing it is to take daily medication. “
Yet many of these studies are now in doubt, as Bekker says they will be funded by American resources. “It’s not just Pepfar; We are also concerned about restrictions placed on other types of research funding, such as the National Institutes of Health, ”she says. “It’s just going to get harder to innovate and move progress.”
According to Ngure, there are still hope that other donors can come up who can support the World Fund in the acquisition of Lenacapavir, while Bekker says his new options are investigating to fund HIV prevention and research by European agencies, and possibly donor financing from sources in sources in sources Scandinavia, Japan and Australia. At the same time, she believes that the events of the past month illustrate that Africa countries themselves should be able to finance more preventative efforts.
“Somehow, Africa must act and contribute to the fight,” she says. “I think that’s the big question. How much we can contribute on this continent by countries that could not necessarily cover a large amount of research and development but needed in the future. “
At the same time, she is afraid that without the same resources from the US, the unique opportunity offered by Lenacapavir.
“It’s amazing that it happened just as we had the breakthrough,” she says. ‘I think it’s going to set us back for many years and eventually cost a lot more in public health spending. Because finally, if we can control this epidemic faster, it will save the planet in the long run and save lives. “