by John Kerns

HIV/Aids drug boost

SA rolls out ARVs in one pill

A combination of all three ARVs in one drug has been approved.
A triple threat against HIV/Aids

In the 1980s and early 1990s Aids used to be a virtual death sentence with many people who could not get access to medication succumbing to the illness.

The discovery and introduction of new medicines improved the situation somewhat but many could not adhere to the strict regime of the cocktail of drugs they had to take on a daily basis.

The introduction of single dose pills has made the treatment as easy as taking a daily vitamin tablet. Three different Anti-retroviral medication drugs or ARVs daily or triple therapy were needed to keep HIV in check effectively.

Some patients were unable to comply and ended up developing drug resistance and eventually succumbing to the disease.

Health Minister Dr Aaron Motsoaledi announced in 2012, that a tender for the triple fixed-dose combination (FDC) of tenofovir, emtricitabine and efavirenz had been approved.

This new drug for HIV/Aids patients has officially been rolled out, according to the Department of Health. 

It is hoped the drugs will be available to all patients, with the first priority being pregnant women and new patients.

Close to a million HIV infected South Africans are expected to receive the treatment over the next two years.

The new drug FDC will be distributed to all public hospitals and clinics.

This also means that pregnant women who are HIV-positive will be given the FDC during pregnancy and breast feeding as well as after giving birth if their CD4 count is less than 350.

“I think one must allow for a transitional period. It will take some time to comprehensively introduce it to all patients but I think we will be able to do this successfully in a 12 month period,” said Western Cape Health MEC, Theuns Botha.

According to the department's chief director of procurement, Gavin Steel, single-dose or fixed-dose combination drugs – which combine three different ARVs in one pill – are considerably cheaper to distribute. 

Health department economist, Anban Pillay, said his department also managed to negotiate "the ­lowest fixed-dose combination drug price in the world", enabling the government to drastically expand its ARV programme.

The department now pays between R89 and R95 a month for the treatment of a single patient, compared with R150 a month in 2010.

Kevin Rebe from the Anova Health Institute's Health4Men HIV clinic in Cape Town warned that the government would have to ensure it has strategies in place for sufficient ARV supplies in order to prevent a repeat of previous crises when stocks ran out.

"Since this is a new drug in the South African state-sector ARV programme, manufacturers may not have enough buffer stocks on hand. But this problem can be managed through careful implementation". 

The single dose pills have major benefits in terms of compliance. One pill, once a day, is far easier for most patients to keep track of than multiple pills, even if they can all be taken at the same time.

This means that HIV-positive patients are more likely to take their pills consistently and correctly, making the drugs much more effective.

It has taken the government 10 years to put 1.9 million people on HIV treatment.

With the new FDC drugs, the department plans to put about 500 000 new patients on ARVs each year over the next three financial years. 

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