“This requires a good healthy demand to ensure that for each generic companies, it will be worth it,” explains 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 at the interval, we were counting on the financing of donors. Even my country, South Africa, which has a good GDP and finances 80% of its response to HIV, already buys antiretrovirals for 6 million individuals per year. I imagine it will take them a few years to be able to mobilize money for Lenacapavir as well. »»
With the PEPFAR apparently now concentrated mainly on the treatment of existing patients, to the detriment of prevention, clinicians like Nomathemba Chandiwana, doctor-scientist of the Tutu Health Foundation in South Africa, fear that the rate of infection will begin to increase Rather than on Fall, something that will have a marked impact on public health on the African continent and beyond.
Speaking during the NCD alliance for Forum last week in Kigali, Chandiwana explained that the consequences of new infections are not only linked to HIV itself. Research shows more and more that people living with long -term HIV infections, even those controlled by antiretroviral treatment, are more at risk of developing metabolic conditions such as hypertension, obesity and diabetes of Type 2, a burden of illness that is already increasing from sub -Saharan Africa. “HIV itself disturbs your metabolism, as are many antiretrovirals,” explains Chandiwana. “We see the same chronic diseases in people living with HIV as in the general population, but at an earlier and accelerated age.”
For this reason, there is also a need for a new generation of HIV treatment, and an explored concept has been to use the Lenacapavir as the basis of future combined therapies for those already with the virus. In addition to potentially relieving some of the metabolic side effects, it was hoped that this could lead to treatment protocols that did not need people infected with HIV to take daily drugs.
“Various ideas have been discussed,” says Bekker. “Could you combine a bimonthly cabotegravir with a six-month lenacapavir injection [as a form of viral suppression]So you only came six times a year for treatment, and everything would be injectable? There is a weekly antiretroviral pill in preparation, and could you combine this with a six-month injectable? It could be very liberating for people because they tell us all the time how stigmatizing it is to take daily medicines. »»
However, many of these studies are now doubted, because Bekker says they had to be funded by American resources. “It’s not just Pepfar; We are also concerned about the restrictions imposed on other types of research funding, such as the National Institutes of Health, “she says. “It will become more difficult to innovate and advance progress.”
According to Ngure, there is still hope that other donors could emerge who can support the Global Fund in the purchase of Lenacapavir, while Bekker says that it explores new options to finance HIV prevention and the Research through European agencies, and possibly funding from donors from sources in Scandinavia, Japan and Australia. At the same time, she thinks that the events of last month have shown that African countries must themselves be able to finance more preventive efforts themselves.
“In one way or another, Africa must intensify and contribute to combat,” she said. “I think it’s the big question. How much we can also contribute to this continent through countries that have not necessarily been able to cover a large amount of research and development, but in the future. »»
At the same time, she is afraid that without the same resources in the United States, the unique opportunity offered by Lenacapavir can be lost.
“It is incredible that it happened just as we had a breakthrough,” she says. “I think it will make us go back for many years and ultimately cost much more in public health expenses. Because in the end, if we can control this epidemic more quickly, it will save more money on the long -term planet and save lives too. »»
