World Aids Day: The fight forges ahead

WHEN we look back at South Africa and the world’s history with the HIV/Aids epidemic, it is intriguing how far the human species has come in almost ‘having things under control’. It is for this reason that World Aids Day is recognised the world over on December 1.

Started by the World Health Organisation (WHO) back in 1988, the day brings together people from around the world to raise awareness about the disease and to portray international solidarity in the face of the epidemic. According to the WHO, the day is an opportunity for public and private partners to spread awareness about the status of the disease and to encourage progress in its prevention, treatment and care.

“It has become one of the most widely recognised international health days and a key opportunity to raise awareness, commemorate those who have died, and celebrate victories such as increased access to treatment and prevention services,” they said.

In 1981, when it was first discovered in the United States, it was then duped a ‘Gay men’s pneumonia’. Following that, the disease was steeped in stigma. Thankfully, research into a cure began and the subsequent development of Antiretrovirals (ARVs), and now the latest addition to the fight against the disease is the development of Pre-exposure Prophylaxis (PrEP) medication.

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Antiretrovirals

The birth of Antiretrovirals brought about the much-needed relief that people with the disease had a second chance at leading normal lives. Antiretrovirals is a medication that is taken daily to prevent the disease from replicating in the body. This grants the immune system a chance to repair itself and prevent further destruction. ARVs have evolved massively over the last 30 years since they have been available.

There are six main types of ARVs in South Africa, with each class of drug attacking HIV in a different way. These are namely, abacavir (Ziagen), emtricitabine (Emtriva), Iamivudine (Epivir), tenofovir disoproxil fumarate (Viread), and zidovudine (Retrovir). Generally, drugs from two classes are combined to ensure a powerful attack on HIV.

The first ever ARVs to be rolled out to the public in the country were brought out in 2004, and these required the patient to take multiple pills throughout the day. On top of this immense responsibility, the side effects proved difficult for some patients, hence the rolling out of the second-regime ARVs –  tenofor emtricitabine efavirenz (TEE). With this version of ARVs, patients only had to take one pill once a day.

The latest addition to the ARVs family has simplified the lives of those living with the disease even further. The hard work of doctors, professors, government and researchers has brought a three-in-one, fixed-dose combination that includes dolutegravir, lamivudine, and tenofovir disoproxil fumarate (TLD).

With the support of Unitaid, the Government of South Africa was able to roll out this state-of-the-art treatment regime in 2019. Unitaid Executive Director Lelio Marmora said that because about 20% of people living with HIV worldwide are from South Africa, the introduction of the new treatment is expected to have a far-reaching impact.

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“We are pleased that our investments, globally and directly in South Africa, have helped set the stage for this more affordable and effective treatment,” said Marmora.

Cost-effective and by far the most effective treatment for HIV, TLD is currently being used by more than 60% of HIV patients.

Pre-exposure Prophylaxis (PrEP)

The development of PrEP has played a pivotal role in decreasing the number of new HIV infections the world over. PrEP is medication that reduces your chances of getting infected with HIV, whether from sex or injection drug use. Taken once a day, this medication can prevent pre-exposure as well as post-exposure when taken within 72 hours of being exposed to HIV.

Not only does PrEP provide some sense of relief for people who do not want to contract the disease, but it is also widely used for rape victims who may have been unwillingly exposed to the disease. Subsidised by the Department of Health, just like ARVs, this medication is available free of charge from any public health facility, both clinics and hospitals.

Needless to say, there is still a long way to go in finding a cure for HIV/Aids. With the ever-advancing medicinal trends, there is hope that we will someday wake up to an HIV-free South Africa and world.

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