Africa must make ARVs: Continent still epicentre of HIV infections

The 22nd edition of the International Conference on Aids and Sexually Transmitted Infections in Africa recently took place in Harare, Zimbabwe.

The event offers key roleplayers and decision-makers in Africa an opportunity to address the region’s HIV epidemic and our unique response to it.

According to the sixth South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, there are an estimated 7.8 million people living with HIV in South Africa.

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Earlier this year, the World Health Organisation (WHO) confirmed there were an estimated 39 million people worldwide living with HIV and 25.6 million of those were in Africa, making our continent the global epicentre of the virus.

A critical theme emerging from this year’s conference has been the impact of the Covid pandemic on HIV resources in Africa.

Sadly, over $500 million (about R9.3 billion) previously ringfenced to fight HIV, TB and malaria in Africa had to be re-allocated to the region’s Covid Response Mechanism, following the global outbreak in 2020.

This has significantly hindered progress in terms of the continent’s HIV response, creating a potentially hazardous gap in access to lifesaving HIV, TB and malaria programmes.

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This follows numerous reports that have confirmed that African countries were left last in line to access Covid resources, with some countries, including SA, paying far higher premiums for lifesaving vaccines than their European counterparts.

These circumstances reflect the dire need to improve Africa’s capacity to produce medicines and healthcare products locally.

According to the WHO, approximately 380 000 deaths could be attributed to HIV-related causes last year. Industry experts and international organisations attribute these tragic outcomes to Covid, for causing disruptions to key HIV treatment and prevention services across the continent.

This underscores the need to improve our regional capacity to produce locally manufactured antiretroviral treatments (ARVs) and pre-exposure prophylaxis (Prep) specifically.

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Kiara Health, a SA medtech company, have made some progress in this regard following the signing of a memorandum of understanding (MOU) with the Population Council for a licence for the dapivirine vaginal ring (Prep ring), a novel HIV prevention product for women.

The innovative ring is a blend of silicon and an antiretroviral, dapivirine. This MOU brings the local manufacture of the Prep ring one step closer to improving SA’s capacity to produce our own HIV treatments, in a manner that will also help decrease Africa’s reliance on foreign imports.

Based on the data provided by the US department of state bureau of global health security and diplomacy, without Pepfar, HIV related deaths could increase by 400% while the number of Aids orphans could double.

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At the International Conference on Aids and Sexually Transmitted Infections in Africa 2023, key stakeholders from across the continent shared these and other experiences as they aim to continue reducing the rate of new infections while increasing access to treatment.

We can hope that this conference will be leveraged as a unique opportunity for decision-makers to collaborate with industry role-players to address any gaps in financing, health system strengthening and programming, with the aim of ending Aids by 2030.