The Southern African Clinicians Society, together with Metropolitan Health, Aspen Phamacare and SA Business Coalition on Health and Aids, recently hosted a roundtable discussion on Pre-Exposure Prophylaxis (PrEP) which was aimed at exploring the opportunity to improve health outcomes in the prevention of HIV. PrEP is a preventative measure taken orally and used against possible new HIV infection.
Opening up the discussion, Dr Eric Hefer said PrEP was another big step in the fight against HIV.
He highlighted that at the end of last year, the Medicines Control Council (MCC) of South Africa approved a second label indication for Truvada (in tablet form) for the indication of PrEp. According to Hefer, the second approval indication is set to reduce the risk of adults, particularly those belonging to vulnerable groups, from getting HIV. Those vulnerable groups have been named as men who have sex with men (MSM), sex workers, adolescent females and couples where one partner is HIV-positive and the other is negative.
Hefer did, however, emphasise that prophylaxis and Travuda are to be used in combination with safe sex practices and rigorous use at all times in preventing infections.
Stavros Nicolaou, senior executive at Aspen Pharmacare said, “This is one of the most exciting announcements in the field of HIV in over a decade and paves the way for our country to take a major step towards the World Health Organisation’s (WHO) goal of achieving 20 million people on treatment by 2020 and an Aids-free generation by 2030.”
Nicolaou added that although this was a significant breakthrough, the modalities of how to expand access, particularly to targeted vulnerable groups remains to be worked out.
“The private and corporate sectors in South Africa are important sectors in broadening HIV coverage. We call on private medical funders in the country to begin covering patients for PrEP, which will not only materially improve the mortality and morbidity rates of our country, but will also provide long-term healthcare cost savings,” Nicolaou stated.
He also mentioned that the initial price of Truvada was R550 but they have managed to drop it to R480.
Dr Francesca Conradie, president of the Southern African HIV Clinicians Society and clinical research advisor at The Wits Health Consortium said the clinicians society welcomes the addition of Pre-Exposure Prophylaxis as part of HIV prevention.
“While we have a number of strategies to prevent HIV infection including condom usage and voluntary male medical circumcision, there are still unacceptably high rates of infections occurring every day. The use of two medications Tenofovir and FTC as a fixed dose combination has been shown to be effective as HIV prevention,” explained Conradie.
She, however, highlighted that there is little training on PrEP available to healthcare workers. “As the society, we have collaborated with key opinion leaders to draft an accredited training curriculum including sensitisation of healthcare workers and training on the approved guidelines with case studies to reinforce learning objectives. This will equip healthcare workers of all cadres to safely use another modality to reduce HIV infection rates.”
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