New anti-HIV injection could be gamechanger for South Africa

A woman dances as she listens to music while attending a World AIDS Day commemoration at Nkosi's Haven in Johannesburg on Nov. 30, 2019, on the eve of World AIDS Day. [AP Photo]

There is potentially good news this World AIDS Day (Dec. 1), with a new injection that prevents the development of HIV showing excellent results in trials. There are still some obstacles to its further rollout in South Africa however.

South Africa has one of the highest rates of HIV in the world, with over seven million people living with the virus.

While the country has made significant strides in terms of treatment, with millions of people on anti-retroviral medication, there were still about 160,000 new infections last year, according to U.N. data.

A new injectable drug, known as pre-exposure prophylaxis (PrEP), offers protection for people at high risk of getting infected. Unlike the already available oral PrEP - which must be taken daily -- the shot is only given every two months.

Linda-Gail Bekker, CEO of the Desmond Tutu HIV Foundation, says a study of its use in women in Africa showed an 89 percent reduction in HIV infections in users of injectable PrEP compared to oral PrEP.

It could be a game-changer for women at risk of contracting HIV, which causes AIDS, because it puts prevention in the hands of the user. Young women can take it discreetly, without asking their partner to do anything.

"When the injectable PrEP was compared with oral PrEP it was found to be far superior in its ability to protect women against HIV acquisition. ... It is very exciting to have these less frequently dosed, long-acting agents for people who struggle to take treatment daily," said Bekker.

The drug, Cabotegravir long-acting (CAB LA), has been approved for use in South Africa. While widely available in the United States and Europe, the injectable is still pricy, reportedly costing several thousand dollars a shot.

"So we've got two problems in terms of access, the one is just a limited manufacturing capability and the second is the affordability of this product -- the price we believe is going to have to come down quite markedly for most low and middle income countries to be able to afford it," said Bekker.

Fortunately, the company producing it has shared the license with the Medicine Patents Pool, a U.N.-backed public health organization, and granted licenses to three more companies to produce generic versions of the drug.

Thuli, a transgender woman living in Cape Town who did not want to give her full name, took part in one of the early trials in South Africa -- and those participants can continue accessing it.

She said she preferred the injection to the pill.

"I love, I love, I love. I feel that the CAB-LA is good for me and it's been working so good.... I feel like just the pills is a lot of work for me, since I'm taking the hormones as well," said Thuli.

Dr. John Nkengasong, U.S. Global AIDS Coordinator, told VOA the United States is working with the South African government to introduce CAB-LA.

"We find ourselves at an important point in the fight against HIV, where science continues to evolve, innovation continues to bring new tools into the market, and the long-acting PrEP injectables are just one such example," said Nkengasong.

Following the first trials and the drug's approval for use in South Africa, several pilot projects were supposed to be rolled out this year.

Those were delayed but are now expected to get underway in early 2024, Bekker says.