Cape Town/Johannesburg — Médecins Sans Frontières/Doctors Without Borders (MSF) welcomes the inclusion of Fixed Dose Combination (FDC) formulations of antiretroviral (ARV) drugs in the national 2012-2014 ARV supply tender, as announced by the South African Department of Health today.
"The inclusion of FDCs is good news for the 1.7 million people currently on ARVs in South Africa, because they now finally have access to simpler and improved treatment options – which significantly cuts down their daily pill burden from 3-5 pills down to just one," says Dr Gilles Van Cutsem, MSF's medical coordinator in South Africa and Lesotho.
"Rolling out drugs in FDC formulations will have significantly positive implications to help keep patients adherent to their life-long treatment."
Simplifying the first line treatment regimen allows for the roll-out of community based interventions such as ART adherence clubs like those in the Western Cape, and for the considering a change in the prevention-of-mother-to-child-transmission policy to PMTCT Options B or B+.
South Africa has committed to the ambitious target of including 3 million people in antiretroviral therapy (ART) by 2015. If this is to be achieved, expanding access must be complimented with health systems running more efficiently and services geared toward to supporting and retaining people on ARV care that ensures treatment adherence.
FDC formulations not only benefit patients but also relieve the burden on the South African health system by simplifying the ordering and monitoring of ARV stocks. With fewer pills to pack, transport and dispense cost reductions are also possible.
"This is an important step in the right direction for South Africa by joining neighbouring states in Southern Africa in a move to simplify and harmonise treatment regimens in a region where the burden of HIV is the highest in the world," Van Cutsem concludes.
In response to newly released UNAIDS figures on the global HIV epidemic, please find the following statement from MSF:
"It's encouraging to see the number of new child infections declining as a result of more pregnant women having access to HIV treatment in 2011, compared to the year before. Still just over half of pregnant women with HIV in developing countries get treatment which is unacceptable, considering it can prevent their babies from acquiring the virus, while also keeping the mothers themselves healthy.
Too many pregnant women do not receive HIV treatment when they need it, and too many countries still lag behind, providing sub-optimal care with less effective drug regimens. In 2013, we hope to see more countries upgrade their policies to scale up life-long treatment earlier to all pregnant women living with HIV. Treatment for HIV positive pregnant women has multiple benefits, including protecting the mother's health, greatly reducing risk of transmission to her babies, and reducing the risk of transmission to her sexual partner. Some countries where we work are already rolling out improved strategies to reduce mother-to-child transmission of HIV.
Scaling up HIV treatment to 15 million people from eight million today is feasible and has the crucial triple benefit of reducing illness, reducing death, and reducing the risk of transmission. The pace of scale-up needs to be increased, so that every month more people are started on life-saving HIV treatment than the month before. Better treatment strategies such as starting people on treatment even earlier in their disease progression, in addition to providing all HIV-positive pregnant women with HIV treatment for life, are among the strategies that we expect more countries to start implementing next year." - Dr.
Manica Balasegaram, Executive Director, Médecins Sans Frontières / Doctors Without Borders (MSF) Access Campaign.