Africa: South Africa Delays Rollout of New Blockbuster HIV Drug

Dolutegravir, a drug previously feared to cause deformities in unborn children, is now the preferred HIV treatment option, even among women of reproductive age.

Stocks of the new treatment are already on the shelves of some clinics -- but lingering concerns over a possible low risk of birth defects associated with this new antiretroviral have stalled the country's switch to better medication for a second time.

The national health department has been forced to postpone a nationwide rollout of the latest blockbuster HIV treatment amid persistent concerns about what may be a low risk of birth defects linked to the drug's use. This is despite the World Health Organisation (WHO) greenlighting the drug for use globally in July.

The medication, known as dolutegravir, was set to be introduced in September as part of a new three-in-one pill that would combine the relatively new antiretroviral (ARV) with two more commonly used ARVs, tenofovir and emtricitabine.

Most South Africans on HIV treatment already use these two drugs alongside a third called efavirenz. But a 2019 research review by the WHO found that dolutegravir was better than efavirenz at dropping the level of HIV in people's blood down to very low levels -- also known as being virally suppressed. It was also more forgiving of skipped doses, reducing patients' risk of developing drug resistance.

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