Rwanda should consider manufacturing ARVs since they are a lifelong treatment for patients, yet there is no guarantee that foreign partners will continue providing them to the country "forever", Hind Hassan, the UNAIDS Representative to Rwanda, told The New Times.
Rwanda depends on external resources to treat more than 220,000 people living with HIV in the country. The medication is manufactured in foreign countries and provided to Rwanda via an arrangement that is mainly financed through the Global Fund or the US President's Emergency Plan for AIDS Relief (PEPFAR).
"This is a lifelong treatment and we don't expect that external resources will continue forever. So, the government needs to see how it can take over that component because it is a government responsibility to ensure that there is no disruption to this treatment," Hassan said.
"The government needs to try to see how to mobilise local resources. One of the ways of doing so is by having local manufacturing of ARVs. This has two benefits, one is that the ARVs will be provided at less cost because they are produced locally. Secondly, the local private sector will be expanding in terms of manufacturing and will pump more money and resources into the economy," she added.
According to the Rwanda Population-Based HIV Impact Assessment (RPHIA), a national household-based survey conducted between October 2018 and March, the prevalence of HIV among adults in Rwanda was 3.0 per cent.
A report released by UNAIDS mid 2023 recognised Rwanda among countries that have effectively managed the HIV/AIDS epidemic, having made significant milestones in terms of treatment, testing, and raising awareness.
Along with Botswana, Eswatini, and Tanzania, Rwanda successfully met the "95-95-95" target set by UNAIDS.
The target entails ensuring that 95 per cent of individuals living with HIV in a country are aware of their status, 95 per cent of those aware of their HIV-positive status are receiving antiretroviral treatment, and 95 per cent of people on treatment have achieved viral suppression.
Speaking to The New Times, Muhammed Semakula, the Head of the Department of Planning, Monitoring and Evaluation, and Health Financing at the Ministry of Health (MoH), said the current policy of the government is promoting pharmaceutical companies and a lot has been done in terms of preparing the stage, enabling the investors to come to Rwanda.
"We have seen BioNTech come in for vaccine production. We are also seeing a lot of interest from investors to start manufacturing medicine. Some of them want to go into medical equipment (manufacturing)," he said.
Donald Kaberuka, a Rwandan economist and former president of the African Development Bank, urged Africa to make efforts to manufacture medicine and medical equipment, but noted that he is not unaware of the complex nature of the problem, for example in terms of the investments needed, both local and foreign.
"I am not unaware of the complications around the regulatory systems, safety and the realities of the markets," he said.
"All I am saying is, we have little choice. On this, there is a conversation to be heard across the spectrum of governments, business, philanthropies and international organisations like the Global Fund, GAVI, and others. It is an important conversation, as we have started here in Rwanda in terms of vaccine manufacturing," he added.