Kisii — The use of Pre-exposure Prophylasix (PrEP) has expanded significantly over the past few years contributing to reduction of new HIV infections.
A vital tools in HIV prevention, particularly for the high-risk populations, PrEP has seen significant uptake among sex workers in Africa.
Achieng *, an online sex worker based in Kisumu, started using PrEP after her partner tested positive to HIV when she accompanied him for medical treatment.
Achieng says she resorted to sex trade, considered an offense against morality in Kenya under Sections 153 and 154 of the Penal Code, after her long-distance relationship broke apart over infidelity concerns.
"This broke my heart, I didn't know what to do, he cheated on me and contracted the virus, my tests came out negative and I was also put on PrEP," says Achieng.
"I started using PrEP to prevent myself from contracting HIV since I serve so many people whom I don't know their HIV status," she says.
Lenacapavir treatment
Felix Mogaka, a clinical scientist at Kenya Medical Research Institute (KEMRI), says lenacapavir treatment, an investigational drug to prevent HIV infection, presents effective outcomes given clinical trials conducted in Uganda and South Africa, showed 100 per cent effectiveness in preventing new HIV infections.
"Lenacapavir is more effective compared to the current HIV products such as oral prEP," he notes.
Mogaka however signles out accessibility of lenacapavir as a key concern requiring urgent attention.
Speaking to Journalists in Kisumu during a Media for Environment, Science, Health and Agriculture (MESHA) science café, Mogaka called Gilead to prioritize eastern and southern African countries which accounts for more than 80 per cent of all new HIV infections.
He noted that for most African countries being lower and middile income, acces to the treatment remains a challenge.
"We believe that the two African countries where trials were conducted will have an extended access to this treatment by virtue of their participation," said Mogaka.
He asked Gilead, an American biopharmaceutical behind antiviral drugs including ledipasvir, to work with generic medicine producers, organizations and the government to enhance access.
"This is not the only long acting prEP formulation that is out there, we have the eight weekly injection that has [been] approved for a number of years now but it's not accessible in Kenya and other African countries," said Mogaka .
He noted the key question is when Africa will have access to this treatment.
Innovative approaches
Jared Baeten, Gilead's Senior Vice President, Clinical Development Virology Therapeutic Area Head, told the media roundtable that the biopharmaceutical recognizes the need for innovative approaches in addressing the diverse needs of individuals and communities affected by HIV.
He highlighted Gilead's role in HIV treatment efforts, offering a range of antiretroviral therapies (ART) that have significantly improved the quality of life for people living with HIV.
"Our dedication to transform innovation in HIV treatment goes beyond the laboratory, we believe in collaborating at the global, National and local levels in bridging the gaps of HIV awareness and improving linkage to and retention in care," he said.
Beaten said there is ongoing work in laying strategies in different countries depending on their economic situation and HIV incidents to put in place favourable pricing regimes.
He did not however reveal which camapanies, in any, and countries Gilead will consider for licensing.
Steep price
HIV activists at the conference demanded affordable pricing of lenacapavir treatment noting that lower and middle income countries which account for about 85 per cent of HIV infections.
Most new HIV infections and AIDS-related deaths occur in lower- and middle-income countries, particularly in sub-Saharan Africa, according to UNAIDS.
"Lenacapavir treatment is a life changer in some populations, we need to see this treatment produced generically and supplied to all low and middle income countries to the people who need it," said Dr. Helen Bygrave, chronic disease advisor for MSF.
UNAIDS has called Gilead to open the access of the twice-yearly injectable Lenacapavir treatment to lower- and middle-income countries to bolster a campaign to end the HIV pandemic by 2030.
At the 2024 International AIDS Conference, UNAIDS Executive Director Winnie Byanyima emphasised that Gilead has a long injectable miracle preventive lenacapavir tool.
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Generic manufacturers
Byanyime asked Gilead to license generic manufacturers to produce the treatment and make it more affordable.
"This will transform access for gay men, transgender people, for sex workers and young women in Africa who could [be] free from stigma and fear of [being] attacked for just [being seen] swallowing tablets," said Byanyime.
She expressed concern of the lenacapavir pricing "only for rich countries" an inequity she said will not help a global response to end pandemic.
Byanyime noted lenacapavir treatment costs up to $40,000 per person per year in the US, a figure that remains too expensive for people in the lower- and middle-income countries in Africa, Asia and Latin America to afford.
"We want Gilead to make this happen now, not in six years' time. Don't limit this miracle product to a few producers," the UNAIDS boss said adding that steep prices exclude millions from treatment.
She asked the manufacturer to grant the generic licensing through the UN and make the generic available to all in Africa, Asia and Latin America.
