IN a major boost to the fight against HIV and Aids, Zimbabwe has been selected as one of the 10 countries globally to roll out lenacapavir, which is described as one of the most promising new HIV prevention tools that have emerged, offering protection against the virus with just twice-yearly injections.
The ground-breaking intervention by the US President’s Emergency Plan for Aids Relief (PEPFAR), through an initiative by the Global Fund to Fight Aids, TB and Malaria, is expected to provide lenacapavir to up to two million people in countries with high burdens of HIV across the world.
The US embassy in Harare announced the development in a statement yesterday.
“For decades, we’ve fought to turn the tide against this epidemic and each day we get closer. Through a partnership with US-based @GileadSciences and @GlobalFund, we’re delivering lenacapavir, the first twice-yearly HIV prevention medicine,” the statement said.
“In a large-scale clinical trial more than 99% of people on lenacapavir remained HIV negative. While this has the potential to save millions of lives, here in Zimbabwe it represents a major step towards ending new infections.”
The embassy said by focusing on pregnant and breastfeeding women, the intervention was protecting the next generation.
“By strengthening healthcare systems, we’re empowering Zimbabwe to lead its own fight against HIV.
“And by making lenacapavir more affordable and accessible, no one is left behind,” the statement said.
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Gilead scientists have spent 17 years researching and developing what became lenacapavir.
Health and Child Care deputy minister Sleiman Kwidini yesterday applauded the development, adding that the rolling out of the drug would start next year.
“The medicines can be available maybe in a few weeks to come, but when a new thing comes in, we need to sensitise the people, we need to train people,” he said.
Kwidini said Zimbabwe would ride on its established structures and infrastructure for the successful roll out of the drug.
“We already have structures which have seen our people accessing ARVs [antiretroviral treatment].
“So this is another form of ARV which is given to the people who are negative to prevent new infections so I do not think there is any complication because our people are already accessing ARVs,” he said.
“ARVs are available in our clinics, in rural areas, even the hard to reach areas, people are receiving ARVs. So this is the same way in which we are going to be functioning.”
Meanwhile, Zimbabwe HIV/Aids Activists Union president Stanley Takaona yesterday applauded the development, expressing hope that the drugs will be readily available for beneficiaries.
“The drug is important for us because it is part of prevention and we consider prevention as treatment,” he said.
“But for us, it is the issue of the availability of lenacapavir. Are we going to have access to it? Is it going to be affordable?
“Affordability to the community, you know, ARVs were supported globally. They were free, dispensed free. This is also the same issue.
“If there is no clear point on the issue of its availability on free dispensation, there will also be a very big gap. But we are so excited we know it is part of HIV programming, but we want to remain watchful on how it is going to be dispensed.
Takaona also said relevant authorities should start disseminating information to communities on how they can access the drugs.
Public health economist Tendayi Chipango said the intervention should also be extended to other groups who are at high risk of HIV infection, including those often marginalised by political or cultural contexts.
“By looking beyond ‘political or cultural restraints’, aligning investments with the epidemiological profile and service delivery opportunities, not only will cost-effectiveness improve, but also accelerate reduction in new infections,” she said.
“In this way, targeted introduction of lenacapavir has the potential to both strengthen existing PMTCT [prevention of mother to child transmission] outcomes and expand protection for other key populations, ultimately moving Zimbabwe closer to its HIV epidemic control goals.
“This could serve us quite well if put to good use, that is within a comprehensive continuum of care.”
She said other groups that could be considered included the LGBTQI community and adolescents because of the cross-generational relationships in Zimbabwe.
“We should identify those who are sexually active and be forthcoming when it comes to providing such things and we will definitely benefit better from it in the future assuming they are also looking at partners just the way PrEP is used,” Chipango said.
Community Working Group on Health executive director Itai Rusike said the domestic health financing landscape required a full revitalisation and redesigning to address issues of sustainability in HIV and Aids programming.
“The overreliance on external partners is risky and unsustainable as donors can withdraw financial support anytime should their interests shift for one reason or other,” he said.
Rusike said lenacapavir needed to be incorporated into an integrated national programme.
“The lenacapavir becomes a very powerful tool for preventing new HIV infections, but not in isolation. It allows the country to strengthen its HIV and Aids arsenal,” he said.
“We still urge government to revitalise the PHC [Primary Health Care] for UHC [Universal Health Coverage], implement a comprehensive health reform with a NHI [National Health Insurance], so that the donors also put their resources where visible and lasting results can be achieved.”
