Botswana rolls out first-line drug for all HIV patients

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An HIV drug first approved less than three years ago is being rolled out in Botswana as a core medicine to be administered to everyone diagnosed with HIV, whereas previously antiretroviral treatment (ART) was reserved for sicker patients.

Following the largest ever tender secured by GlaxoSmithKline‘s HIV business in Africa, reports Reuters. ViiV Healthcare, which is majority-owned by GSK, said it was the first time that Tivicay, or dolutegravir, was being made available as a first-line treatment as part of a national health programme in sub-Saharan Africa.

The report says campaign groups such as Medecins Sans Frontieres have been pushing for the new drug to be offered to people in developing countries since it was first approved in the US in 2013, as the drug is well tolerated and extremely effective.

UNAIDS representative Gang Sun said approximately 100,000 more people were expected to start on ART, beginning this month, due to its roll-out. US ambassador to Botswana Earl Miller said in the report it meant the country would avert more than 120,000 new HIV infections and 55,000 deaths over the next 15 years – the US government is supporting Botswana fight HIV, with the goal of controlling the epidemic in the country in the next three years.

The report says no financial details were given of the contract between ViiV and the Ministry of Health in Botswana, and a GSK spokesperson declined comment on price. The company has said in the past it would operate tiered pricing, with lower prices for poorer countries.

The World Health Organisation recommended the use of dolutegravir as alternative first-line HIV treatment late last year and Dominique Limet, ViiV’s CEO, said the Botswana deal would now accelerate access to the drug. “It will allow people living with HIV in Botswana to have access to dolutegravir as part of a national test and treat initiative, locally referred to as the ‘Treat All’ programme,” he said.

The medicine is a so-called integrase inhibitor, which prevents viral DNA from integrating into the genetic material of human immune cells. Pfizer and Shionogi also hold minority stakes in ViiV, the report says.

Full Reuters report

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