HIV wonder drug dolutegravir to be rolled-out in Kenya
UNITAID partners to bring newer and more effective HIV treatment options to countries where they are needed most.
Kenya is to become the first African country to provide a generic version of the antiretroviral drug (ARV), dolutegravir (DTG), for routine use among people living with HIV. From the integrase inhibitor (INI) drug class, dolutegravir is widely lauded as superior to all other third agents used in first-line therapy.
HIV treatment regimens normally consist of two nucleoside reverse-transcriptase inhibitor (NRTIs), usually tenofovir and either lamivudine or emtricitabine, plus what is called a ‘third agent’ – either a non-nucleoside reverse-transcriptase inhibitors (NNRTIs), a boosted protease inhibitor (bPI), or an INI.
As dolutegravir is a newer drug, high costs mean it is largely unavailable across low- and middle-income countries, and without innovative partnerships, it will remain so. For example, thanks to a deal brokered between the government of Botswana and ViiV Healthcare, the pharmaceutical company who developed dolutegravir, non-generic dolutegravir (Tivicay) has already been available as part of the national health programme in Botswana for just over a year.
With help from UNITAID, the Government of Kenya will provide generic dolutegravir in the first instance to 27,000 people living with HIV who are unable to tolerate the side effects of efavirenz – the most common third agent used in first-line therapy in Kenya.
The initiative will expand to include all people newly starting treatment by the end of the year. There are currently 1.5 million people living with HIV in Kenya, and just over a million are on treatment.
“New regimens including DTG offer great potential for better and less costly HIV treatment,” said Lelio Marmora, Unitaid Executive Director. “Through this catalytic work, we are significantly reducing the time it takes for people living with HIV in countries like Kenya to access the latest ARVs on the market. These are important developments as we move towards HIV treatment for all in need.”
Several clinical trials have shown dolutegravir to be highly effective, if not superior to most other drugs, as well as having a very high drug resistance profile. It is also highly tolerable compared to many other drugs, particularly efavirenz, on which many people experience psychiatric problems that affects their adherence.
UNITAID will also be rolling-out the initaitve in Uganda and Nigeria, and working towards providing a fixed-dose combination (FDC) pill containing tenofovir, lamivudine and dolutegravir, which will further promote adherence.