HIV Prevention News Around The Globe

Public Pharma vs. abusive prices: the case of the latest HIV-prevention drug

The high price tag on the HIV drug lenacapavir underscores the widespread dysfunction within Big Pharma

Lenacapavir, an injectable antiretroviral drug developed by Gilead Sciences, recently made headlines after a Phase 3 clinical trial in South Africa and Uganda showed it to be 100% effective in preventing HIV among cisgender women and adolescent girls. Though hailed as a breakthrough in HIV prevention, lenacapavir serves as a stark reminder of the problems with the pricing of life-saving medicines.

While further data from this study and results from studies involving other populations are needed, lenacapavir could be considered the most durable HIV prevention method to show efficacy among cisgender women—a population for whom biomedical HIV prevention evidence has been severely limited. Yet, this case highlights a broader, systemic problem within the pharmaceutical industry, which is dominated by large transnational corporations, commonly referred to as Big Pharma.

Although lenacapavir may not be the best option for everyone or in all settings, along with other long-acting pre-exposure prophylaxis (PrEP) formulations it could be crucial for people who face barriers to daily pill-taking. As a twice-annual injection, it could significantly improve the feasibility of PrEP for many people who could benefit from this new regimen.

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465 000 people living with HIV in the North West

The North West had the fifth highest HIV prevalence rate in the country at 12.3% in 2022, with HIV prevalence in the province at 20.8% among those aged 25 to 49 years old overall.

In addition, a large number of people living with HIV (PLHIV) in the province were women. This is according to the Human Sciences Research Council (HSRC), which released the key findings of the Sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI) for the North West on Monday. According to the overall principal investigator of the study, the HSRC’s Professor Khangelani Zuma, the survey showed that in 2022, HIV prevalence in the province was 20.8% among those aged 25 to 49 overall and more than two-fold higher (29.0%) among females than among males (13.4%).

Among adolescents and youth, HIV prevalence was 2.5-fold higher among females (8.3%) than among males (3.3%) of the same age. The survey revealed that the HIV prevalence peaked at 31.4% among those 40 to 44 years in 2022 compared to 36.8% among those 45 to 49 years in 2017. However, there was a decrease in HIV prevalence in 2022 among those aged 30 to 39 and 40 to 49. “Of great concern is the worsening situation among adolescents and youth, with HIV prevalence being worse or similar to that of 2017.

“The prevalence of HIV among adolescents 15 to 19 is higher (4.5%) in 2022 than in 2017 (3.2%), indicating continued infections among adolescents and youth,” Zuma noted. The data presented are for three priority districts in North West namely, Bojanala, Dr Kenneth Kaunda and Ngaka Modiri Molema, where oversampling was undertaken to enhance the precision of the HIV prevalence estimates. By district, in 2022, HIV prevalence among all ages was highest in Bojanala (15.4%), followed by Ngaka Modiri Molema (12.1%) and Dr Kenneth Kaunda (11.9%).

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Promising new approach to combat HIV

Researchers at Université de Montréal's affiliated hospital research center, the CRCHUM, say the discovery could help lessen and even eliminate viral loads in people undergoing antiretroviral therapy.

Metformin, a drug used to treat type 2 diabetes, could help deplete the viral reservoir and eliminate it entirely in people living with HIV who receive antiretroviral therapy, Canadian researchers say in a new study. In 2021, a team led by immunologist Petronela Ancuta of Université de Montréal's affiliated hospital research center, the CRCHUM, showed that metformin, when taken for three months, improved patients' immunity and reduced the chronic inflammation usually associated with complications such as cardiovascular disease.

Antibodies to the rescue

Another benefit of metformin is that it over-expresses the BST2 protein, which acts as a kind of glue to keep virions clinging to the surface of HIV-infected cells. The immune system then spots them and can target them with antibodies.

"Together with my colleague Andrés Finzi, we tested the ability of several broad-spectrum neutralizing anti-HIV antibodies to recognize viral reservoir cells after metformin exposure in vitro," said Ancuta. "Some of them recognized the virus very well, suggesting their ability to attract and trigger the destruction of infected cells by NK cells through a process of cellular cytotoxicity."

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Interactive health and HIV game app reaches more than 300 000 young people in Côte d’Ivoire

GENEVA, Switzerland, 09 September 2024 /African Media Agency (AMA)/- Four weeks before the African Cup of Nations football tournament kicked off it was down to the wire. José Fardon, a Côte d’Ivoire web designer and digital developer, had his whole team frantically working on a special edition of an interactive health and HIV game app, called “A l’Assaut du Sida”, ‘Tackling AIDS’ (AADS) to coincide with the tournament.

The UNAIDS team had secured funds for the latest rendition of the online game and had rallied UNICEF and the Global Fund to chip in. “We had launched various versions of the game in the past, but this required a different look and feel to gel with the sporting event,” said Mr Fardon, founder of SYL.

The success was beyond anyone’s expectations. The 20,000 tournament volunteers recruited by the Ministry of Youth not only played the online game themselves but they fanned out around the stadiums promoting the game by sharing the QR code with the hundreds of thousands of supporters. And with various prize giveaways during the tournament and afterwards, more and more people downloaded the app to play. Since mid-January 2024, AADS has reached nearly 200,000 adolescents and young people with the latest version reaching a lot of young boys and men (cumulatively, the three versions have reached almost 300 000 people.)

UNAIDS Country Director Henk Van Renterghem, like his predecessors before him, saw the value and potential of using digital technology to reach adolescents and young people. “General knowledge about HIV and overall comprehensive sexual education has decreased and young people are struggling with so many choices that this easy to download game is without a doubt relevant,” he said.

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Zeroing in on vaginal microbes that most increase HIV risk

Signature combination of BV bacteria and immune proteins associated with highest risk could help guide prevention. Nearly two-thirds of new HIV infections in sub-Saharan Africa occur in women, and a woman’s vaginal microbiome can influence her risk. In particular, an overgrowth of bacteria called bacterial vaginosis, or BV, raises HIV risk.

But not all BV-associated microbes raise HIV risk to the same degree. New work, published today in The Journal of Infectious Diseases, Fred Hutch Cancer Center scientists and a team of investigators from around the world report 14 BV-associated bacteria — and one immune protein — that put women at highest risk of HIV infection. “The findings have several implications, particularly for prevention,” said Fred Hutch microbiologist David Fredricks, MD, whose lab helped to generate the data used in the study. “These markers could be used in risk stratification, for identifying women at highest risk of acquiring HIV.” Once identified, these women could be guided to interventions, such as pre-exposure prophylaxis (PrEP) or antibiotic treatment, that may help reduce their HIV risk, he said.

While other studies have examined the relationship between the vaginal microbiome and HIV infection, the current work is one of the few studies to characterize the vaginal microbiome prior to detection of HIV. It’s also the largest study that assesses how both inflammatory markers and the makeup of the vaginal microbiome contribute to HIV risk.

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Opportunities

Call for Abstracts for the 4th International Conference on Public Health in Africa (CPHIA)

CPHIA is the largest annual public health gathering in Africa and the second largest globally after the World Health Assembly.

Key details

Submission deadline: Monday, 23 September 2024 by 23:59hrs EAT/20:59hrs UTC. No abstracts will be accepted past the official deadline.

Notification date: Applicants will be notified of acceptances by Friday, 18 October 2024.

Presentation: Accepted abstracts will be presented at the CPHIA 2024 conference in Rabat, Morocco, on 26 – 29 November.

You can read more about the guidelines and how to submit your abstract here

Call for expressions of interest to serve 2024-2026 United Nations WHO Youth Council (Fully-funded and open to youth worldwide)

The World Health Organization (WHO) is excited to announce the opening of the application process for the second term of the WHO Youth Council, scheduled to run from 2024 to 2026. This is a unique opportunity for organizations worldwide to contribute to global health initiatives by engaging in meaningful youth-focused discussions and activities. WHO invites eligible organizations to submit their expressions of interest and encourages all applicants to review the provided instructions and eligibility criteria carefully

We are asking all WHO Youth Council members to be a part of the WHO Civil Society Commission. If your organization is not yet a member, please submit your application here in addition to submitting your expression of interest for the WHO Youth Council.

Application process

Interested organizations are required to complete the online application form available at WHO Youth Council Application Form.