South Africa to start producing an affordable version of the HIV-prevention drug prophylaxis

South Africa is set to manufacture an affordable and generic version of the long-acting HIV-prevention drug, cabotegravir (CAB-LA), for the first time, according to a report by The Guardian. Currently, less than 40% of medicines are produced on the continent, as production is concentrated in 38 countries.

The generic version of cabotegravir is a breakthrough as it significantly reduces the risk of HIV transmission through sexual intercourse and is more cost-effective than the branded drug. By blocking the virus from entering cells, cabotegravir has shown to be more effective than daily HIV-prevention pills available in many parts of Africa.

The branded version of CAB-LA is priced at around $3,500 per injection in the US, but it is sold at a lower price to nearly 90 countries, including South Africa. However, the cost is still too high for the South African government to afford. The injection needs to be administered every two months, following World Health Organization (WHO) guidelines.

To address this issue, Cipla, an Indian drug company, has confirmed that it will produce the generic version of cabotegravir at its plants in Benoni and Durban, potentially providing access to millions of people at risk of HIV infection in Africa.

In March, ViiV Healthcare and the United Nations-backed Medicine Patent Pool (MPP) granted licenses to three companies, including Cipla, to produce CAB-LA. The other two companies, Aurobindo and Viatris, are also Indian pharmaceutical companies involved in HIV treatment. The manufacturing technology shared by ViiV typically takes at least five years for a product to reach the market.

ViiV currently holds the patent for CAB-LA in South Africa until 2031, meaning that without the licenses granted to generic alternatives, there would be no competition for the next eight years. This move to produce generic cabotegravir can address disparities that became evident during the COVID-19 pandemic when Africa struggled to secure enough vaccine doses while Western countries had already obtained substantial supplies.

The campaign led by India and South Africa at the World Trade Organization (WTO) to waive intellectual property rights on COVID-19 vaccines, medicines, and tests highlighted the need to mitigate medicine shortages. Intellectual property deals, such as the one facilitated by the MPP, can contribute to alleviating such shortages and ensuring access to essential medications.