
More than a million South Africans are now on antiretroviral drugs
The Treatment Action Campaign and Section 27 today congratulated Health Minister Dr Aaron Motsoaledi and his team for securing antiretroviral drugs for South Africa at the best global prices for the next two years.
“It is my pleasure to announce the massive reduction in the prices of antiretroviral drugs which has resulted in the 53,1% reduction in the cost of the total tender which translates to a R4,7 billion savings,” Motsoaledi said yesterday.
Section 27 activist Jonathan Berger responded today: “This is in stark contrast to the previous tender, which resulted in South Africa paying significantly more than necessary for ARV medicines.
“For example, South Africa will now be paying – on average – about R115 per patient per month for the standard triple combination of tenofovir (TDF), lamivudine (3TC) and efavirenz (EFV). Under the previous tender, the country committed to pay about R110 for EFV alone – just a few rands less for only one drug.”
Remember the dark days when TAC fought the government on issues like access to antiretrovirals? South Africa has come a long way since then and Motsoaledi is leading from the front.
While welcoming the antiretroviral tender gains, TAC and Section 27 still raise the following concerns:
* First, the rules under which the tender was conducted do not make provision for price reductions in the event that input costs (such as the costs of active pharmaceutical ingredients) decline.
* Second, as was the case with the 2008 ARV tender, the published documents do not explain how the points awarded to winning bidders were allocated.
* Third, the 2010 tender did not include any TDF-containing three-in-one fixed dose combinations (FDCs). We believe that the DoH should continue to strive to include such FDCs in future procurement processes, as their use will greatly improve patient adherence.
* Fourth, the extent to which the DoH was able to take control of the tender process remains unclear – in our view, the National Treasury appears to have retained undue influence.
Dr Abdool Karim explains how to use an applicator with gel
The gel offers moderate protection to women against HIV – reducing a woman’s risk of getting HIV during sex by 39%.
But among women with high adherence (80% or more) the efficacy was 54%.
It also provided 51% protection against genital herpes infections.
This is the first tool of HIV prevention that is within the control of women.
This is also the first positive result from a microbicide trial, after 11 trials testing six candidates in the past showed no effect.
It’s a day to celebrate since the results show prevention research is moving in the right direction.
Principal investigators, Dr Quarraisha Abdool Karim, Professor Salim Abdool Karim, their team and the 889 female volunteers, have given the microbicide field a major boost.
But the study, which is a proof of concept trial, needs to be repeated to scale to get independent confirmation of these results.
They are being presented at 1pm today at the XVIII International AIDS Conference in Vienna, Austria by the Centre for the AIDS Programme of Research in South Africa (CAPRISA).

Injecting drug users are not the only focus of the AIDS Conference in Vienna next week.
One of the priorities for African delegates will be the release of the results of the CAPRISA 004 microbicide trial next Tuesday, 20 July at 1pm.
This randomised controlled trial in South Africa tested the safety and efficacy of a 1% tenofovir-gel candidate, the first to use an antiretroviral to block infection.
The gel was tested among some 900 volunteers in CAPRISA’s rural Vulindlela site and urban Thekwini site.
Scientists and activists – particularly in the field of HIV prevention – are waiting in suspense to find out if this gel works.
None of the six candidates tested in 11 trials over the past 15 years has been successful yet.
The Global Campaign for Microbicides and Treatment Action Campaign have already organised a satellite session at the conference on the implications of the outcome.