Slow-moving HIV pill prevention pill, Truvada to get a makeover


By Gatonye Gathura

Kenya is among three African countries to participate in a radical makeover of the slow-moving daily HIV prevention pill called Truvada.

Users of the pill, officially launched in Kenya, last year say its colour, size, packaging and daily frequency are all great put offs.

In response USAID has provided US$10 million for the development of a discreet drug delivery technology to be tried in Kenya, South Africa Uganda.

The project will develop a drug delivery parch than can be placed discreetly on the skin programmed to deliver a specific dose of Truvada into the blood stream.

Such a technology, called microarray patch, the Americans think will overcome some of the problems that have discouraged the uptake of the pill.

HIV experts say some Truvada users complain about the colour, size and even the rattling sound that the tablet makes when being taken out of its plastic container.

Dr Nelly Mugo of Kenya Medical Research Institute recently told the media that some users complain that people mistake them to be taking HIV treatment medication.

The pill, Dr Mugo a strong advocate of Truvada said has also been linked to the sex stimulant Viagra and another drug used for mental health because of their blue colour.

“We have had several meeting with the manufacturers on these concerns,” Dr Christine Ogolla, a programme director at the Elizabeth Glaser Aids Foundation told journalists in Nairobi recently.

A statement released last week by Queen’s University Belfast, UK, the lead agency in the new project says they will work mainly with women in the three countries to address the concerns.

“The patches will be a discreet, easy-to-use technology that contains tiny projections that painlessly penetrate the top layer of skin to deliver the drug,” says the university.

The patch, if it works will overcome the problem of colour, size and rattling while releasing the drug over several weeks or months instead of the current practice of swallowing the pill daily which is a cause for poor adherence.

Others in the project are the pharmaceutical companies ViiV Healthcare and LTS Lohmann Therapie-Systeme AG and the NGOs PATH and Population Council.

So far data shows only about 13,000 Kenyans have taken up the pill against a Ministry of Health five-year target of 500,000 users.

The main driver of Truvada, the US President’s Emergency Plan for Aids Relief targets at recruiting about 5,000 users in Kenya in 2018 and about 40,000 in the next few years.

Truvada is manufactured by the American pharmaceutical company Gilead Sciences which reported global sale revenues in excess of $10.2 billion from Truvada in 2014 to 2016.

The 2016 total sale revenue for Gilead, from all products, is reported at $30.39 billion or slightly more than Sh3 trillion.

Health experts are also grappling with the requirement that Truvada users be tested for kidney function at least three times annually which they say could be expensive and burdensome for the local health systems.

A study published earlier this month by among other Dr Mugo suggests that the frequency for kidney testing could be safely reduced to twice instead of three times annually.


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