News24 | Why we don't have long-acting HIV treatment in South Africa

Though not available in South Africa, long-acting injectable HIV treatments exist. (Etactics Inc/Unsplash) Taking HIV treatment in SA means taking one or more antiretroviral tablets a day. People in some other countries have the option of two injections administered every two months.

Spotlight unpacks why long-acting HIV treatment is not available in SA. HIV prevention injections have recently been making headlines around the world, but there has been much less noise about antiretroviral injections to treat HIV. Though not available in South Africa, such long-acting injectable HIV treatments exist and are being used in some places.

There is a clear frontrunner in this field. Monthly injections of the antiretrovirals, cabotegravir and rilpivirine, for the treatment of HIV was approved by the United States Food and Drug Administration (FDA) in January 2021. A year later, this approval was expanded to allow for jabs to be administered only every second month.

The FDA has also approved six-monthly lenacapavir injections, but only for tough-to-treat HIV. Why no cabotegravir/rilpivirine in SA? As pointed out by Professor Francois Venter, the head of Ezintsha at Wits University, neither the combination of cabotegravir and rilpivirine nor rilpivirine injections on their own have been registered with the country's medicines regulator, the South African Health Products Regulatory Authority (Sahpra). Cabotegravir injections for use for HIV prevention have been approved by Sahpra, but su.