SA pharmaceutical manufacturers have called on the US President’s Emergency Plan for Aids Relief (Pepfar) to procure more HIV/Aids medicines from African producers, arguing this will boost the continent’s drugmaking capacity and provide protection against future health security threats.
Pepfar is the world’s biggest HIV/Aids donor and is credited with saving more than 25-million lives with the more than $110bn it has provided over the past two decades to the countries hardest hit by the disease, including SA. Though Sub-Saharan Africa is home to two-thirds of the world’s HIV/Aids burden, less than 1% of the $750m spent by Pepfar each year on HIV/Aids-related commodities goes to products sourced from Africa.
Local manufacturers are now calling on Pepfar to expand on a commitment it made in December 2022 to shift at least 2-million HIV/Aids patients on antiretroviral treatment to medicines made in Africa by 2030.
“We would like to build on the success of Gavi’s African Vaccine Manufacturing Accelerator, with incentives for African pharmaceutical manufacturers,” said Pharmaceuticals Made in SA (Pharmisa) chair Stavros Nicolaou. In an international vaccine initiative, Gavi announced a $1bn package in 2023 to support African vaccine manufacturers to build capacity and mitigate the risk of AU member nations being last in line when shots are in short supply, as they were during the Covid-19 pandemic.
African pharmaceutical manufacturers that might benefit from such support include JSE-listed Aspen Pharmacare and Adcock Ingram, as well as drugmakers in Nigeria, Ghana, Uganda, Tanzania and Kenya.
Potential mechanisms to support African companies making antiretroviral treatment included expedited approval by the US Food and Drug Administration, which scrutinises all medicines procured with Pepfar money, and direct financial support such as milestone payments, said Nicolaou.
US global aid co-ordinator John Nkengasong declined to be drawn on whether Pepfar was willing to pay a premium for HIV/Aids treatments produced in Africa, saying only that spending on health commodities should be considered as insurance against future health risks. Discussion on how best to support African pharmaceutical manufacturers should include other donor agencies, such as the Global Fund to Fight HIV/Aids, tuberculosis and malaria, and development finance institutions such as the African Development Bank and World Bank, he said. “Pepfar cannot go it alone,” he said in an interview with Business Day last week.
Pepfar had already taken steps to promote African manufacturers of HIV tests and plans to spend $20m on procuring 15-million HIV tests produced by African manufacturers in 2025, said Nkengasong. Growing the African manufacturing industry for HIV tests was an important platform on which to base the growth of the continent’s HIV/Aids drug makers, he said.
Nkengasong was in SA last week with a bipartisan US congressional delegation, and attended a series of events including a special session on the role of young people in ending HIV/Aids as a public health threat by 2030. On Friday, Pepfar announced a new $20m initiative to strengthen HIV/Aids programmes aimed at young people, including in SA.
Young people are a key target as they are at high risk of HIV infection, but generally have lower rates of undergoing life-saving treatment and are less virally suppressed compared to adults, said Nkengasong. “When we unpack the data, it tells you the rate of viral suppression among the age group 15 to 25 is about 60% of the population level in Tanzania, and 70% in Ethiopia,” he said.
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