UGANDA—The Joint Clinical Research Centre (JCRC) has revealed its plans to launch a clinical trial utilizing injectable anti-retroviral medications (ARVs) to combat the HIV epidemic in Uganda.

This disclosure was made on the sidelines of the JCRC 15th Annual HIV Update meeting, which was hosted in the Mestil Hotel in Kampala with the goal of revealing significant advances in HIV research and care.

Dr. Cissy Kityo, the executive director of the JCRC, and Dr. Jane Ruth Aceng, the Health Minister, among others, attended the meeting.

JCRC is a government entity owned by the Ministry of Health, the Uganda People’s Defence Force, and Makerere University, and its function is to conduct HIV research.

According to the Uganda AIDS Commission (UAC), there were over 51,000 new HIV infections and over 17000 fatalities in Uganda in FY2022/2023.

UAC further stated that ARV adherence is a vital step in lowering fatalities and transmission, with a rate of 73 percent, down from 96 percent in FY2020/2021.

According to UAC, persons who use their prescription have good viral load suppression, which lowers the danger of mortality and also lowers the chance of transmission during sexual intercourse.

Dr. Aceng stated during the meeting that, while the country has made tremendous progress in the fight against HIV, adherence to medicine remains an issue, prompting a study into the use of long-acting anti-retroviral therapy (ART) drugs.

The latest development comes as the UAC waits for the National Drug Authority to approve the long-acting cabotegravir, which is intended to prevent HIV infection.

Cabotegravir is manufactured under the patent of ViiV Healthcare, a cooperation of pharmaceutical companies Pfizer, GlaxoSmithKline, and Shionogi based in the United Kingdom.

According to Dr. Kityo, injectable ARV medicine cabotegravir is administered once every two months along with another injectable drug, rilpivirine.

So far, cabotegravir has also been approved by the Ministry of Health in Uganda for use alone in the prevention of HIV infection.

According to Dr. Kityo, using CABOTEGRAVIR and RILPIVIRINE (CAB and RPV) instead of tablets every day will minimize fatigue and improve adherence.

She also revealed that there is an ongoing study in Uganda, Kenya, and South Africa, the first of its kind in Africa, that is being organized by the JCRC to examine injectable ARVs on the African continent.

The CAB and RPV experiment involve 512 participants from three countries and will be finished in 12 months, in August 2023. After another year, the results will be presented at an international meeting.

She also noted that, in conjunction with Baylor Uganda, JCRC is currently evaluating long-acting ARVs in adolescents aged 12 to 19, that participants would be observed for 24 months, and that studies on Sunlenca will begin in 2024. 

She also stated that by employing these treatments to address low medication adherence and reduce the fear of taking pills, Uganda will be moving closer to its goal of eliminating AIDS as a public health problem by 2030.

She concluded by mentioning that the Food and Drug Administration (FDA) in the United States has approved Sunlenca (lenacapavir), a novel antiretroviral drug for adults with human immunodeficiency virus type 1 (HIV-1).

Sunlenca is administered as a subcutaneous (under the skin) injection once every six months, providing for convenient dosing for patients whose HIV infections cannot be adequately treated with other current treatments due to resistance, intolerance, or safety concerns.

Aside from Uganda, nations such as Zimbabwe are using ART, with the WHO announcing that the Medicines Council Authority of Zimbabwe approved the use of long-acting injectable cabotegravir as an HIV pre-exposure prophylaxis (PrEP) in November 2022.

With the long-lasting injectable cabotegravir being proven by UAC to be an effective, safe, and user-friendly disease preventive strategy compared to other existing choices, UAC is hoping that it can lower the health burden of HIV/AIDS, which claimed 17000 lives in 2022.

According to Dr. Daniel Byamukama, the UAC’s head of HIV prevention section, the medicine will be available in January 2024, with orders placed through the Global Fund for injectable PrEP. The Global Fund is used to purchase injectable PrEP for HIV/AIDS, malaria, and tuberculosis.

With all national approvals in place by the end of 2023, injectable PrEP will be offered for free to both men and women.

Furthermore, the drug will aid in the reduction of the HIV/AIDS epidemic, which disproportionately affects women, who confront cultural sensitivity around sexual matters in socially conservative societies.

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