“In my community and through my advocacy work, it is clear that dolutegravir is able to change the lives of people living with HIV.”

George Kampango is Programme Officer (Research and Advocacy) at the Malawi Network of People Living with HIV and AIDS. Known as MANET+, the organisation is the national coordinating body for community-based support groups in Malawi and was founded in 1997 by a group of people living with HIV (PLHIV) who recognised the need to organise their activities to achieve greater impact on national HIV policies.

According to latest figures, there were 1,000.000 (980,000 – 1,100.000) people living with HIV in Malawi in 2017. The HIV prevalence rate among adults aged 15 to 49 is 9.6 percent. 39,000 people became newly infected with HIV in 2017 and there were 17,000 AIDS-related deaths, a decline of 50 percent since 2010. It is estimated that 71 percent of PLHIV have access to antiretroviral medicines[1].

Speaking to the impact of dolutegravir, (DTG), George says, “My country started transitioning to DTG in January 2019. What I see as the current issue is that of leaving behind women living with HIV of child bearing age. I think the women falling within that age bracket are being denied the right to a better treatment product. The treatment guidelines provide for men, women beyond 45 years of age and those on permanent contraception to have access to the DTG-based regimen, TLD (tenofovir/lamivudine/dolutegravir).

“I would readily recommend DTG to PLHIV because in my view, DTG satisfies the goals of an antiretroviral therapy. I am talking about maximising viral suppression and the risk of cross-resistance, minimising long term toxicity, maximising capacity of immune reconstitution, optimising overall clinical outcome and quality of life, but also minimising the overall cost of care, because DTG is affordable, due to the licences that have been negotiated.

“There is tremendous feedback from the people who speak highly of DTG as a drug that has insignificant side effects and, above all, is very friendly. As mentioned above, viral suppression is maximised, which shows that DTG is efficacious. That is why I said I would readily recommend its use because it optimises the quality of life.

“In my community and through my advocacy work, it is clear to me that DTG is able to change the lives of people living with HIV. They are able to perform just like any other Malawian, even those that consider themselves free from HIV. It is, therefore, important that the best products are made available to all that need them in this country. DTG and TLD should be available for all people.

“What I see as a challenge in the near future is what actions will be taken in the event that the World Health Organization (WHO) comes up with recommendations that will be based on the final results of the Botswana study[2], which has been the driving force in the development of the current treatment guidelines. The messaging stands out conspicuously as a challenge that we must all be prepared to face and address.”

From January 2012 to December 2018, MPP generic manufacturing partners have supplied 389,000 patient-years of DTG and TLD treatment in Malawi[3].

 

Notes:

[1] UNAIDS Malawi country fact sheet

[2] WHO – Clinical evidence of DTG use during pregnancy

[3] More sales have occurred through procurement agencies

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