South Africa will start rolling out cheaper and more effective antiretrovirals tomorrow on World AIDS Day. The country is home to the world's largest number of people living with HIV/AIDS.
The drugs, known as TLD, are a departure from the commonly used TLE. TLE600, a fixed-dose, once-daily medication with a 600mg dose of tenofovir disoproxil fumarate, lamivudine and efavirenz, is currently the standard of care for most HIV treatment programs in low- and middle-income countries. TLD contains dolutegravir instead of efavirenz and is already the HIV medication of choice in high-income countries like the United States.
Due to TLD's improved tolerability and higher resistance barrier, efforts are underway to get the drug out to low- and middle- income countries through programs such as the US's PEPFAR (President's Emergency Plan for AIDS Relief). Dolutegravir is the preferred first-line and second-line treatment recommended by the World Health Organisation and the drugs have already been introduced in several African countries including Kenya and Botswana.
South Africa's health department hailed the drugs as "the fastest way to reduce HIV viral load". Unitaid's director of operations Robert Matiru said the new TLD drug "is highly effective and has much more rapid viral suppression" than the current treatment regime. "It has fewer side effects in general and is much more resilient... and also is even cheaper," he told AFP.
TLD, which is available in generic form, will start at a price of $75 per person per year and could drop lower, according to Unitaid.