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Uganda will soon be having access to the drug Cabotegravir (CAB-LA). It is hoped that this will fundamentally boost the country’s fight against the scourge of HIV and AIDS.

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In July 2022, the World Health Organization (WHO) published new guidelines recommending Cabotegravir (CAB-LA) to be offered as an additional option in HIV prevention to groups with significant risk to infection.

What is CAB-LA?

CAB-LA is a long-acting injectable pre-exposure prophylaxis (PrEP) HIV medicine that has shown significant levels of safety and efficacy in prevention of HIV transmission.

In fact, 2 studies showed that the drug resulted in a 79% relative reduction in HIV risk compared with oral PrEP medication. This was largely attributed to the convenience in administration that enhances adherence through limiting stigma.

Initially, CAB-LA is administered twice in a space of 4 weeks and thereafter once every 8 weeks.

The drug is patented by ViiV Healthcare, an institution born out of a partnership of drug powerhouses GSK, Pfizer and Shionogi- a pharmaceutical company from Japan.

Late last year, Zimbabwe, through their regulatory body (Medicines Control Authority of Zimbabwe) became the first country in Africa to approve CAB-LA for use in its territory. Setting the pace for the rest of a continent that has more than 25 million people living with the virus.

Uganda is set to follow suit and have the drug available to its approximately 1.4 million citizens living with the virus.

What was said?

Dr Daniel Byamukama, head of the HIV prevention division at the Uganda Aids Commission (UAC) stated that there were plans to roll out the drug at the onset of January 2024.

“We have made orders using the Global Fund [HIV/Aids, Malaria and Tuberculosis] for injectable pre-exposure prophylaxis (PrEP). You take one injection every two months. If you are HIV negative you will not contract HIV,” said Dr Byamukama.

He further stated that the onus was on the National Drug Authority (medicines regulatory agency in Uganda) and other relevant institutions to expedite the necessary approvals.

“We are sure all the national approvals will be ready by the end of this year and that injectable PrEP will be available for countrymen and women, starting January next year. It will be completely free of charge.”

What’s more

According to UAC, women are more disproportionately affected by HIV compared to men and children. As at December 2022, approximately 60% of persons living with HIV in the country were women while men and children accounted for 35% and 5% respectively. The same report also estimates that 17,000 people die every year in the country due to HIV-related illness.

“Injectable PrEP has one advantage; that it is discreet. Most of the affected people are women. A woman carrying a box of oral PrEP pills is prone to violence from her partner. She is prone to being accused of promiscuity,” Dr Byamukama said.

“For an injectable, you walk into the pharmacy or the hospital, you get one injection once in two months. That is quite discreet. Your husband or partner will never know about it so the controlling behaviour of sexual partners that always stop women from accessing these services will be addressed,” he further stated.

“We are sure that after getting all necessary national approvals by end of this year, by January next year, people will have begun accessing for prevention. We are targeting all sexually active people who consider themselves at high risk. If you are married to a sex worker or your husband has multiple sexual partners; you are married to person who is HIV positive, and/or you are a sex worker…, it is safe and effective,” Dr Byamukama added.

Conclusion

More still needs to be done before the people of Uganda can benefit from CAB-LA. However, there is cause for cautious optimism in the nation that the drug will become a game changer in the fight against HIV in the country.

But, time will tell.

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