South Africa’s savings in procurement of antiretroviral drugs to increase access to treatment for people living with HIV

Published on 30 Nov 2012 View Original

South Africa has, for the second time in a row, reduced the cost of procurement of antiretrovirals (ARVs) as announced by South African Minister of Health, Dr Aaron Motsoaledi on 29 November. ‘As far as we are concerned, South Africa has become the lowest price setter for ARVs in the world’, said Dr Motsoaledi to an excited audience at a packed press conference. The new agreed prices will save an additional US$250 million approximately.

Earlier in 2010, South Africa reduced for the first time the prices of the ARVs purchased following a change in its procurement approach. Since 2010, the National Department of Health has managed to reduce expenditure of ARVs by 53%. This translates to an estimated saving of US$ 685 million over a two-year period from 2011 to 2012.

‘What this essentially means is that more people in South Africa will have access to life-saving ARVs while keeping expenditure at its lowest. It is wonderful news’, said Dr Catherine Sozi, UNAIDS Country Coordinator in South Africa.

In addition, the Minister of Health announced that the new tender will be for fixed-dose combination ARVs—meaning that people who take ARVs will only have to take one pill once a day instead of three pills twice a day. The simplification of the regimen translates into fewer pills, fewer times a day and fewer side effects and will have a significant impact on the quality of lives of people living with HIV in South Africa. The triple fixed-dose ARV will be a combination of tenofovir, emtricitabine and efavirenz.

Local manufacturers in South Africa have been awarded 70% of the tender. ‘I am sure suppliers will understand that [the negotiations] are in the best interests of patients’, said Dr Motsoaledi. ‘We are now able to treat more patients with the same budget’.

Fixed-dose combination to all pregnant women

The Minister of Health also announced that all pregnant women in South Africa will receive fixed-dose combination during pregnancy and breastfeeding regardless of their CD4 count. If their CD4 count is below 350 antiretroviral therapy will be life-long.

South Africa has already achieved a significant drop in the rate of mother-to-child transmission (MTCT) of HIV in the last year—from 3.5% in 2010 to 2.7% at six weeks in 2011. With the introduction of fixed-dose combination it is expected that the rate will drop even further and make a difference during the breastfeeding period, which is where most new infections among children currently occur.

All of the changes announced yesterday will be effective from 1 April 2013.