The international initiative Unitaid announced on Friday 18 that it will fund the introduction in Brazil and South Africa of an innovative, “highly effective and long-lasting” injectable HIV preventive treatment.

The new long-acting pre-exposure prophylaxis (PrEP) treatment “could have a revolutionary impact, improving options and making HIV prevention a more viable option for more people,” said Unitaid spokesperson Herve Verhoosel at its headquarters in Switzerland.

The programme, Verhoosel explained, is particularly aimed at “adolescent girls and young women in South Africa, who are currently the first to be affected by HIV, and transgender people and men who have sex with men in Brazil, other highly affected segments of the population”.

Unitaid estimates that 30% of transgender people in Brazil are living with HIV, as well as 18% of men who have sex with men.

In sub-Saharan Africa, six out of seven new HIV infections among adolescents are among girls, and young women are twice as likely to be living with HIV as their male peers, according to the agency.

The new treatment is based on long-acting cabotegravir, developed by ViiV Healthcare, a consortium of British pharmaceutical company GlaxoSmithKline with US-based Pfizer and Japan’s Shionogi.

Last December, the US Food and Drug Administration (FDA) approved long-acting injectable cabotegravir as pre-exposure prophylaxis for adults and adolescents, which was welcomed by the Joint United Nations Programme on HIV/AIDS (UNAIDS).

The injectable version has been shown to be 70-90% more effective than daily oral PrEP, recalled Unitaid, an initiative hosted by the World Health Organization that promotes access to treatment for diseases such as AIDS, malaria and tuberculosis in developing countries in the South.

The new treatment requires only six injections a year, each of which works for two months, preventing the virus from replicating in the body, effectively reducing viral load.

Although existing oral drugs known as “oral PrEP” can prevent HIV in 99% of cases, uptake has been slow and targets for reducing new infections have been missed, according to Unitaid.

That is often because people with HIV fear stigma, discrimination, or intimate partner violence if they take the pill every day.

The first doses going to Brazil and South Africa were donated by pharmaceutical companies, Verhoosel said.

The treatment costs a very high $20,000 a year in rich nations, prohibitively expensive in other regions, so “adequate and affordable supplies must be ensured so that people everywhere can benefit without delay,” Verhoosel said.

Unitaid has called on laboratories to adapt their prices to low-income countries and, in the long term, to allow generic manufacturing.

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