Médecins Sans Frontières (MSF) is poised to introduce long-acting cabotegravir (CAB-LA) for pre-exposure prophylaxis (PrEP) in its southern African projects. This injectable, administered every two months, offers a significant advancement in HIV prevention, potentially curbing the epidemic, particularly among high-risk populations.
Médecins Sans Frontières (MSF) is poised to introduce long-acting cabotegravir (CAB-LA) for pre-exposure prophylaxis (PrEP) in its southern African projects. This injectable, administered every two months, offers a significant advancement in HIV prevention, potentially curbing the epidemic, particularly among high-risk populations.
PrEP is a preventative medication taken regularly to reduce the risk of HIV infection. “CAB-LA has demonstrated superior efficacy compared to oral PrEP in reducing new HIV infections,” stated Dr. Antonio Flores, an MSF HIV/TB advisor based in South Africa. “Given the absence of an HIV vaccine or cure, scaling up CAB-LA globally, especially in low- and middle-income countries, is crucial.”
In 2024, Zimbabwe, Malawi, Zambia, and eSwatini initiated CAB-LA programs. South Africa is set to receive a portion of the 231,000 CAB-LA doses allocated by the President’s Emergency Plan for AIDS Relief (PEPFAR) before year’s end. Following negotiations with ViiV Healthcare, the sole manufacturer, MSF secured a limited supply for its projects in Zimbabwe, Mozambique, Malawi, and eSwatini.
“The launch of CAB-LA will significantly benefit our patients in Zimbabwe,” emphasized Dr. Gerald Hangaika from MSF’s Mbare project. “Its bi-monthly administration enhances adherence by eliminating the daily burden of oral medication and the need for constant medication storage, thereby improving privacy. This combination of privacy, convenience, and effectiveness is highly valued by most patients.”
The World Health Organization (WHO) recommended CAB-LA for HIV prevention in July 2022. However, in 2023, ViiV Healthcare distributed enough CAB-LA for approximately 13,000 individuals globally, with nearly 70% allocated to high-income countries. To ensure widespread access, pharmaceutical companies must adequately supply long-acting formulations, guarantee affordable pricing for low- and middle-income countries, and support the growth of generic manufacturers.
“We recognize the significant potential of CAB-LA for vulnerable populations in conflict and unstable contexts,” stated Dr. Flores. “MSF is committed to delivering this transformative injection to these settings. We urge ViiV Healthcare to provide adequate supply.”
To prepare for the rollout, MSF conducted a four-day training program for medical staff, covering key aspects such as clinical eligibility, side effect management, and PrEP counselling.
Despite a 60% decline in HIV infections since 1995, new infections persist, particularly among women and girls in Africa. Since the mid-1990s, MSF has been at the forefront of the HIV/AIDS response, implementing prevention and treatment programs, advocating for equitable access to HIV medications, and employing innovative care approaches.
