Thursday, October 22, 2020

Botswana’s “treat-all” HIV drug marred by secrecy

Information surrounding procurement and financial details of dolutegravir, an HIV drug considered very expensive to be used on newly diagnosed HIV patients in Botswana is classified.

Sources in the Ministry of Health say any information between Ministry of Health and ViiV Healthcare is classified.

Experts say this is one of the most expensive health agreements ever reached by a government and pharmaceutical company in the sub-continent.

ViiV is a global specialist HIV company majority owned by GlaxoSmithKline (GSK).

GSK is one of the world’s leading research-based pharmaceutical and healthcare companies.

The tender was announced by ViiV last Friday. Sunday Standard investigations revealed that at least 30 tablets of Tivicay costs around $1, 429, and 93.

Reluctance to reveal the financial details of the contract between ViiV and Botswana was also became apparent when GSK spokesperson declined to disclose such information to international media.

Permanent Secretary in the Ministry of Health Shenaaz El-Halabi told Sunday Standard during an interview that she had no information on the procurement of Dolutegravir. She said procurement are dealt with by the Central Medical Stores (CMS)

“It’s an anti-retroviral drug that is going to be used for our ‘treat all’ campaign. The clinical guideline committee launched the “treat all” today, (Friday) as a way of launching the campaign and the drug that is going to be used,” Halabi told Sunday Standard.

“Our target is 100 thousand people. This is everybody who is infected with HIV but yet not on any treatment. From our projections we have about 100 thousand people that we have to put on treatment. We can’t put everybody on the same time so we have divided that over time,” she said.

Halabi had no idea on the length of the contract and how much it will cost the Ministry of Health.

“Generally CMS are the once issuing tenders and also awarding tenders. So there is a process that is followed there in terms of tendering and awarding of tenders. That is why I do not know how much the tender was,” said Halabi.

She however requested to be sent a questionnaire and promised to enquire and give feedback in terms of how much the tender cost.

Not only Halabi was clueless on the details of the tender, Assistant Minister of Health Alfred Madigele was also in the dark about the details of the tender.

He referred this publication to CMS.

Dolutegravir (Tivicay) is an integrase strand transfer inhibitor (INSTI) for use in combination with other antiretroviral agents for the treatment of HIV. Integrase inhibitors block HIV replication by preventing the viral DNA from integrating into the genetic material of human immune cells (T-cells). This step is essential in the HIV replication cycle and is also responsible for establishing chronic infection. Tivicay is approved in over 90 countries across North America, Europe, Asia, Australia, Africa and Latin America.

This tender is considered the largest tender ever secured by ViiV Healthcare in the sub- Saharan Africa, a region particularly impacted by the HIV epidemic.

As part of the agreement, ViiV Healthcare has committed to providing dolutegravir 50mg. The medicine would be used as a first line core-agent to treat newly diagnosed patients tested under the programme in Botswana.

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