Zim makes history

LETTICIA MAGOMBO

Zimbabwe has become the first African country to approve the use of long-acting injectable cabotegravir (CAB-LA) as pre-exposure prophylaxis (PrEP) for HIV prevention.

The approval by the Medicines Control Authority of Zimbabwe (MCAZ) followed recommendations by the World Health Organisation (WHO) in July this year that CAB-LA may be offered to people at substantial risk of HIV acquisition as part of comprehensive HIV prevention approaches.

CAB-LA is the third PrEP product recommended by the WHO for HIV prevention. Tenofovir-based oral PrEP was recommended in 2015 and the dapivirine vaginal ring, another long-acting product, in 2021. The availability of these three products provides increased choices for HIV prevention.

“WHO welcomes the news that Zimbabwe has approved the use of CAB-LA, which will pave the way for its use, providing more safe and effective options for HIV prevention,” said Dr Meg Doherty, Director of WHO’s Global HIV, Hepatitis and Sexually Transmitted Infections Programmes.

Until the MCAZ approval, CAB-LA has only received regulatory approval in 2 high-income countries.  The US Food and Drug Administration approved its use for HIV prevention in December 2021. In August 2022, Australia’s Therapeutic Goods Administration was the second national regulatory body to approve CAB-LA. Zimbabwe is the first country in Africa and first low- and middle-income country to do so.

The Community Working Group on Health (CWGH) said the CAB-LA must be made widely accessible to all Zimbabweans.

Itai Rusike, CWGH executive director, told Business Times the regulatory approval of CAB-LA needed to be buttressed by government action.

“We welcome the approval by the government of Zimbabwe to use cabotegravir for PrEP. It is very encouraging that Zimbabwe has become one of the first countries in Africa to approve the use of cabotegravir long HIV injectable that has been proven to be efficient in HIV prevention. The government should now make sure that the cabotegravir long HIV injectable is widely available and easily accessible to all our health institutions and to all those that need it without facing financial hurdles,” Rusike said.

He added that the PrEP would be of much benefit to the nation and would enable those living with HIV to live without fear.

“PrEP dramatically reduces the risk of HIV acquisition for women as well as men. We are aware that for more than a decade the World Health Organisation has recommended that pregnant and breast-feeding women at risk of HIV should be offered PrEP and the people of Zimbabwe should embrace this new development to reduce risk of HIV infection. Antiretroviral therapy (ART) has turned HIV into a manageable chronic condition. When ART is working effectively, HIV cannot be transmitted. This allows people with HIV to live fuller lives without the fear of infecting others.”