Despite some shortcomings, the health sector is making progress, particularly in research and innovation. eHealth He spoke to a few industry experts, about their health highlights from the past year, and gained insight into what they think should be the priority focus areas this year.
Tandani Tsedu, Head of Corporate Communications and Marketing, South African Medical Research Council (SAMRC)
South African sites, including three SAMRC sites in KZN, were part of a multi-country Phase 3 study that confirmed the superiority of injectable PrEP over oral PrEP.
We have the vital medical tools to prevent HIV infection such as the vaginal ring, long-acting injectable pre-exposure prophylaxis (PrEP (CAB LA), and oral prophylaxis, but collectively we need to address equity issues to facilitate access to the people who need it most Prevention tools, particularly in South Africa where young women are still vulnerable to HIV infection.
South African researchers are engaging the pharmaceutical industry to advocate for cost-effective access to injectable PrEP.
Nzama Mbalati, Communications Director for The Healthy Living Alliance (HEALA)
Food prices have become excruciatingly high, but the president’s announcement last year to expand the zero-labeling of certain foodstuffs[would]provide a greater proportional benefit to the poor for access to food. cAd campaigns like #NotTodayNestle for 2022 are important, especially for children, because the food industry often meddles in food control policies.
It is essential to remain vigilant at every step to identify, expose and combat industry interference. #NotTodayNestle was the epitome of staying sober. It ensures that the industry does not break the law and that we can protect babies from harm caused by formula. It is also important to ensure that mothers are not overly influenced in regards to their infant’s feeding choices.
The government should promote several initiatives that address food insecurity and malnutrition, including school feeding and social protection programmes. He. She It needs to revive the comprehensive national plan for food and nutrition security. It is important that communities facing challenges in accessing water have alternative ways to grow more food.
There is also a need to examine city planning to achieve greater food security, reform our relationship with food, consider optimal diet composition, and de-clutter junk foods through stronger regulation of the food environment.
Shabeer Madi, Professor of Vaccines and Dean of the Faculty of Health Sciences at the University of the Witwatersrand
The success of the WHO-funded mRNA Center with Afrigen in Cape Town was another notable moment. It has been shown that mRNA vaccine development can occur locally. This technology provides the opportunity to develop new vaccines for diseases that do not yet have preventive medicine. It could also see improvements in existing vaccines.
The creation of the mRNA hub is probably the most prominent, although taking it to the next level of vaccine manufacture remains unclear. It remains to be seen if the success in creating the mRNA hub will translate into the large-scale manufacture of mRNA vaccines. There are also intellectual property rights issues that need to be navigated.
We need to develop a more strategic immunization program that extends from pregnancy (where mothers, fetuses and young children benefit) to immunizing the elderly. It should cover people from birth to death.
South Africa aims to ensure that at least 90% of children in all provinces are fully vaccinated against common childhood diseases. Unfortunately, we lag behind other African countries in vaccine coverage, reaching 80% and even 70% coverage in some subregions. Another problem is that we have an almost non-existent vaccine program for adults, which has partly contributed to the difficulties in rolling out Covid vaccines.
We must also continue initiatives aimed at vaccine development in South Africa, beyond just bottling and finishing, expanding vaccine manufacturing capacity and being an early adopter of new vaccines.
Dr. Julia Turner, Senior Technical Advisor and Dr. Leon Levine, Chief Technical Specialist for Right to Care
Increased absorption of dolutegravir
There was initial concern that dolutegravir could adversely affect babies born to mothers taking the drug, but now there is enough evidence to refute this. Armed with this knowledge, healthcare workers and patients felt safe switching to the TLD fixed-dose combination containing tenofovir, lamivudine, and dolutegravir.
This is a great tablet because it is only taken once a day, has few side effects, and works very well to suppress viral loads for patients. This means that patients can live as long as an HIV-negative person, and that they will not pass HIV on to their sexual partners. For fathers, this means that babies born to mothers with suppressed/undetectable viral loads have a very low chance of contracting HIV.
Intravenous antiretroviral therapy
These worked better than the oral tablets to prevent HIV transmission. a A modeling study conducted in 2022 and published in The Lancet in January 2023 estimates that the introduction of injectable capogravir prophylaxis could reduce HIV infection by 29% in 20 years.
We hope these injections will become widely available in South Africa soon. These studies have shown that some patients can take only 2 ARVs instead of 3 ARVs. Currently, these dual treatment regimens are only used in some patients.
In 2022, two of these dual therapy regimens will become available in the private sector as fixed-dose combination tablets. This means they can be taken as one tablet per day (lamivudine + dolutegravir, and rilpivirine + dolutegravir).
Since there are many suppliers of dolutegravir fixed-dose combination tablets, it is extremely unlikely that they will be out of stock. However, pediatric patients, tuberculosis patients with HIV and kidney disease are more likely to run out of stock with sometimes catastrophic results.
We hope that there will be smooth implementation of the new antiretroviral guidelines, an increase in the absorption of fixed-dose dolutegravir combination tablet in adolescents and adults, and pediatric dolutegravir tablets in young children.
Allison Best, Director of Communications for TB HIV Care
The approval of updated guidelines for tuberculosis prophylaxis was a major moment in the fight against the disease. The release of TB PRACTECAL results was another milestone. The new 6-month regimen was more effective than the current standard of care, which can last up to 20 months.
Another highlight was the roll-out of targeted mass testing for tuberculosis in priority areas. The availability of child-friendly TB treatments in the public health system (6 years after the global launch) was also celebrated.
The big things to look out for this year in the field of tuberculosis will be the launch of the National Strategic Plan for HIV, Tuberculosis and STIs 2023-2028 and the UN High Level Meeting on Tuberculosis where commitments were made during the previous period. United Nations high-level meeting (OHLM) on tuberculosis in 2018 to be revised.
Another is the advances in tuberculosis vaccines that have been facilitated through Tuberculosis Vaccine Acceleration Council, and the 1/4/6 X 24 Treatment Working Group (TAG) campaign calling for once-a-week or 1-month preventative treatment, 4-month treatment for drug-sensitive TB and 6-month treatment for drug-resistant TB by 2024. – E-Health News