Medics and caregivers will no longer have to worry about children rejecting or spitting out bitter ARV drugs.
This is because Kenya is among six countries that will receive the “four-in-one” strawberry flavoured paediatric HIV drug, according to manufacturers of the drugs who spoke to Nation.
The communications office of Geneva-based Drugs for Neglected Diseases Initiative (DNDi), which manufactures the drug alongside Indian company Cipla, told Nation that once the medicine is approved, Kenya alongside Uganda, Tanzania, Cameroon, Burkina Faso and Senegal will receive it.
DNDi received a $17.3 million grant for their paediatric HIV programme from another non-profit, Unitaid, a substantial amount of which was channelled into the programme.
DNDi wrote on their website on November 29 that “Quadrimune is currently under review by the US Food and Drug Administration (FDA) for use in children between three and 25kg bodyweight.”
This announcement comes after Dr Catherine Ngugi, the head of National Aids and STIs Control Programme (Nascop), attended a week-long Icasa conference in Rwanda last week and held a meeting with DNDi to solidify the agreement to have the medication come Kenya.
Health CS Sicily Kariuki wrote to Nation: “We are working for Kenyan to be among the first countries to roll out this treatment.”
Dr Ngugi stressed that they were “hopeful that the medicine will come to Kenya by July 2020.”
The medicine will be a relief from the bitter tasting Lopinavir-Ritonavir, known by its generic name, Kaletra, which children spit out or refuse to take altogether. Kaletra also requires refrigeration, a requirement that many mothers cannot meet.
Dr Patrick Oyaro, an HIV expert and CEO of Health Innovations Kenya, participated in the study and told Nation that when children spit Kaletra out, it contributes to their developing resistance to the medication due to an incomplete dosage.
Dr Ngugi also said the drug will boost Kenya’s ambitious 90-90-90 target, which seeks to have 90 per cent of all children living with HIV diagnosed, 90 per cent of those diagnosed HIV+ receiving treatment, and 90 per cent of those children receiving treatment achieving viral suppression by 2020.
She said that, at the moment, the viral suppression for children in “not that good”. In 2017, Nascop reported that only 67 per cent of children below nine years and 66 per cent aged 10 to 19 had achieved virally suppression. This is far below the 90 per cent target.
Kenya has received praise for its fight against HIV, but there are challenges that the country has not surmounted. One of those is access to paediatric friendly medicine.
Paediatric HIV in considered a neglected diseases— no wonder DNDi got involved— because not many companies manufacture drugs for it. The country has been participating in the pilot study— still run by DNDi— to try better tasting medicine in children since 2015.
Between 2015 and 2019, Kenya participated in the LIVING study where 1,003 children were enrolled across 12 sites in the country Uganda and Tanzania. Kenya had five sites. In June 2015, America’s Food and Drug Administration (FDA) approved an oral “2-in-1” formulation developed by Cipla. These formulations didn’t require refrigeration and could also be sprinkled on food.
In February 2018, DNDi told Nation, interim results of the LIVING study were released, showing that 83 per cent of the children in the study were virologically suppressed at 48 weeks with the 2-in-1, compared to 55 per cent at the beginning of the study.
However, the 2-in-1 still had to be taken with the two other drugs still bitter if left in the mouth for too long and the pellets were also a bit big so very young children found it difficult to take.
In June 2019, DNDi’s LOLIPOP Study resulted into the 4-in-1 known as quadrimune.
The country has also managed to cover only a portion of the HIV-positive pregnant women who need to prevent their unborn babies from getting infected with HIV. The prevention of mother to child coverage in 2017 was about 77 per cent.
The Ministry has also been trying methods of treatment that would give children treatment depending on their ages, the amount of “soldier white cells” in their body to fight infection (CD4 count): In 2009, a day old baby to 12 months were eligible for ART in 2009, in 2012 it moved to two years, then in 2012, 10 years in 2014 and now “treat all”.