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HIV prevention: Uganda to benefit from vaginal ring rollout

Dapivirine vaginal ring

Kampala, Uganda | THE INDEPENDENT | Uganda has been selected among the initial beneficiaries of the International Partnerships for Microbicides (IPM), as the developers move to roll out the HIV-preventing vaginal ring in Africa.

The flexible vaginal ring which contains Dapivirine, an antiretroviral drug, is inserted in the vagina and left there for 28 days. During this time, the ring continuously releases antiretroviral drugs to prevent HIV infection.

The ring has undergone three trials to determine its safety and efficacy and at the end of these studies, scientists established that the HIV risk was cut by more than half across all analyses, and in some, by 75 percent or more among women who appeared to use the ring most regularly.

Diantha Pillay, IPM’s Senior Manager for Product Access says countries in Africa are at different levels of rollout having attained approval for use by the European Medicines Agency (EMA) in 2020 and eventual prequalification and inclusion into clinical guidelines by the World Health Organization last year.

Pillay explains that high prevalence countries like Uganda are being facilitated to ensure that they benefit fastest.

The trials in Uganda were conducted at sites in Masaka and Kampala where one was led by IPM that developed the ring and the other by the Microbicide Trials Network-MTN. Pillay told African journalists attending a transnational science Café on Thursday night that Uganda will initially access the vaginal ring through a pilot project before opening it up for general access.

With the model they are employing she said, users are not expected to pay as they are talking to governments to buy for their citizens. The ring is estimated to cost USD 30.

However, while IPM is pushing for a wide rollout of the ring saying it will offer a choice for women who cannot use other Pre-Exposure Prophylaxis (PrEP) methods such as daily pill, only South Africa and Zimbabwe have secured national regulatory approval for the device.

Pillay said they have submitted papers for approval to regulatory authorities in other high prevalence countries saying that in Uganda, their submissions are under review by the HIV Prevention committee.

Roll-out has been designed to go through four stages starting with attaining regulatory approvals, then going to governments for them to design policies and clinical guidelines that recognize the device before going into pilot implementation studies and eventually large-scale rollout.

In an earlier interview with URN, Dr Joshua Musinguzi, the Programme Manager for AIDS Control in the Ministry of Health said the ring is welcome considering the challenges of inconsistent use of oral PrEP. He however couldn’t confirm whether the government would fund the ring once the necessary approvals are complete.

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