Bitter HIV battle gets 'berry' interesting

Indian pharmaceutical major Cipla has come out with a strawberry flavoured, four-in-one AIDS medicine costing less than a dollar per day for the kids, who are at the highest risk of dying if they do not receive treatment.

Irrespective of the risk, the biggest problem in treating HIV in children is that the medicines come as hard pills or bitter syrups, which the kids and babies found hard to swallow.

In addition, the existing medicine requires refrigeration, which is an issue in sub-Saharan Africa where most of such deaths happen.

Quadrimune, a pleasantly tested, heat-stable medicine has the potential to trigger changes at the grassroots.

“Children living with HIV have been neglected for too long, with the recommended treatment for years consisting of a bitter-tasting syrup with 40% alcohol content. With Quadrimune, we will finally have a treatment designed specifically for infants and young children,” Bernard Pécoul, executive director of not-for-profit Drugs for Neglected Diseases initiative said in a statement.

About a month ago, Cipla sought approval from the US Food and Drug Administration for use in children between three and 25 kg body weight, sources told DH.

A decision from the US regulator is expected by May 2020 after which the company may look for avenues to bring the product to India.

Nearly two decades ago, the Indian generic manufacturer responded to a call from Nelson Mandela’s government to make ARV drugs for the South African public at prices they could afford. The company received backlash from the big pharma but stood to its ground and delivered, leading to a price drop of such medicines.

“We now expect Cipla to also register the 4-in-1 in India. It is our priority that children living with HIV in India have access to 4-in-1,’’ said Suman Rijal, DNDi director in India.

While new HIV infections among children have declined by 41% since 2010, thousands of children continue to fall between the cracks.

In 2018, 160,000 children (aged 0–14 years) became newly infected with HIV, and 100,000 children died from an AIDS-related illness.

They died either because they weren’t diagnosed, or because of a lack of treatment — a shocking indictment of how children are being left behind, says a new report released by the UNAIDS earlier this week.

Developed jointly by Cipla and DNDi, the new fixed-dose combination medicine contains four WHO-recommended anti-retroviral drugs - abacavir, lamivudine, lopinavir, and ritonavir, in the form of granules filled in capsules.

Parents and caretakers will be able to administer the drugs to children by sprinkling the granules with soft food, water, or milk. The 4-in-1 does not require refrigeration and is easy to administer to infants and children of different weights and ages.

Cipla said it would provide the medicine at an ex-factory cost of $15 per pack of 120 capsules, giving a price of $ 1 per day for children in the medium weight bracket of 10 to 13.9 kg and with prices lower, at 50 cents per day for younger children and infants.