South Africa still has four critical gaps to fill before it sees the end of AIDS

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South Africa has the largest number of people living with HIV in the world. It accounts for up to one third of new HIV infections globally. 

In 2016 there were an estimated 7.1 million people living with HIV In the same year close to 10 million people were tested for HIV.

But huge strides are being made in line with the country adopting the UNAIDS’ 90-90-90 strategy. Under the plan the aim is for:

90% of all HIV positive people to know their HIV status

90% of people who know their HIV status to be on treatment, and

90% of those on treatment to have suppressed viral loads by 2020. Viral suppression is when a person’s viral load – or the amount of virus in an HIV-positive person’s blood – is reduced to an undetectable level.

South Africa has made tremendous progress towards meeting the 90-90-90 targets. In 2016, South Africa’s National Aids Council estimated that 86% of all HIV positive people in the country knew their HIV status, 65% of the those who knew their HIV status were taking antiretroviral therapy and 85% of those taking antiretroviral therapy were virally suppressed.

To complete the last leg South Africa has four important things to do. It must address the gaps in HIV testing; it must start people on antiretroviral treatment and make sure that they remain on it; it must ensure that people maintain virological suppression and, lastly, it must strengthen its strategies around prevention.

All these areas have challenges that may prevent South Africa from taking the last few steps to meet the target.

The challenges
The HIV testing: the country’s guidelines recommend that all adults are tested for HIV at least once a year. Groups that are at a higher risk of being infected should be tested every three to six months.

But HIV testing programmes show that certain groups are tested much less than this. For example, a significant proportion of men go untested as do adolescents, young people, and men-who-have-sex-with-men.

To narrow this gap and increase access to HIV testing and treatment, community and workplace based HIV testing and counselling should be strengthened and HIV self–tests should be improved.

Antiretroviral treatment: this is the most powerful tool in South Africa’s response to HIV. Treatment has reduced illness and death from a peak of 325 000 in 2005 to 126 000 AIDS related deaths in 2016 as well as the number of new infections at population level in some settings.

And improvements are being implemented all the time. For example, last year amendments to the national treatment programme meant that all HIV positive people could receive ARVs regardless of their CD4 count.

But there are still disparities in starting treatment particularly among men, young people, female sex workers and other key populations. These groups are more likely to start treatment late in the course of HIV infection.

Community based ART initiation as well as high quality client-centred HIV care and treatment services will be essential to address these gaps.

Suppressing the virus: staying on HIV care and maintaining viral suppression is essential if the 90-90-90 targets are going to be met.

But in South Africa there are still high numbers of people who stop taking treatment and attending care. People stop taking their medication for lots of reasons. The reasons range from being pregnant at start of ART or having a low CD4 count at entry into care, a lack of disclosure of HIV status, and inflexible clinic hours.

The national HIV care and treatment programme has recommendedvarious strategies to improve adherence to medication and these are being implemented across the country. These include clinic visits to help monitor people on treatment as well as community based adherence clubs and peer groups. Another has been the recommendation that chronic medicines are delivered through private pharmacies.

What is needed are for programmes to better understand and address the provider, individual and community factors which determine why some people living with HIV can remain in care for a long time and why some cannot.

Prevention: Primary prevention focuses on people who are HIV negative and aims to keep them that way. The weapons in the prevention arsenal are diverse and include:

behavioural change (abstinence, reducing the number of sexual partners as well as correct and consistent condom use),

male circumcision,

pre-exposure prophylaxis and post-exposure prophylaxis.

But these interventions vary in effectiveness at population level depending on coverage and for some adherence.

Next steps
By implementing the 90-90-90 strategy South Africa is expecting to reduce the number of new HIV infections dramatically in the next five years. This will involve scaling up a combination HIV prevention interventions as well as maintain high levels of viral suppression and reduce time spent with unsuppressed viral loads. With all this in place the number of new HIV infections is expected to fall from 270 000 in 2016 to less than 100 000 by 2022.

But ending AIDS as a public health threat will require a sustained focus on health promotion by creating conditions that allows communities and individuals to make informed choices regarding HIV prevention, care and treatment - and empowering of communities and individuals to act on those choices.

Bill and Melinda Gates Foundation contributes $62 million to health projects in Africa

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The Bill & Melinda Gates Foundation has announced their commitment to contribute to the EU's External Investment Plan.

The Gates Foundation will contribute $50 million (€40.9 million) in financing, as well as an additional $12.5 million (€10.2 million) in technical assistance, to investment projects in the health sector in Africa through the EU's framework to improve sustainable investments in Africa.

This pooling of resources is designed to encourage additional private investment towards achieving the Sustainable Development Goals, and will allow successful projects to be scaled up more rapidly.

The European Commission welcomes this strong support to its efforts towards sustainable development in Africa, and will match this contribution with another €50 million.

European Commission President Jean-Claude Juncker said: "The EU accounts for a third of foreign direct investment into Africa – this is now helping create jobs and growth on both of our continents. But we must do more to improve the business environment and provide a platform for African innovators to grow. This requires the full involvement of the private and philanthropic sectors, and I am grateful to the Bill & Melinda Gates Foundation for their much needed engagement. This is an investment in our shared future. Europe's partnership with Africa is one in which we support each other, help each other to prosper and make the world a safer, more stable and more sustainable place to live."

Bill Gates said: "Improving health outcomes allows a society to become more prosperous and productive. There has been a lot of progress in this area in sub-Saharan Africa since 2000, but we need to do more to incentivize research and innovation that benefit the poor. It is fantastic that the European Commission, in partnership with African countries, is leading the way in reducing deep-seated inequities in global health. This commitment will create opportunities that will help people lift themselves and their communities out of poverty.”

This new partnership on health follows a first joint initiative with the EU, announced on 12 December 2017 at the One Planet Summit in Paris, to support the development of tools and techniques to benefit smallholder farmers in developing countries.

Through that initiative, the Commission will provide €270 million, and the Bill & Melinda Gates Foundation $300 million (€244.7 million), to finance agricultural research to help the world's poorest farmers better adapt to increasingly challenging growing conditions brought about by climate change. France, Germany, Italy, Spain and other EU Member States will also take part in this programme.

The European Union and Africa are working together to tackle the common challenges of today, from investing in youth, fostering sustainable development and strengthening peace and security to boosting investment in the African continent, supporting good governance and better managing migration.

The EU's External Investment Plan was adopted in September 2017 to help boost investment in partner countries in Africa and the European Neighbourhood, in particular with a new €1.5 billion European Fund for Sustainable Development (EFSD) Guarantee.

This ambitious initiative supports innovative financial instruments such as guarantees to boost private investment. With an input of €4.1 billion from the EU, it will help mobilise up to €44 billion of private investments by 2020.

Such investments are mainly targeted at improving social and economic infrastructure, for example municipal infrastructure and proximity services, on providing support to small and medium-sized enterprises, and on microfinance and job creation projects, in particular for young people.

www.gatesfoundation.org

Sanofi calls for applications for start-up challenge

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Pharmaceutical company Sanofi is calling for entries to the Afric@Tech start-ups challenge targeted at innovators in the medical and healthcare sectors in Africa.

Initiated by Sanofi in all African countries, the challenge seeks to identify and reward the best start-ups in their goal of revolutionising practices in the health sector on the continent.

"For over 50 years, we have been committed to improving access to medicines and healthcare for all African communities and people. We feel it is our responsibility to accompany, develop and shine a light on these talented South African start-ups," says Thibault Crosnier Leconte, country chairman and RX general manager, Sanofi SA.

According to a statement, Africa@Tech comprises three challenges aimed at providing innovative and adapted solutions to improve access to medicine and healthcare in Africa.

The first challenge focuses on new tech solutions for earlier diagnostics of non-communicable diseases, the second challenge focuses on how telemedicine can improve access to healthcare on the continent, and the third challenge deals with solutions that improve the education of health professionals in the field of chronic diseases in Africa.

Once the start-ups have been evaluated, a jury will select those that will participate in the Africa@Tech innovation journey.

The selected start-ups will be able to demonstrate their solutions in front of the audience of Viva Technology. They will also receive financial assistance and individual support from Sanofi, through a system of coaching and mentoring.

The contest is free and open to all South African start-ups. Candidates have until 15 February to submit their applications online.

Africa: Business Unusual Will Drive Africa's Quest to Achieve Health Care for All

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Nairobi — Africa's quest for health continues to be held back by a combination of factors such as natural disasters and pandemics, prevailing high rates of communicable and rising incidence of non-communicable diseases, sedentary lifestyles, road accidents and greater population mobility.

With the region accounting for approximately a quarter of the world's disease burden and just 3 percent of its doctors, it is difficult to be optimistic about the future.

Every year for example one million people in Kenya, fall into poverty and stay poor due to a catastrophic health shock. Nearly 11 million Africans fall into poverty due to high out-of-pocket payments for healthcare, even as the continent is expected to provide access to essential health services, medicines and vaccines for all its citizens by 2030 as part of the Sustainable Development Goals agreed on globally.

Kenya's President Uhuru Kenyatta has prioritised universal health coverage (UHC) for all in his second term.

It is obvious that to achieve UHC, more resources will not only have to be mobilized for the health sector, new partnerships must also be forged, such as the one between United Nations, Government of Kenya and technology company Philips, to improve access to health care in hard to reach communities. New models of blended financing and impact investing need to take up the slack to address the scarce resources, which must also be used more efficiently and effectively.

The Better Business Better World Africa Report shows how challenges in the delivery of health care can be turned around into large business opportunities with a potential value of US$259 billion and could create over 16 million jobs in Africa by 2030.

Innovation Tech could be a game-changer in diagnostics, health information, supply chain management, health financing, and even remote tele-surgery performed by robotic arms.

Few frontiers provide greater potential for African countries to achieve UHC than information technology. "Just as mobile payments have transformed Kenyan markets, I think innovations in the health sector-- from machine learning algorithms that help diagnose disorders, to digitized prescriptions that make drugs more affordable-- could have a transformative impact on health, quality of life, and the efficiency of our investments in healthcare," says Dr. Temina Madon Executive Director for the Center for Effective Global Action at U.C. Berkeley.

A crucial enabling factor is the continent's impressive mobile penetration profile. Africa is getting more and more interconnected. With prices falling, smartphone penetration more than doubled between 2014 and 2016. By 2020, smartphone adoption on the continent is expected to surpass 50 percent, meaning that technology will be well placed to open up health systems to the poorest and most vulnerable people.

Increasing penetration and scaling of private, public-private and community insurance schemes could transform access to better healthcare, especially if the right insurance mechanisms, including forms of micro-insurance, are put in place. Digital solutions such as Kenya's M-Tiba could play an important role in the realization of UHC.

Google researchers have trained image recognition algorithms to auto-detect signs of diabetes related eye disease by analysing retinas which could help prevent blindness.

Stanford University innovators are creating a cell phone based mosquito monitoring platform for anyone to submit a mosquito buzz - producing the most detailed global map of mosquito distribution that can help prevent mosquito borne diseases.

Drones, as those of Zipline, are revolutionizing supply chain management systems in Rwanda and Tanzania, drastically reducing the time of delivery of blood at the facility when patients are in need and at risk of dying.

With the ubiquity of smartphones and a shortage of specialist doctors, calling or texting a physician for a consultation and to obtain a prescription can be done in a flash, literally. With ICT prices dropping, telemedicine will be more than a niche application of cutting-edge tech; it could be the future norm of medicine.

Dashboard systems will help policy makers and implementing agencies monitor progress of programmes and identify areas in need of improvement. Likewise, Geographic Information Systems (GIS) can provide geographically-referenced data to help in identifying relationships, patterns and trends in diseases.

Taken together, these innovations will ensure that each building block and therewith entire health systems can be strengthened and that resources mobilised in the health sector are used more efficiently and effectively.

Fortunately, these innovations are already in existence, albeit many of them at pilot-level implementation stages. Countries need to identify tools that are available in the market, especially those that are based on open source software that allow for adaptation, and take them to scale. The price of failing to take up such opportunities will be a slower march towards economic progress, as families continue to use up their life savings, sell assets, or borrow to meet the cost of health care.

A demographic dividend looms in Africa, and countries need to capitalize on the employment opportunities offered by the health sector while strengthening their health systems. A young army of community health workers who are tech savvy and can reach the last mile, could offset the chronic shortage of doctors and nurses through task-shifting.

UNDP's Administrator Mr. Achim Steiner has underscored the importance of multi-sectoral partnerships as a vehicle to attain UHC. Such partnerships he says, "are key in connecting players nationally and globally, across sectors and silos to drive progress on UHC".

This is exactly what innovative Platforms such as the SDG partnership Platform in Kenya are beginning to catalyse - harnessing global tech innovations and intellectual firepower to serve the continent's populations with public-private investments to achieve Universal Health Care for basic human dignity and as a springboard for greater economic growth.

And Kenya can lead the way in achieving Universal Health Coverage.

What If Amazon Ran Hospitals?

What if Dr. Alexa offered you the next appointment with your doctor in the Amazon Clinic? What if you could buy your prescription drugs in Amazon’s online pharmacy? What if you could get your personalized plaster cast from the 3D Printing Department? In light of the recent moves of Amazon and other tech giants in the healthcare field, we imagined what it would look like if Amazon operated an entire hospital.

Tech giants move into healthcare

Facebook, Google, and Amazon are aiming for new horizons. The playfield must be too small for them solely on the technology markets. They certainly have the capacity to move into new fields. As The Economist writes, their huge stock market valuations suggest that investors are counting on them to double or even triple in size in the next decade.

So, where do they want to utilize their power? Recent moves show they have ambitions in healthcare. Google has made steps forward in the field with CalicoHuman Longevity Inc. joined forces with Cleveland Clinic for a human genomics collaboration aimed at disease discovery and making aging a chronic condition. In September 2017, Microsoft announced the launch of its new healthcare division at its Cambridge research facility, to use its artificial intelligence software to enter the health market. Its research plans include monitoring systems that can help keep patients out of hospitals and large studies into conditions such as diabetes.

And what about Amazon?

According to CNBC’s news in January 2018, the Seattle-based giant hired one of Amazon’s most high-profile hires to date in health, Martin Levine. He has been working for Iora Health, which focuses on Medicare patients in six US markets. He could be joining Amazon’s internal healthcare group known as 1492, which is testing a variety of secretive projects. Many analysts suspect that Amazon is considering selling prescription drugs online as rumor said in autumn 2017 or that it might be opening drug stores in its Whole Foods chains. Some analysts even considered Amazon’s popular digital assistant, Alexa as the future’s possible digital doctor. Amazon, Berkshire Hathaway, and JPMorgan Chase also announced a partnership to cut health-care costs and improve services for their US employees.

So, US consumers might one day find themselves logging in to Amazon Healthcare Prime, or asking Dr. Alexa what they should do about their cold. But what if we go even further than that? Let’s do a thought experiment. What if Amazon decided to open a clinic in the future?

Hi Ann! Your prescription drugs from Amazon Clinic just arrived!

Your phone buzzes with the above message. As a reaction, you go to your door and notice the tiny medical drone with your package in your backyard. In the neatly wrapped box, you find all the medication the GP prescribed for your pneumonia. The order is fairly easy to make on Amazon’s website with a special code that your GP gave you to allow the purchase of the drugs from Amazon Clinic’s own online pharmacy.

The scene is not that far away from reality considering Amazon’s recent moves in pharma. The tech giant might have been considering selling drugs online. In 2017, it received wholesale licenses in several US statesand induced a lot of fear in big pharma players about disrupting the industry. Besides, drone delivery is already on the palette of services offered by Amazon. In December 2016, it delivered the first packages with popcorn and fire TV to its customers in the UK. The US’ airspace watchdog, the FFA, also started to set out rules for drone delivery. Thus, selling pharmaceuticals and delivering medication by drones seem like a natural combination for the future Amazon Clinic.

Moreover, medical drones have a great potential to respond to medical emergencies or disasters. Google already patented a device that can call for a drone in emergency situations to fly in with life-saving medical equipment on board. You would push a button, and a drone would appear on the spot. How amazing would that sound? And what about drones delivering automatic external defibrillators (AEDs) directly to people who have just suffered a heart attack? Researchers from the University of Toronto are already experimenting with the idea based on their inspiration from ambulance drones in the Netherlands. It goes without saying that a future Amazon Clinic would have a swarm of medical drones for drug and blood transportation or medical emergencies.

Artificial Intelligence-based support system in the Amazon Clinic

There is incredible growth in computers’ ability to understand images, text, and video in the form of Artificial Narrow Intelligence (ANI), a field called computer vision and natural language processing. The former is used as a primary technology for self-driving cars, Google image search, automatic photo-tagging on Facebook, and it is extensively utilized now in healthcare, for example in the field of medical imaging.

In December 2017, Amazon also announced a couple of services based on ANI. Amazon Rekognition Video uses smart algorithms to detect objects and faces in customers’ video content; the tech giant’s Amazon Transcribe turns audio into text; Amazon Translate (what a surprise) translates text, and last but not least, Amazon Comprehend analyses text for sentiment and key phrases. How could all these services support the work of medical professionals in a hospital?

The Amazon Clinic might deploy smart algorithms to aid doctors’ work in making decisions about treatment paths. Amazon might build its own deep learning algorithm just like IBM Watson, which is able to find the latest scientific studies and sift through millions of options in seconds to find the best solutions. Amazon Rekognition Video might not only detect objects in customers’ video content, but also in medical imaging helping the work of radiology departments. Moreover, Amazon Transcribe might spare the time of making medical notes for doctors by transcribing patients’ account of their conditions as well as medical professionals’ recommendations. As administration puts a high burden on doctors and considerably lowers job satisfaction, tools for easing this hideous task would be more than welcome in future hospitals.

Amazon healthcare package deals and Dr. Alexa

No matter whether you are looking for blood glucose monitors, otoscopes or blood pressure cuffs, snoring aids or defibrillators, you can find everything on Amazon. The tech giant is already selling medical equipment, first aid kits, and non-prescription drugs online, so jumping into more serious healthcare business is truly not so far away.

Now, imagine the Amazon Clinic going some steps further. What if you could have special package deals on Amazon Healthcare Prime? The doctors prescribed you medication for high blood pressure, and you could get blood pressure cuffs or mobile apps helping you measure your medical state at a reduced price – when getting everything in a bundle.

Dr. Alexa might even help you choose from the selection based on your personal history. For example, based on your known allergies to drugs. The digital assistant might also act as the first line in primary care by answering basic medical questions and helping patients with simpler conditions. The concept is already moving into reality. UK’s National Health Service (NHS) started to use a chatbot app for dispensing medical advice for a trial period in 2017, with the aim of reducing the burden on its 111 non-emergency helplines. Moreover, Dr. Alexa could also ease the administrative burden on medical staff by patient management and organizing doctors’ schedules.

3D printing drugs and medical equipment in the Amazon Clinic

Imagine that the future Amazon Clinic would apply disruptive technologies such as surgical robots, tiny robot companions or TUG robots for carrying medication and equipment. Imagine that doctors would use 3D printers to create finger splints and other personalized plaster casts, tumor or organ models or low-cost prosthetic parts inside the Amazon Clinic. The 3D Printing Department would be responsible for all medical equipment necessary in other parts of the hospital.

And what if the Amazon pharmacy could even use 3D printing to make drugs in any color or shape you choose online? This is closer than you think. In August 2015, the FDA approved an epilepsy drug called Spritam that is made by 3D printers. It prints out the powdered drug layer by layer to make it dissolve faster than average pills. In June 2015, the UK’s Daily Mail reported that scientists from University College of London are experimenting with 3D printing drugs in odd shapes; such as dinosaurs or octopuses in order to make it easier for kids to take pills.

The possible downsides of a future Amazon Clinic – Recommendations and Black Fridays!

Imagine that you would receive recommendations for treatments, hospitals and even doctors based on your own habits. Just as the algorithms of Amazon, Google and Facebook show you ads based on your browsing history. So, if you suffer from diabetes, every content you receive will have something to do with the condition. Or if you do your grocery shopping and Amazon saw you buy some liqueur you might get some recommendations for healthy living from Amazon Health Prime. That would be an annoying nag as well as a scary connection between parts of your personal data.

Imagine that you had a Black Friday in medicine, too! On certain days of the year, treatments and drugs would be less expensive, and even doctors would get paid less – but could get better reviews more easily. At first, it could sound like a good idea but think about it. What if patients did not buy medical equipment or drugs that they actually needed in order to wait for some discount? It could cost their health, or in extreme cases their life!

The entire medical history of you

It is not a coincidence that Black Mirror comes into your mind when reading the section title. The creators of the dystopic series already imagined what could happen when people would be evaluated solely based on their social media profiles and interactions. Imagine what would happen when reviews would determine the future of doctors and treatments? What if you could review doctors and treatments just as you do with books on Amazon? If many patients were dissatisfied with a treatment due to its side effects, it would go out of the window. This is not how evidence-based medicine works. Moreover, the power of the masses could sweep away great professionals with fewer charms – which should never happen.

Not only medical professionals but also patients might be reviewed and evaluated like that. Patients would have a profile on Amazon with their entire medical documentation, genetic information – and the evaluation they received from their doctors. If someone has bad reviews, treatment might become more expensive for them. Very scary prospects there!

Should Amazon run a hospital?

Some ideas sound funny and promising; others sound just like script lines from Black Mirror. Anyhow, healthcare would definitely look different with Amazon-run hospitals – perhaps more patient-centered and more business-oriented.

But healthcare should not be pure business. Medical evidence, empathy, and caregivers dedicated to their jobs make healthcare unique. Thus, a lot of techniques which Amazon, Google, Microsoft, Apple or Facebook apply in their businesses would not work or would have catastrophic consequences in healthcare. Especially in direct patient care.

No wonder that Apple, Google, and all the other tech giants move rather forward on the market for medical equipment, wearables or artificial intelligence solutions that indirectly affect patients. The fact that Amazon decided not yet to sell drugs online but rather concentrate on the medical equipment might also have something to do with that. So, there is no question that tech giants want to take a leap of faith in healthcare, but they still have a lot to learn to get into the industry successfully.

Sport protects mental health of children who experience trauma

Sport protects mental health of children who experience trauma Study finds abused or neglected children who play sports are less likely to develop mental illness.

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Taking part in sport protects children who are abused or neglected from developing mental health problems in later life, according to a major public health study.

People who had adverse childhood experiences (ACEs) but regularly played sports as children were less likely to have a mental illness as an adult, the study found. People who had traumatic childhoods were also more likely to be mentally healthy if they took part in sport as adults.

The study confirmed a strong link between ACEs, which include sexual and physical abuse, parental separation and living with domestic violence, and mental illness as an adult.

It said people who had four or more ACEs were four times more likely to be receiving treatment for current mental illnesses and 10 times more likely to have self-harmed or felt suicidal than those who had experienced none.

The study from Public Health Wales (PHW) and Bangor University looked at what could help people with troubled upbringings. Published on Thursday, the report said: “Of childhood activities measured, only regular participation in sports showed a protective effect against mental illness.

“Among those with four or more ACEs, the adjusted proportion reporting current mental illness fell from 25% of those who did not regularly participate in childhood sports to 19% in those who did.”

The report urged caution: “It is not possible from this survey to explore whether participation in sports builds resilience in children or whether children with greater resilience are more attracted to sports.”

But it added: “The relationships found here suggest increased sports participation should be further explored as a means of developing resilience and protecting mental health.”

The report found that adults who were members of clubs and community groups were also more likely to be mentally well. It found that playing sport also helped adults, with the proportion of people being treated for a mental illness if they played sport almost half that of those who did not.

It said: “There are associations between regular adult participation in sports and current mental illness. While much attention has been paid to the cardiovascular and weight reduction potential of sports participation, its impact of friendship opportunities, benefits to mental health, access to role models and the other aspects of resilience that engagement in sports facilitates needs to be factored into its benefits.”

A previous report from PHW and Bangor University revealed that children who had ACEs were more likely to become physically ill as adults.

Children with four or more ACEs were more than twice as likely to be diagnosed with a chronic disease in later life than those who had experienced none, the report said.

They are four times more likely to develop type 2 diabetes, three times more likely to develop heart disease and three times more likely to develop respiratory disease.

Once-a-week pill for HIV shows promise in animals

Human trials of a once-a-week oral pill for HIV could start, after successful tests in pigs, claim US scientists.

The slow-release tablet could free patients from having to take daily medication, they say.

It looks like a normal capsule, but on reaching the stomach its coating dissolves and a special structure packed inside unfolds.

This 4cm (1.5in) star-shaped scaffold stays in the stomach for seven days, steadily releasing its cargo of drugs.

More tests in other mammals, including monkeys, are recommended but the researchers say trails in people could begin within two years.

HIV experts said the prospect of a new treatment option was to be welcomed, but that a once-a-week HIV pill for people was "still a way off".

Credit: GIOVANNI TRAVERSO

Credit: GIOVANNI TRAVERSO

 

The star is too large to move out of the stomach but still allows food to journey through to the small intestine.

Once it has delivered its payload, the star begins to degrade and passes on through the digestive tract.

In the pig trial, the researchers dosed it with enough of three antiretroviral drugs - dolutegravir, rilpivirine and cabotegravir - to last for seven days.

The researchers say, in the future, the oral drug delivery device could be used for a wide range of diseases, not just HIV.

Slow release

Preliminary tests in pigs have already been done with a malaria drug called ivermectin and the star remaining in the stomach for up to two weeks.

Researcher Giovanni Traverso, from Massachusetts Institute of Technology and Brigham and Women's Hospital in the US, said: "We wanted to come up with a system to make it easier for patients to stick to taking their treatments.

"Changing a medication so it only needs to be taken once a week rather than once a day should be more convenient and improve compliance.

"Once-a-month formulations might even be possible for some diseases."

A company called Lyndra is now developing the technology and plans human trials of the long-lasting oral delivery pills within the next 12 months. Tests with HIV medication could begin after that, subject to approval and more animal tests.

Dr Traverso said: "There are lots of patients this could help, including people with dementia or mental health disorders such as schizophrenia."

Some slow-release drugs could already be given by injection, he said.

A spokeswoman from the British HIV Association said: "This research is still in the early stages of development and there is clearly some way to go from testing in pigs and mathematical modelling to human trials before its effectiveness can be assessed."

A Terrence Higgins Trust representative said: "Medical advances have come on leaps and bounds for HIV in the UK in recent years, however we do know that taking a pill each day does present practical barriers for some people living with HIV.

"We welcome the prospect of a treatment that removes these barriers, and presents all people living with HIV with further choice, provided that it is no less effective than current options available."

The HIV research, published in the journal Nature Communications, was funded by the Bill and Melinda Gates Foundation, the National Institutes of Health and the Brigham and Women's Hospital.

Health Minister calls on Africa to ensure quality and safe medicines

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Mr Kwaku Agyeman-Manu, the Minister of Health, has called for stronger collaboration and networking among African countries, to sustain the momentum for the harmonisation of the processes for medicine registration and regulation to safeguard the health of the people.

This, he said, would save the continent of the challenges of having to deal with cross-border transfer of fake medicines and other substandard pharmaceutical products, which have huge negative impacts on health systems as well as on patients.

Speaking at the third Biennial Scientific Conference on Medical Products Regulations in Africa on Monday in Accra, Mr Agyemang-Manu said although significant strides had been made over the years to enhance and modernise the regulation of pharmaceutical manufacturing and product quality across the world, the drug registration system in Africa remained complex and varied.

The two-day conference being organised by international stakeholders with support from the Government of Ghana, the West African Health Organisation (WAHO) and the New Partnership for Africa's Development (NEPAD) is on the theme: “Sustaining the Momentum for Regulatory Harmonisation in Africa”.

The delegates attending the conference include key stakeholders made up of regulators, policymakers, academia, the scientific community, private sector and civil society from across Africa.

The participants are discussing and contributing towards the future of medicine regulation and harmonisation in Africa, which affects both industrial and regulatory aspects, as well as the aspirations of civil society and its wish to benefit from best practice and best medicine.

While welcoming the delegates to the conference, Mr Agyemang-Manu noted that the African Medicines Regulatory Harmonization (AMRH) initiative, currently being run by the countries had some ongoing pilot projects aimed at improving national regulatory processes and that when that was completed, it would go a long way towards meeting the goal of regulatory harmonization and convergence.

The Minister, however said in the absence of that, each country was presently invoking their own separate audit and assessment processes, and many of them dealt with regulatory issues independently, which meant that manufacturers had to make formal registrations in every country, and each country’s regulatory agency would assess whether the drug was right for its market or not.

Mr Agyeman-Manu said this, almost guarantees the fact that Africans would be the last to benefit from new drugs launched onto the international market.

He said: “what is needed is a single agency, which could do all these work once, rather the current duplication, and then allow applicants and individual countries to benefit from it without having to reinvent the wheel”.

He emphasized that the harmonisation of the processes for medicine regulation had been on the drawing table for far too long and that time was overdue, for countries to unite their resources and strengthen their networking systems to make that dream a reality.

The Sector Minister said there was also the need to double efforts at building strong systems that would guarantee the quality and safety of all pharmaceutical products, while reducing duplication of functions, and also minimising the timing for registration processes.

Dr Agama Margaret-Anyetei, the Head Division, Health, Nutrition and Population at the African Union Commission, said the conference would serve as a platform for stakeholders to brainstorm on the role of ethical and regulatory approval of clinical trials of new medicines, as well as neglected tropical diseases.

She said African leaders and Heads of States have agreed to establish the proposed continental body known as the African Medicines Agency by 2018, to regulate medicines and strengthen systems along the value chain to protect the health of the people.

Mrs Delese Mimi Darko, Chief Executive Officer of the Food and Drugs Authority, said “we are working as individual countries to harmonise our systems, our procedures, our processes and we have already started”.

She explained that the member countries in the ECOWAS sub-region had already started working towards the harmonisation processes, citing Ghana, Nigeria, Sierra Leone, Liberia and The Gambia, as among the countries to harmonise the way things were done.