Every year, roughly, about two million people do contact HIV infections worldwide. This has been an ongoing war between countries, companies, and individuals who have put both effort and resources in the fight against this horrific dilemma that has plagued humanity.
Over a decade ago, an organization called Gilead Sciences Inc, came up with a new prevention and sustenance procedure called pre-exposure prophylaxis (PrEP).
This medication, when strictly adhered to can reach efficiency levels of about 99% (according to Gilead), but there was a catch to it.
The medication proved to be less effective in certain cases, causing significant damages to the kidney, bones, and teeth. We will be discussing extensively how this supposed miracle prodrug became a nightmare, even to the far end of African communities.
This medication in question involved the use of a drug or pill called Truvada, which is basically a mixture of two components emtricitabine, and tenofovir disoproxil fumarate (Krakower 2017). It is the most widely used treatment for HIV prevention, in that it mitigates the replication of HIV-1 after it has entered the human body.
In medical terms, it is the obstruction of the activities of HIV-1 reverse transcriptase, which results in the termination of the sequence or chain.
But because Truvada had major, and in most cases, irreversible consequences, it has precipitated a lot of Truvada lawsuits, and here are reasons why.
It is crucial to bear in mind that both TDF and FTC have been documented to have adverse results (adverse drug reactions, or ADRs).
A Siemieniuk et al. made a meta-analysis which indicated that, in many cases, the administration of TDF/FTC had resulted in stillbirth/early neonatal death and early premature delivery in HIV positive participants.
Although there wasn’t any valid data on HIV-negative participants, many studies have shown that another aftermath of the two drugs is the lowering of bone mineral density.
In order words, an extra concern is the possible long-term effects of Truvada pre-EP on the general health of the population.
Monitoring and evaluation of ADRs and related toxicities are a major challenge in the public health sectors of countries with emerging economies, which is mainly the lack of adequate structures or systems for pharmacovigilance and drug-surveillance that assess, tracks and monitor safety profiles of ARVs.
But in the US, it is quite different. There are systems and well-documented metrics for determining the range of deterioration that has resulted from the constant use of these prodrugs.
This is why a company like Gilead Sciences Inc, is being held responsible for the deliberate exploitation of patients and people that are already in a desperate situation. Let’s leave the scope of the US and go down to Africa, where they don’t have anyone to hold accountable.
And how they are still struggling to have a taste of the drugs that are already being rejected in the US. After these medications were handed down to them almost at no cost, so who are they to complain.
Patients on ARV therapy (ART) are most of the time evaluated through an impromptu surveillance system that is presently incompetent in detecting ADRs.
In an insufficient health sector like that of South Africa, pre-EP for healthy and fit individuals will compete for meager resources that are not even enough to sustain a growing disease burden.
In September 2016, South Africa began the implementation of the World Health Organization (WHO) evidence-based guidelines for universal test and treat—(UTT)
The strategy aimed at testing 90% of infected people, treat 90% of those tested and have viral loads suppressed in about 90% of individuals medicated.
South Africa has one of the biggest, if not the biggest ART programs in the world. They are mostly financed by the Fiscus, and the implementation of UTT will marginally shoot up the number of persons on Antiretroviral therapy.
An addition to the budget will, therefore, be needed in an already declining economic climate. UTT will no doubt push the demand for healthcare services within the context of a heavier burden of disease, top demand for medical personnel, and insufficient infrastructure.
Most Public hospitals and clinics are at the brink of collapsing because of too many patients flocking in numbers, with complaints ranging from medication stock-outs to sluggish funding and assistance from donors, whose generosity has flat lined for the past seven years.
Therefore to add a huge figure of sexually active but healthy people to this overburdened healthcare platform would hasten its further deterioration.
On the other hand, TDF and its use have been associated with chronic nephrotoxicity, changes in sensors of renal function, serious renal adverse effects, and decreases in both bone—and—bone mineral density.
It should also be taken into notice that most data on TDF ADRs are from controlled and monitored clinical trials within demographics that are genetically different from much of SA’s population.
Furthermore, many persons in settings with very limited resources, do make use of a dual system of healthcare, traditional and conventional.
With an approximate 26.6 million users of traditional medicine in South Africa, new drug-herb interactions are likely to be in play. The limitations that policies such as UTT pose for underdeveloped countries have well been outlined, and have been predicted for sub-Saharan Africa (SSA).
The same limitations outlined by Bigna and colleagues resonates with the roll-out of Truvada to healthy and active people in SA. A conclusion was reached that SSA cannot afford UTT.
SA can’t afford the cost and implications of Truvada roll-out. SSA should endeavor to plan in adopting WHO policies, bearing in mind local resource limitations.
Of course, as decent human beings, we do not want to be inclined to believe Truvada roll-out is influenced by pharmaceutical companies that stand to profit regardless of the detrimental consequences to the country. But with recent developments, there is no doubt as to their agenda.
Coming down to the United States where there are means and appropriate measures for ensuring and tracking the progressive reports and side effects of the consumption of Truvada-it unapologetically clear that this drug that has been monopolized by Gilead Sciences Inc has done more harm than good.
There are so many other cases of processes that have been propagated to exploit people who are in a desperate situation, but we are not going to delve into that—-after all, what is the point of visiting an old wound without a proper way to heal it?
Now, if you so find yourself in these types of cases, or perhaps you even know a family member who might be going through such a mishap. Then don’t be troubled, for there are several good law firms that specialize in fighting and haggling for a reasonable compensation on your behalf.
Emphasis on the word reasonable, because there is no amount of money that can be equated with health and a sound mind. “Health is wealth” and health is priceless.