The Minister of Health, Dr Aaron Motsoaledi in collaboration with a number of international organisations and agencies reached a breakthrough pricing agreement which will accelerate the availability of the first affordable, generic, single-pill HIV treatment regimen containing Dolutegravir (DTG).

The new fixed dose combination will be available to low and middle-income countries (LMICs) at a reduced price of US$75 per person, per year.

The large volumes of ARVs purchased by South Africa were used to leverage the decrease in pricing that will benefit all low and middle income countries. The agreement is expected to accelerate treatment rollout as part of global efforts to reach all 36.7 million people living with HIV with high-quality antiretroviral therapy.

The announcement will have profound implications for the HIV treatment programme in South Africa's public health sector.

The HIV programme has grown from 923,000 patients on treatment in 2009 to 3.9m patients on treatment as of the end of August 2017. In September 2016, the Minister of Health announced the roll-out of the test and treat initiative with the aim to have 6 million HIV positive patients on treatment by 2022.

South Africa will introduce the new fixed dose combination of three drugs, Tenofovir, Lamivudine and Dolutegravir (TLD) in April 2018. It is projected that this new regimen at the price announced will save South Africa about R11 billion over the next 6 years.

Apart from the financial savings, which will decrease pressure on our national fiscus, its introduction will also have significant benefits for patients. Dolutegravir is a highly effective antiretroviral, which is well tolerated by patients and has fewer side effects. Patients are therefore more likely to be adherent and more likely to be virally suppressed – which means that they are not likely to transmit the virus to others.

The South African Government together with the Government of Kenya, in partnership with the Clinton Health Access Initiative (CHAI), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the Bill & Melinda Gates Foundation (BMGF), UNITAID, the United Kingdom’s Department for International Development (DFID), the United States’ President’s Emergency Plan for AIDS Relief (PEPFAR), the U.S. Agency for International Development (USAID), and the Global Fund to Fight AIDS, Tuberculosis and Malaria, has been working on this ground breaking pricing agreement.

“I am excited about this innovative agreement which will allow the government of South Africa to accelerate the introduction of the Dolutegravir-based fixed-dose combination which will greatly benefit our patients due to its superior therapeutic qualities,” said Minister of Health of South Africa Dr. Aaron Motsoaledi.

“The considerable price reductions could yield savings of up to R11.7 billion over the next six years for us, which means that we can initiate additional patients on treatment with the same amount of resources. Ramping up treatment with good viral suppression will enable us to reach HIV epidemic control more quickly. We are aiming at launching the new tender in April 2018,” Motsoaledi said.

South Africa’s commitment to make TLD available to patients was key to securing this ground-breaking pricing agreement.