Today it is World Aids Day

Did you know that MEG supplies drugs for Opportunistic Infections (OI) for approximately 5% of the global HIV affected population?

HIV remains a major public health issue that affects millions of people worldwide. During the last 20 years, significant progress in detection, treatment and prevention of HIV has been made. However, important global targets for 2020 were not met due to the devastating impact of the Covid-19 pandemic. In comparison to 2019, 11% less people were reached with HIV prevention programs and services and testing dropped by 22% according to the Global Fund Results Report 2021. Covid-19 continues to exacerbate inequities and disrupt services.

The theme of World AIDS Day 2021 is:

“End inequalities. End AIDS. End Pandemics”.

MEG subscribes the re-focus as suggested by WHO;

1. Re-commit to end HIV.
2. Tackle HIV and COVID-19 together.
3. Focus on equality.
4. Concentrate on those left behind.

MEG activities to support these goals:

• During 2021, MEG has been entrusted the supply of first line ARV’s, predominantly TLD and the supply of PEP (Post Exposure Prophylaxis) and VMMC (Voluntary Medical Male Circumcision) kits.
• MEG staff was heavily involved in the research improving availability and supply of ‘New’ products, such as the Dapivirine Ring.
• The main focus, similar to previous years was on the continued supply of drugs for Opportunistic Infections (OI). Since several years, MEG focus has been heavily involved in the supply of OI drugs, from high quality, where possible from producers based in Africa, close to the majority of patients served by MEG.
• MEG has managed to approve two additional African manufacturer during last year, despite the COVID travel limitations and performed two pre-screening trips to in total 3 additional new countries, where MEG could potential source from. These Local Sourcing activities focused last year on two major OI drugs, being; Co-trimoxazole tablets (Photo 1) and syrups and fluconazole tablets. Other products for which minimum one suitable source was identified were; erythromycin, doxycycline and nystatin tablets.
• MEG can offer, in close collaboration with its selected local partners, temperature controlled delivery services in the East African region and/or last mile delivery in country (Photo 1).
• MEG was successful in 2021 with international product sourcing and qualification of other specific OI drugs. MEG would like to mention a few examples;
  • Flucytosine 500 mg tablets, an item difficult to source from a quality generic manufacturer. One generic source was added to the list of qualified vendors. Through this source, MEG can guarantee better product availability against a better price ex-factory. MEG is now jointly working to expand the product registration in target countries and actively looking for additional high product quality sources, with the capability to produce API in house.
  • Amphotericin B, MEG has secured two generic sources for this product. For the liposomal product presentation (which is less toxic and often providing a higher cure rate) generic version was identified in India though at a very high price and for time being on export ban and one generic source was identified in China. MEG is now day-to-day involved in seeking options to lift the Indian export ban for this product, such that a quality product becomes available for a wider (global) audience.

▶ 1 - Temperature controlled delivery service.
▶ 2 - Co-trimoxazole tablets ready for deliveries to ‘state’ medical stores in Nigeria.