Re­move toxic Aids drug from the mar­ket

Chronicle (Zimbabwe) - - National News -

THE shock­ing dis­cov­ery that more than 20 per­cent of Africans who are tak­ing Efavirenz, a first line drug to man­age HIV and Aids, could have been tak­ing an over­dose over the years re­it­er­ates the com­pelling need for author­i­ties on the mother con­ti­nent to in­vest in the health of their peo­ple. Since the ad­vent of con­ven­tional medicine in Africa, Africans have largely been tak­ing drugs and us­ing med­i­cal equip­ment that are made in Amer­ica and Europe. African gov­ern­ments and the pri­vate sec­tor on the con­ti­nent have in­vested lit­tle in mod­ern medicine and equip­ment.

As we have al­ways warned, such a state of affairs can pose im­mense chal­lenges for Africans as West­ern gov­ern­ments and their drug manufacturers may not be re­lied on all the time.

We, how­ever, must make it clear that there are many sin­cere or­gan­i­sa­tions and gov­ern­ments in the West who have as­sisted Africa in its de­vel­op­ment agenda and this in­cludes pro­vid­ing sup­port in the field of medicine. Some of the as­sis­tance has come free of charge or at sub­s­dised prices, which has gone a long way in help­ing re­source-poor gov­ern­ments di­rect some of their re­sources to other pri­or­i­ties and their peo­ple to live healthy lives.

Bur, Africans must in the same breath, un­der­stand that in many of their ac­tiv­i­ties, Euro­peans and Amer­i­cans are gen­er­ally geared for their ben­e­fit, more specif­i­cally, mone­tary profit. Also, they have an obli­ga­tion to their peo­ple and as such Africa is sec­ondary.

For this rea­son, we stress that African gov­ern­ments and sci­en­tists must take a lead in com­ing up with bud­gets to fund re­search into new med­i­cal drugs and equip­ment to pre­serve the health of their peo­ple.

We quote in our lead story to­day a lo­cal sci­en­tist, Pro­fes­sor Collen Masimirem­bwa, the pres­i­dent and chief sci­en­tific officer with the African In­sti­tute of Bio­med­i­cal Sci­ence and Tech­nol­ogy (AiBST) say­ing re­search had shown that the con­cen­tra­tion of Efavirenz in Africans was higher com­pared to Euro­peans tak­ing the same medicines.

“Over 20 per­cent of pa­tients in Zim­babwe and in Africa for that mat­ter, are over­dosed when they are be­ing given the cur­rent stan­dard dose,” he said.

“We have now re­alised that the dif­fer­ence is be­cause of the ge­netic make-up of African peo­ple where they have a vari­ance which re­duces their ca­pac­ity to re­move the drug from the body once given the stan­dard dose. Cau­casians, on the other hand, have a vari­ance that quickly breaks down the drug (Efavirenz) in their bod­ies faster than in Africans.”

The high con­cen­tra­tion of resid­ual Efavirenz in Africans, he said, causes more side ef­fects in them com­pared to their coun­ter­parts.

He said this is the rea­son why most HIV pos­i­tive peo­ple tak­ing Efavirenz ex­pe­ri­ence mul­ti­ple side ef­fects com­pared to oth­ers in some parts of the world.

Prof Masimirem­bwa said AiBST had come up with a ge­netic test to as­cer­tain the pos­si­bil­ity of re­duc­tion of Efavirenz dose in the prod­uct to match with the African ge­netic make-up to re­duce the side ef­fects.

Some of the drug’s side ef­fects are di­ar­rhoea, skin rash, nau­sea, dizzi­ness, lack of con­cen­tra­tion, headache, fa­tigue, vom­it­ing, and anorexia.

“The ge­netic tests and the dos­ing al­go­rithm of how to re­duce the dose will have a huge im­pact be­cause it will mean peo­ple will be treated safely, which is the most im­por­tant part of treat­ment,” said Prof Masimirem­bwa.

“Many peo­ple were com­plain­ing of side ef­fects, then we said why it is that way? When we mea­sured the con­cen­tra­tion, we re­alised that it was high,” he said.

Given the shock­ing dis­cov­ery, AiBST, in part­ner­ship with the Gov­ern­ment and Harare City Coun­cil has set up a re­search unit at Chi­tung­wiza Cen­tral Hos­pi­tal meant to as­sess the safety and ef­fec­tive­ness of medicines in African pop­u­la­tions be­fore they are in­tro­duced into the mar­ket.

He said once ac­cred­i­ta­tion and the other pa­per work is fi­nalised, all clin­i­cal tri­als will be con­ducted at Chi­tung­wiza Cen­tral Hos­pi­tal. Sam­ples will be sent to Wilkins Hos­pi­tal in Harare, which houses AiBST lab­o­ra­to­ries.

“In­deed, there is clear ev­i­dence that the dif­fer­ence in the ge­netic make-up can af­fect a num­ber of drugs, but not all drugs that is why this project is ex­tremely im­por­tant.

“We are now say­ing with a clin­i­cal trial unit, those phar­ma­ceu­ti­cal com­pa­nies can work with us at an early stage to make sure that their prod­ucts are safe and ef­fec­tive for African pop­u­la­tions,” he said.

We truly hail Prof Masimirem­bwa for this ground-break­ing find­ing. He is a lo­cal sci­en­tist, not a Euro­pean or Amer­i­can one this time, to have made such a sem­i­nal dis­cov­ery. We look for­ward to more work in that re­spect that could lead in Efavirenz be­ing with­drawn from the mar­ket.

It is also good that it has not just ended as a dis­cov­ery that iden­ti­fies a po­ten­tially fatal short­com­ing but has led to his or­gan­i­sa­tion mo­bil­is­ing in­vest­ment in a fa­cil­ity to test all im­ported drugs for their ef­fi­cacy on lo­cal pa­tients and lo­cal con­di­tions.

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