Remove toxic Aids drug from the market

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.