The
Food and Drug Administration approved a new drug, Truvada, on July
16, 2012. While this antiretroviral drug is not a cure for HIV/AIDS,
it is meant to help lower the risk of contracting HIV. The pill is
for high risk individuals, including sex workers, IV - drug users,
gay and bisexual men with multiple sexual partners, uninfected people
in long-term relationships with partners who have HIV/AIDS, and
heterosexuals who regularly engage in risky sexual behavior.
Truvada
is not new. The drug was approved in 2004 and was taken in
combination with other antiretroviral drugs for treatment with HIV.
Truvada combines the anti-HIV drugs Emtricitabine and Tenofovir
disoproxil fumarate into one pill. The drug blocks the action of a
protein that HIV needs to replicate in a person's body. The cost is
around $14.000 per year. The pill is to be taken once a day, and safe
sex still has to be practiced. In order to qualify for Truvada,
individuals must be HIV negative and must get tested every third
month. This is to assure that you are still HIV negative, otherwise
you might develop a resistance to the antiviral.
The
Debate
The
approval of Truvada has caused contentious debates. Some public
health experts argue that Truvada will foster a false sense of
security among users, leading people to believe they are immune to
the virus and reducing their use of condoms. To prevent this, the FDA
has worked with the manufacturer, Gilead Sciences, to develop a risk
evaluation and mitigation strategy that includes educational programs
for health professionals who prescribe the drug. Physicians are
required to talk with their patients regularly about their sexual
behavior and how to take the drug in order for it to work correctly.
Other health professionals have raised concerns about the possible
difficulty of people remembering to take their pill every day and ask
how unrealistic it might be to prescribe a daily pill to a healthy,
HIV negative person. Another
concern is the high cost of Truvada. People who really need it may
not be able to afford it. There is no guarantee that Medicaid,
Medicare, or private insurance would cover the cost of Truvada. Many
of those who are at high-risk are in lower socio-economic groups.
Patent laws in the US will likely block the availability of cheaper
generic versions of the pill.
Don't
despair; there are solutions to these obstacles.
Saying
the drug is too dangerous or that people will forget to take the pill
every day is paternalistic, some argue. If the drug is prescribed to
a patient, the physician must make sure the patient understands that
Truvada is not a miracle pill to prevent HIV. There can be no
confusion about how to use the drug. If people want to protect
themselves, they should have the right to do so. Besides, women in
theUS and other countries remember to take birth control pills to
prevent pregnancy–demonstrating taking one pill every day can be
worked into a person's routine.
Governments
should pay for the drug. One might ask why he or she should be
responsible for someone else's health, sexual behavior or personal
choices. Here is why:
HIV
and AIDS are everyone's problem. There are 50.000 new infections in
the United States every year. Governments and their citizens have
made great progress battling HIV and AIDS. We have launched safe sex
campaigns and have educated people about the epidemic, but these
efforts will only do so much. Everyone knows that most people will
not stop having sex! While Truvada will not end the nation's HIV/AIDS
epidemic, it will decrease the rate of new infections in the US over
time (and perhaps in the rest of the world too if other countries
approve this preventive drug.) The HIV/AIDS crisis is not contained
at present; HIV and AIDS do not discriminate. We all need to combat
the spread of HIV/AIDS in order to end this epidemic.
Read
the FDA's statement here:
http://www.cdc.gov/nchhstp/newsroom/FDA-ApprovesDrugStatement.html
Sanna
Klemetti
