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A new HIV prevention pill, known as MK-8527 or alimatravir, has entered the final stage of testing, and South Africa could be one of the first countries to get it. The pill is taken once a month and has shown promising results in early trials.

The pharmaceutical company Merck, also known as MSD in South Africa, has given generic manufacturers permission to make copies of the pill before the final studies are completed. This move could bring the medicine to people faster than previous HIV prevention drugs.

HIV prevention options are expanding. Having more options available could lead to an increase in the number of people using these medicines. A recent study in South Africa found that over half of the people who chose the six-monthly HIV prevention jab had never used HIV prevention medicine before.

Mitchell Warren, head of the international HIV advocacy organization Avac, says that giving people more choices could lead to thousands of new users. “We don’t yet know if the medicine will work, so it’s a risk that Merck is taking, but it’s, in my opinion, a wise and strategically-taken risk,” he said.

Three African countries, including South Africa, Uganda, and Kenya, are hosting phase 3 trial sites for the pill and are also home to generic manufacturers that have been licensed to produce the medicine. Aspen Pharmacare, South Africa’s largest drug maker, is one of the companies that has received a license to produce the pill.

Aspen will import the key ingredient of the pill and then manufacture the final product in South Africa. If the pill is approved, Aspen will be able to sell and export it to 129 low- and middle-income countries, including all 54 countries in Africa. This is a significant boost for Africa’s pharmaceutical industrialization and regional manufacturing ambitions, according to Stavros Nicolaou, group senior executive for trade at Aspen.

A recent study estimates that generic alimatravir could be made for as little as $4.50 per person per year. This is significantly cheaper than the estimated cost of producing a generic version of the six-monthly HIV prevention injection, lenacapavir.

Mitchell Warren notes that for the pill to be successful, large volumes of doses will be needed, which are not yet available in the HIV prevention medication market.

They are working to make the medicine more accessible.