Mozambique marks a historic milestone in the fight against HIV/AIDS, becoming the first country to receive doses of a new-generation antiretroviral produced entirely on African soil. The World Health Organization (WHO) has confirmed that this is a decisive step towards the continent’s health self-sufficiency, the result of a partnership between African countries, manufacturers and the Global Fund.
The medicine, known as TLD – a combination of dolutegravir, lamivudine and tenofovir – will be supplied by laboratories of the pharmaceutical company Universal Corporation Ltd (UCL), of Kenya. In 2023, UCL was the first African entity to obtain WHO prequalification for the production of this internationally recommended first-line HIV treatment.
According to Meg Doherty, WHO director of programmes for HIV, hepatitis and sexually transmitted infections, “the Global Fund’s procurement for Mozambique of first-line HIV treatment manufactured in Africa is a major milestone for strengthening supply chain systems in Africa”. She also stresses that this advance “will contribute to better health outcomes for people living with HIV who need uninterrupted supplies of medicines”.
Although the exact volume of doses intended for Mozambique has not been revealed, the WHO stresses that local production alone is not enough. “Advance market commitments, fair procurement policies and ongoing technical support are needed”, the organisation warns, arguing that African manufacturers should be given priority in global supply chains and fair access to health technologies, provided they meet rigorous quality and efficacy criteria.
The introduction of TLD in Mozambique comes at a time when the country faces a high rate of HIV/AIDS incidence: about 43 in every thousand inhabitants live with the disease. However, the Mozambican Government has set a target in the Government’s Five-Year Programme (PQG) 2025–2029 of reducing that figure to 13 in a thousand by the end of the period, with a particular focus on young people.
The African continent remains the most affected by the epidemic: it is home to almost 65% of all people living with HIV in the world. Even so, access to treatment has until recently depended almost exclusively on the import of medicines and diagnostic tests from outside the continent.
For the WHO’s director of regulation and prequalification, Rogério Gaspar, this change represents more than a technical advance. “Quality-assured local production is an urgent priority. Every African manufacturer that achieves prequalification brings us closer to self-sufficient, resilient and equitable health systems”, he said.
The WHO also warns of the risks of financial fragility affecting HIV testing programmes, in a context of reduced donor funding. In response, the Nigerian company Codix Bio has obtained a WHO licence to manufacture HIV rapid diagnostic tests (RDTs). This initiative aims to broaden access to affordable tests and ensure the continuity of diagnostic services.
