In this interview, Samer El-Ali, Medical Director at Gilead Middle East, discusses the evolution of HIV treatment and prevention in the Middle East. He highlights significant advancements in antiretroviral therapy (ART), including single-tablet regimens and long-acting injectables, which have dramatically improved patient outcomes. El-Ali also addresses the challenges faced by the MENA region in combating HIV and the collaborative effort required to meet global HIV targets by 2030.
Middle East Health: How has the prognosis for people with HIV changed over the past few decades?
Samer El-Ali: A few decades ago, people with HIV had a low chance of living more than ten years. However, advancements in antiretroviral therapy (ART) have significantly improved patient outcomes and life expectancy. ART has been dubbed the “Lazarus drug” for its life-saving impact, preventing twice as many deaths as would have occurred without it.
Middle East Health: What are the recent innovations in ART?
Samer El-Ali: Innovations in ART, such as single-tablet regimens (STRs) that combine multiple antiretroviral agents into one daily pill, have simplified treatment adherence, reduced the pill burden, minimized the risk of drug resistance, and improved overall patient outcomes. Additionally, long-acting injectable therapies are emerging as a promising alternative, offering patients the convenience of less frequent dosing and further improving adherence.
Middle East Health: Has any progress been made in preventative approaches?
Samer El-Ali: Yes – a great example of this is the concept of Treatment as Prevention (TasP) which highlights the dual benefit of ART in managing individual health and reducing HIV transmission at a population level. This treatment is available for HIV-negative individuals at high risk of infection.
Middle East Health: What is the status of the HIV epidemic in the Middle East and North Africa (MENA)?
Samer El-Ali: While the burden of HIV is relatively low in the MENA region, research by UNICEF revealed that new infections increased by 54% between 2010 and 2022. While the number of people receiving HIV treatment has doubled since 2015, the region has the lowest treatment coverage globally. Stigma, socio-cultural challenges, ongoing conflicts, and humanitarian crises all present barriers to testing and treatment access, so stakeholders need to continue to work together to overcome these and end the epidemic in line with global goals.
Middle East Health: What is being done to increase awareness about HIV/AIDS in the region?
Samer El-Ali: Gilead hosts an annual Middle East HIV Summit that brings key stakeholders together to discuss the latest developments and innovations in the fight against HIV/AIDS. The 8th edition hosted earlier this year aimed to equip medical professionals with the necessary tools to guide patients toward appropriate treatment for long-term success. We introduced Gilead’s “Power of Five” strategy – a transformative strategy for guiding HIV treatment selection that focuses on five key pillars: safety and tolerability, patient-centred care, a high barrier to resistance, rapid treatment initiation, and proven experience. This comprehensive approach aims to ensure long-term treatment success and improve the quality of life for people with HIV.
There are also awareness programmes that target both healthcare professionals and the general population. The HIV STAR (Suspect, Test, Advise, Refer) was an initiative we launched in collaboration with regional stakeholders, including infectious disease societies, across KSA, UAE, Bahrain, and Qatar. The aim was to increase awareness among healthcare professionals.
Middle East Health: What role do digital tools play in HIV prevention and treatment?
Samer El-Ali: Digital tools play a crucial role in HIV prevention and treatment by facilitating education, awareness, and engagement among the population. Campaigns like “Ana Faisal”, launched by Gilead in collaboration with the Saudi Society of Infectious Diseases (SSMMID), use AI technology to address HIV stigma and promote testing. Programmes like “La Tamchi 3ala Amak” leverage various channels to raise awareness about HIV and contribute to disease prevention.
Middle East Health: How is Gilead Sciences contributing to the fight against HIV in the Middle East?
Samer El-Ali: Gilead Sciences is at the forefront of ART development, bringing 11 HIV medications to market and advancing a robust pipeline of next-generation therapeutic options. Our commitment to the Middle East is reflected in ongoing efforts to ensure access to innovative therapies and prevention methodologies for HIV across the region.
Middle East Health: What is necessary for the Middle East to meet global HIV targets and end AIDS as a public health threat by 2030?
Samer El-Ali: Global HIV targets, part of the Sustainable Development Goals, aim to end AIDS as a public health threat by 2030. The MENA region, with its relatively low HIV burden, has a significant opportunity to be the first to achieve this goal. Increasing awareness, improving access to ART, and reducing stigmatization are crucial for progress. In addition to this, partnerships and community engagement will play an important role in driving meaningful change toward awareness of HIV prevention and treatment.
