World AIDS Day 1 December 2025

Meet the researchers harnessing flow chemistry to increase ARV accessibility in South Africa

World AIDS Day on the 1st of December 2025, we are proud to shine the spotlight on the Drug Discovery and Development Centre (H3D), University of Cape Town FLOWMAP (Flow manufacturing of Active pharmaceutics) project.

Launched in 2023, FLOWMAP focuses on the use of flow chemistry — a modern technology that can accelerate, enhance, and reduce the cost of drug production — to increase local capacity for the production of active pharmaceutical ingredients (APIs). It is an international collaboration between H3D Centre, Oak Crest Institute of Science in the United States (US), Chemical Process Technologies (CPT Pharma) in South Africa, and KINETICHEM INC in the US.

While South Africa’s pharmaceutical formulation industry is well developed and produces more than half the final pharmaceutical product consumed locally, it has not yet developed the capacity to synthesise and manufacture APIs. In fact, the vast majority of APIs for use in medicines on the African continent must be imported, which often makes life-saving drugs like antiretrovirals (ARVs) expensive and harder to access.

The introduction of flow technology for the local production of APIs implemented through the use of a Synthetron spinning disc reactor offers several benefits: it uses smaller equipment, produces less waste, and allows continuous, consistent manufacturing.

This means lower costs and higher-quality medicines. By applying this approach to ARV synthesis, FLOWMAP aims to make treatment more accessible to those who need it most and help build Africa’s self-reliance in medicine production.

To shed a bit more light on the process, we sent a few questions to Dr Kanyisile Mhlana (PhD), a postdoctoral fellow in flow chemistry at H3D, working on FLOWMAP along with her colleagues Dr mcquillan moyo and Dr Thembela Sonti , PhD - Chemistry.

1. Can you explain flow technology in simple terms?

Flow chemistry is like running your ingredients through a small, controlled tube instead of mixing everything in one big pot. As the ingredients move through the tube, they react smoothly and evenly because the system controls the heating and mixing very well. It’s a newer method compared to the traditional round-bottom flask used in labs. And because you’re constantly adding ingredients at one end and collecting the product at the other, the whole process is quicker, safer, and more reliable.

2. Is this a first for South Africa?

We’re not the only group in South Africa exploring continuous flow technology; institutions like the CSIR are also building strong capabilities in this space. What makes our project unique, however, is the way we’re applying flow specifically to the synthesis and scale-up of HIV-relevant ARV APIs. We’re not just developing the technology; we’re tailoring it to address a very specific public health need. Our unique selling point is our use of the Synthetron continuous flow reactor, which allows us to efficiently develop and optimise these processes at a large scale. This focus on ARV manufacturing, combined with our specialised reactor platform, positions our work as one of the first efforts in the country to use flow chemistry directly to strengthen HIV treatment access.

3. Why could it be a game-changer for addressing HIV in South Africa?

Continuous flow technology could genuinely change how South Africa tackles HIV. It gives us a faster, cleaner, and more affordable way to make ARV medicines right here at home. Instead of relying on long, expensive imports, we could produce high-quality APIs locally, strengthen our supply chain, and make treatment more accessible for the millions who depend on it. In simple terms, flow chemistry helps us deliver life-saving HIV medicines more efficiently, and brings us closer to a healthier, more self-reliant South Africa.

4. What progress has been made so far?

In our current programme, we are developing three antiretroviral (ARV) candidates. For the first molecule, the batch synthesis and small-scale flow translation have been completed, and we are now progressing the process to the Synthetron reactor for scale-up. The remaining two ARVs are also undergoing scale-up on the Synthetron platform and are approximately halfway through their development.

ABOUT WORLD AIDS DAY

An initiative of the World Health Organization (WHO), the theme for World AIDS Day2025 is 'Overcoming disruption, transforming the AIDS response', calling for sustained political leadership, international cooperation, and human-rights-centred approaches to end AIDS by 2030.

"After decades of progress, the HIV response stands at a crossroads. Life-saving services are being disrupted, and many communities face heightened risks and vulnerabilities. Yet amid these challenges, hope endures in the determination, resilience, and innovation of communities who strive to end AIDS," reads the WHO website.

The H3D Foundation salutes each person - from the lab to the frontlines, and everywhere in between - working tirelessly to combat this disease.

KEY FACTS ABOUT AIDS (COURTESY OF WHO)

• HIV remains a major global public health issue, having claimed an estimated 44.1 million lives to date. Transmission is ongoing in all countries globally.
• There were an estimated 40.8 million people living with HIV at the end of 2024, 65% of whom are in the WHO African Region.
• Sub-Saharan Africa carries the largest burden of HIV/AIDS globally, with a disproportionate number of people living with HIV, new infections, and deaths. However, the region has also shown significant progress, leading the global decline in HIV incidence and increasing access to treatment, though challenges remain in reaching certain vulnerable populations.
• In 2024, an estimated 630 000 people died from HIV-related causes and an estimated 1.3 million people acquired HIV.
• There is no cure for HIV infection. However, with access to effective HIV prevention, diagnosis, treatment and care, including for opportunistic infections, HIV infection has become a manageable chronic health condition, enabling people living with HIV to lead long and healthy lives.
• By 2025, 95% of all people living with HIV should have a diagnosis, 95% of whom should be taking lifesaving antiretroviral treatment, and 95% of people living with HIV on treatment should achieve a suppressed viral load for the benefit of the person’s health and for reducing onward HIV transmission. In 2024, these percentages were 87%, 89%, and 94% respectively.
• In 2024, of all people living with HIV, 87% knew their status, 77% were receiving antiretroviral therapy and 73% had suppressed viral loads.