Thursday, 8 August 2013

ARV Shortage

August 2013
At the moment there is a shortage of anti-retroviral drugs (ARVs) throughout Zambia.

Many health facilities, Mwandi Mission Hospital included, have very low levels of stock or have completely run out of Truvada and Abacavir. We were only given 21 bottles of Neviripine syrup for children in the last dispatch from Medical Stores and we have only a few tablets of the same drug left. We have tried to procure a consignment through CHAZ (Churches Health Association of Zambia) but they too have run out. There may still be some stocks available at Mongu, the Western capital, 400km away. Our vehicle is tanked up, waiting for the word to go.

A Ministry of Health spokesman reported in the ‘Times of Zambia’ on 27 July, that the country was expecting 91,500 bottles of Truvada in three weeks’ time (mid-August) and another 400,000 bottles in September this year, with the last consignment of 300,000 bottles of the same drug in October. The Ministry of Health says there is no cause for alarm as there is enough Truvada in-country to last until the next batch is received.  Other ARVs are reported available as well. In the meantime the Government had ordered another 600 000 bottles of Truvada which should arrive in September as well.

In typical “Govspeak” the reason for the shortage was put down to “some logistical challenges in the procurement process.” Another contributing factor was a world shortage of Tenofovir a vital ingredient in the manufacture of Truvada. In what is seen as a possible threat to increase resistance some patients on Truvada and Neviripine are being given Atripla instead. Neviripine is used as second-line treatment according to Zambian protocol. Depending on availability patients are being issued with 2 weeks supply at Mwandi instead of the usual 3 months’ supply.

Allafrica news recently reported that Zambia is now meeting its Abuja 2001 Declaration responsibility to spend at least 15% of the budget on healthcare, part of this to help meet the cost of keeping around 500 000 people on ARVs. This works out at almost 4% of the total population. Around $80 million of $120 million the ARV programme costs comes from donors. Last year the Government contributed $10 million and this is to be raised this year to $35 million, hoping to match a dollar for dollar contribution leading to greater Zambian ownership in footing the bills and implementation of programme. With so many calls on it and with limited resources it is not easy for the Government to achieve greater sustainability in the programme.

Meanwhile at Mwandi to serve 1800 people needing ARVs, a neighbouring mission over 4 hours away has some extra stock at the moment and has promised to share some with us. The Province as well may have some it can give us in the meantime. The AIDS Relief vehicle was sent yesterday to collect what was available. We await its return.


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