Acute ARV shortage hits Zimbabwe

By Paidamoyo Chipunza

An acute shortage of anti-retroviral drugs in public health institutions is reportedly forcing patients to switch to drug combinations which compromise their health. Some hospitals are said to be offering ARVs meant for children to adults.

Mixing different regimens can result in treatment failure because the virus is highly mutagenic and becomes drug resistant. Selected Government health hospitals offer ARVs to about 400 000 people on treatment.

People Living with HIV and Aids representative on the National Aids Council board, Mr Golden Guni, said: “People are switched from one combination to another depending on which drug is available at that time.”

Zimbabwe last year switched to Tenofovier, a new ARV regimen following guidelines released by the World Health Organisations. The regimen is more effective and has fewer side effects. Government was prescribing Stalanev to all people taking ARVs, but the drug had serious side effects.

Some of the side effects included uneven deposition of body fats. Investigations showed that adults were being given paediatric formulations when drugs are out of stock. Mr Guni said this forced Government to give people drugs that last for two weeks only. Previously, people were given three-months’ supply.

The shortage is also attributed to delays in the disbursement of money from the Global Fund. However, head of the Aids and TB Unit in the Ministry of Health and Child Welfare Dr Owen Mugurungi dismissed the reports saying Government had enough drugs in stock.

He attributed the shortages in health centres to logistical problems and bureaucratic bungling. “What I know is that at national level we have enough stocks of ARVs,” Dr Mugurungi said.

He dismissed reports that people were given drugs enough for only two weeks, saying Government’s position was to provide at least a month’s supply. Information gathered by The Herald indicates that the crisis, which started some months back, has affected most districts, including clinics around Harare.

According to the World Health Organisation, drug interruption is among the chief causes of treatment failure. WHO director of HIV department Dr Gottfried Hirnschall said good programme management and the use of simpler, more effective combinations of ARVs helped to manage drug resistance.

“Simpler regimens using fixed-dose combinations have made it much easier for people to adhere to anti-retroviral treatment, limiting the spread of drug resistance in recent years.” However, some health workers are reportedly taking advantage of the crisis creating artificial shortages.

The drugs are reportedly looted and sold at higher prices. However, Government sources attributed the shortages to delay in disbursement of funds by the Global Fund to Fight HIV and Aids.

“A disbursement that was supposed to have been done in January only came through in July. As you know the Global Fund provides the majority of ARVs in the public sector and a delay in the flow of funds makes a huge impact on drug availability.”

The Global Fund is working in 22 districts in Zimbabwe. The Herald