Illegal ARVs flood local black market

By Tinomuda Chakanyuka

Illegal imports of the latest generation of anti-retroviral (ARVs) drugs from neighbouring South Africa and Zambia have flooded the local black market, exposing people living with HIV to health complications.

The imported drugs are also cheaper than the ones that are being sold locally through the formal outlets.

It has been observed that people living with HIV prefer the latest drug regime, the Fixed Dose Combination of Tenofovir, Efavirenz and Lamivudine (Tenolam E), which allows them to take just one tablet a day and reduces the pill burden.

However, the latest drug is not readily available locally as Government is yet to roll out the treatment on a large scale, which has given rise to the sale of the drug on the informal market as people living with the virus are desperate to switch from the old regimen.

Only pregnant mothers and people with co-infections of TB and HIV are accessing the drug, with the rest of the population of people living with the virus still receiving a combination of four tablets a day for free at public health institutions.

Investigations showed that the single tablet Zidolum N, which is a combination of Zidovudine, Lamivudine and Nevirapine, is readily available on the black market with a month’s supply of the drug costing between $30 and $40.

The same drug costs between $56 and $60 at formal outlets.

Also available on the informal market is a double combination of Tenofovir and Lamivudine (Tenolam), which is being sold at between $15 and $20 for a month’s supply which is almost half the price of the regulated price at pharmacies.

The drugs can be bought without prescription.

Zimbabwe National Network for People Living with HIV (ZNNP+) board chairperson, Mr Sabastain Chinhaire, blamed the influx of the illegal drugs on delays by Government to roll out the Fixed Dose Combination to the larger population of HIV patients.

Mr Chinhaire said the only way to curb the illegal importing and selling of the drugs was to ensure availability of the drug through formal channels.

“As a network of people living with HIV, we are concerned with the unavailability of the latest drug regimen. Only about 40 percent of the population of people living with HIV are accessing the one tablet a day treatment and that is exactly what is fuelling the black market.

“It’s a fatal development because these people who are now turning to the black market are doing so without prescription from medical doctors and that puts their health at risk. They also run the risk of buying expired or even fake drugs. But they don’t have a choice because the formal system is struggling to cater for them.

“So as an organisation we will continue to lobby Government for the immediate rollout of the drug to the larger population of people living with the virus. We also want those people on the waiting list to be put on medication immediately because those people are the ones who are also sustaining the black market because they are desperate to improve their health,” he said.

Reverend Maxwell Kapachawo of the Reverend Max and Friends Foundation, an organisation that works with people living with HIV, said the continued stigmatisation and discrimination of people living with the virus was the reason why some people shunned getting their medication through formal markets.

This, he said, had fuelled the illegal imports and the sale of the drugs.

“As long as people living with HIV continue being discriminated then the black market will always thrive. A lot of people are not comfortable buying their drugs from the pharmacies or getting them for free from Government hospitals because of the existing stigma.

“That is the reason why the black market of ARVs has continued to thrive. We need to deal, of course, with other factors such as availability of the drugs, but there is also a need for us to fight this stigma,” he said.

Deputy Minister of Health and Child Care, Dr Paul Chimedza, said the ministry was unaware of the illegal influx of the drugs but warned members of the public against buying the drugs.

“I’m not aware of that and the ministry has not yet received a formal report on the illegal imports. As far as I know we are giving people ARVs for free, so one wonders why someone would want to buy the drugs on the black market.

“If that is the case, then whoever is buying the drugs on the informal market is doing so at their own risk. There is a great chance that these drugs could have expired and some of them might have been wrongly stored. There are a lot of dangers in buying drugs on the black market and people need to be aware of those dangers.

“One needs a doctor’s prescription to be able to start taking treatment to allow monitoring to be conducted efficiently. Now if people buy drugs without prescription and they develop complications it creates a lot of problems for us,” he said.

Dr Chimedza said his ministry would soon engage police to investigate the issue.

Head of the Aids and Tuberculosis Unit in the health ministry, Dr Owen Mugurungi echoed Dr Chimedza’s sentiments, saying the importation and sale of imported ARVs was illegal and an investigation into the matter would soon be launched.

Dr Mugurungi, however, added that the country was moving towards rolling out the Fixed Dose Combination on a larger scale to cater for the greater population of people living with HIV.

“We don’t advise people to buy drugs from the streets. Medicines are there to help people with their conditions and we want to get high quality and authentic ones. There are a lot of counterfeit drugs out there which have fatal effects on people’s health.

“We will definitely send out people to investigate that issue and see how best we can deal with it. Surely if the drugs are meant for Zambia and they are being imported into Zimbabwe, then it means someone in Zambia is being prejudiced,” he said.

“Like I said previously, we are working towards rolling out the one tablet per day treatment in line with WHO recommendations and I don’t see the need for our people to be gullible and jump on to new things that come through informal channels.

“What we are working on is finishing the current stocks of the old regimen, after which we will start procuring the latest generation of ARVs. I’m sure by end of year this year we would be there.”

About 1,4 million adults are living with HIV countrywide and of that figure 955 000 are receiving ARVs, with the remainder still on the waiting list.

At least 156 718 children between 0-14 years are living with HIV, with 46 319 of them on ART.

Zimbabwe commenced its ART programme in April 2004, with the National Aids Trust Fund being the major source of funds. Sunday News