Doctors in Gauteng, KwaZulu-Natal and Mpumalanga, where the bulk of HIV-positive people live, sounded the alarm last week about a lack of the Lopinavir/Ritonavir combination ARV medicine (also known as Aluvia).
It is given to patients who are resistant to the standard, first-line ARVs and the health department estimates around 150 000 patients are on the regimen.
By late last week, some Gauteng and KwaZulu-Natal facilities had completely run out of stock while others were rationing patients to a week’s supply when they were usually given three months’ supply.
Professor Francois Venter, of the Wits Institute for Sexual & Reproductive Health, HIV and Related Diseases, described the situation as a “disaster” because doctors had no effective replacement treatments available.
“We can preach ‘don’t you dare forget to take your tablets’ all we like but when the system isn’t supplying things consistently, it fundamentally undermines any adherence messages,” said Venter, who is also head of infectious diseases at Charlotte Maxeke Hospital.
“Interrupting treatment may contribute to further immune damage, clinical events with the virus coming back, and possibly resistance, especially if the other drugs are continued.”
Stop Stock Outs Project has also received numerous reports from patients and healthcare workers, according to co-ordinator Goitseone Manthata.
Manthata said patients in Mpumalanga are currently being given Alluvia pills with half the usual strength, meaning that patients have to take double the number of pills and this could also lead to confusion.
“An urgent emergency plan needs to be taken up by the department with suppliers or alternative suppliers, to ensure the availability of Alluvia, ”said Manthata
Patient Nontyatyambo Makhapela said at her last visit to collect her treatment at Nokuthela Ngwenya clinic in Dunnottar in Nigel, she was only given a month’s supply as the pharmacy did not have enough stock to give her the usual three months.[quote float = right]Interrupting treatment may contribute to further immune damage, clinical events with the virus coming back, and possibly resistance, especially if the other drugs are continued.”
“I wish they give us the three months supply because we can’t afford to take leave every month and also coming back to clinic is costly,” Makhapela said.
Health Department spokesperson Joe Maila confirmed that there was a global shortage but that the pharmaceutical manufacturer, Abbott’s AbbVie, was “working with provinces to ensure that patients are not affected negatively”.
He said that the manufacturer had issued 220 000 packs of the medicine this month “so there is sufficient stock for patients’ demand but not enough to meet orders”.
However, some desperate clinics in Ekurhuleni and Soweto reported not having enough stock to meet patients’ demands.
Maila said that the patent for Alluvia had recently lapsed, so there was now an opportunity for other suppliers to manufacture the medicine.
“We will make sure that the supplier meets the demand or else we will consider an alternative contractor,” warned Maila.
Numerous attempts to get comment from AbbVie failed after its South African company referred all comment to US spokesperson Ilke Limoncu who failed to give answers for the shortages. – Health-e News.
*Reporting by Kerry Cullinan and Sibongile Nkosi