ARV shortage hits
Aug 23, 2008
Dr. Elizabeth Namagala, a coordinator in the ART division at the health ministry, said they would carry out re-distribution from centres that had over-stocked some ARVs to those experiencing shortages. She said whereas Combivir, the backbone of most ARV combinations in Uganda is still in stock, all
Dr. Elizabeth Namagala, a coordinator in the ART division at the health ministry, said they would carry out re-distribution from centres that had over-stocked some ARVs to those experiencing shortages. She said whereas Combivir, the backbone of most ARV combinations in Uganda is still in stock, all others were in short supply at some sites. Another doctor explained that there are patients on whom Combivir either doesn’t work, or they suffer serious side effects, so they need alternatives.
Namagala, however, said the ministry had the capacity to avert a crisis. She pointed out that Government had placed an order for more ARVs, using part of the sh60b announced in the budget speech. “There is no cause for alarm and the shortage will not last for long,†she said.
Dr. Peter Mugyenyi, the pioneer of antiretroviral treatment in Uganda, explained that the shortage is a global problem. “The current shortage has nothing to do with the ministry of health. Some of the factories delivering first line drugs have failed to deliver but they have assured us that they are addressing the problem,†Mugyenyi noted.
Mugyenyi explained that because of growing worldwide demand, some of the manufacturers could not cope.
“Two months ago we got communication from one of the manufacturers that they would not meet the demand,†he said. “The companies manufacturing these drugs informed us that they were not getting the raw materials in sufficient amounts to meet the worldwide demand for ARVs.â€
Additionally, the demand for ARVs has been rising in Uganda, creating pressure on limited resources. The number of people in immediate need of the drugs had risen from about 225,000 in 2006 to 312,000 today, according to health ministry estimates. On average, 1,500 patients are enrolled on Anti-Retroviral Therapy (ART) every month.
An estimated 1.1 million Ugandans are living with the virus that causes AIDS. Currently, 130,000 patients, including 10,000 children, are receiving ARVs. This is about 42% of the total number of people in urgent need of ARVs. This percentage is one of the highest in Africa.
The current shortage comes at a time when Uganda has started producing ARVs. Quality Chemical Industries, a pharmaceutical company based in the Luzira Industrial Area, started full scale production of ARVs last month.
The Chief Executive, Emmanuel Katongole, yesterday said Government had placed an order worth $1.8m (sh3b). “We are delivering the first batch of the drugs ordered by the Ministry of Health next week,†he told Saturday Vision.
The sh64.6b plant has the capacity to produce 60 million tablets a day. The Government is expected to be their biggest client.
Participants at the second national HIV/AIDS paediatric conference that ended yesterday noted that of the 50,000 children in need of immediate life-saving HIV treatment, only 10,000 are accessing this essential intervention.
Namagala said 50% of the people living with AIDS access ARVs under a government program supported by the World Bank and the Global Fund for HIV/AIDS, malaria and tuberculosis. Others receive treatment under the President’s Emergency Plan for AIDS Relief, employee schemes and out-of-pocket payment.
Highly active antiretroviral therapy, the medication that suppresses HIV to the extent that it can not be detected in blood, first became available in Uganda in 1998 when the Joint Clinic Research centre (JCRC) introduced it. Initially it cost sh2m per monthly dose. This was too costly as the drugs have to be taken life-long, lest the virus makes a come-back.
Later, a drug access initiative and international market forces led to steady price declines until Government announced it would provide the drug to all who need it. Currently the lowest cost options are between sh20,000 and sh30,000 per month.
In September 2007, the media reported that drugs worth sh1.65b were about to expire at the National Medical Stores and drugs worth sh1.2b had already expired. The expired drugs included ARVs.
A new hope for HIV+ pregnant mothers
By Anthony Bugembe and Elvis Basuude
After years of using a single dose of nevirapine to prevent HIV+ mothers from passing on the virus to their babies during delivery, scientific evidence is showing that is not good enough. “The country has been implementing PMTCT since 2000 but the regiments that we are using in Uganda don’t reduce mother-to-child transmission (MTCT) markedly,†said Dr. Justine Nankinga, the national Anti-Reviral Therapy coordinator in the ministry of health.
Now health experts want the strategy changed. Instead of giving just a single dose of nevirapine, they argue that pregnant women should get the full combination of antiretroviral drugs (ARVs).
The methods used nationally since 2000 involved administering a single tablet of nevirapine to the mother at the onset of labour. The baby is given syrup of the same drug within 72 hours after birth. This approach reduces the risk of mother-to-child HIV transmission by half.
However, using a full ARV combination, the risk could be reduced much more dramatically. “Today, research has shown us that if all HIV+ pregnant mothers are given a triple combination of ARVs, we can reduce MTCT to almost 1%,†Nankinga said during the second national HIV paedriatric conference in Kampala.
Dr. Victor Musiime, a pediatrician at Joint Clinical Research Centre, said “Now that more resources are available we are advocating for a triple combination. This is being done in developing countries.â€
However, this is still far from being achieved. “Adopting the new intervention requires the health ministry to revise the current ARV policy guidelines,†said Nankinga, adding, “This would also mean increasing our ARV requirement.â€
According to health ministry estimates, over 20,000 children are born with HIV in Uganda annually. However, using the triple therapy, this could be reduced to just 200 if it becomes available to every HIV positive women.
Namagala, however, said the ministry had the capacity to avert a crisis. She pointed out that Government had placed an order for more ARVs, using part of the sh60b announced in the budget speech. “There is no cause for alarm and the shortage will not last for long,†she said.
Dr. Peter Mugyenyi, the pioneer of antiretroviral treatment in Uganda, explained that the shortage is a global problem. “The current shortage has nothing to do with the ministry of health. Some of the factories delivering first line drugs have failed to deliver but they have assured us that they are addressing the problem,†Mugyenyi noted.
Mugyenyi explained that because of growing worldwide demand, some of the manufacturers could not cope.
“Two months ago we got communication from one of the manufacturers that they would not meet the demand,†he said. “The companies manufacturing these drugs informed us that they were not getting the raw materials in sufficient amounts to meet the worldwide demand for ARVs.â€
Additionally, the demand for ARVs has been rising in Uganda, creating pressure on limited resources. The number of people in immediate need of the drugs had risen from about 225,000 in 2006 to 312,000 today, according to health ministry estimates. On average, 1,500 patients are enrolled on Anti-Retroviral Therapy (ART) every month.
An estimated 1.1 million Ugandans are living with the virus that causes AIDS. Currently, 130,000 patients, including 10,000 children, are receiving ARVs. This is about 42% of the total number of people in urgent need of ARVs. This percentage is one of the highest in Africa.
The current shortage comes at a time when Uganda has started producing ARVs. Quality Chemical Industries, a pharmaceutical company based in the Luzira Industrial Area, started full scale production of ARVs last month.
The Chief Executive, Emmanuel Katongole, yesterday said Government had placed an order worth $1.8m (sh3b). “We are delivering the first batch of the drugs ordered by the Ministry of Health next week,†he told Saturday Vision.
The sh64.6b plant has the capacity to produce 60 million tablets a day. The Government is expected to be their biggest client.
Participants at the second national HIV/AIDS paediatric conference that ended yesterday noted that of the 50,000 children in need of immediate life-saving HIV treatment, only 10,000 are accessing this essential intervention.
Namagala said 50% of the people living with AIDS access ARVs under a government program supported by the World Bank and the Global Fund for HIV/AIDS, malaria and tuberculosis. Others receive treatment under the President’s Emergency Plan for AIDS Relief, employee schemes and out-of-pocket payment.
Highly active antiretroviral therapy, the medication that suppresses HIV to the extent that it can not be detected in blood, first became available in Uganda in 1998 when the Joint Clinic Research centre (JCRC) introduced it. Initially it cost sh2m per monthly dose. This was too costly as the drugs have to be taken life-long, lest the virus makes a come-back.
Later, a drug access initiative and international market forces led to steady price declines until Government announced it would provide the drug to all who need it. Currently the lowest cost options are between sh20,000 and sh30,000 per month.
In September 2007, the media reported that drugs worth sh1.65b were about to expire at the National Medical Stores and drugs worth sh1.2b had already expired. The expired drugs included ARVs.
A new hope for HIV+ pregnant mothers
By Anthony Bugembe and Elvis Basuude
After years of using a single dose of nevirapine to prevent HIV+ mothers from passing on the virus to their babies during delivery, scientific evidence is showing that is not good enough. “The country has been implementing PMTCT since 2000 but the regiments that we are using in Uganda don’t reduce mother-to-child transmission (MTCT) markedly,†said Dr. Justine Nankinga, the national Anti-Reviral Therapy coordinator in the ministry of health.
Now health experts want the strategy changed. Instead of giving just a single dose of nevirapine, they argue that pregnant women should get the full combination of antiretroviral drugs (ARVs).
The methods used nationally since 2000 involved administering a single tablet of nevirapine to the mother at the onset of labour. The baby is given syrup of the same drug within 72 hours after birth. This approach reduces the risk of mother-to-child HIV transmission by half.
However, using a full ARV combination, the risk could be reduced much more dramatically. “Today, research has shown us that if all HIV+ pregnant mothers are given a triple combination of ARVs, we can reduce MTCT to almost 1%,†Nankinga said during the second national HIV paedriatric conference in Kampala.
Dr. Victor Musiime, a pediatrician at Joint Clinical Research Centre, said “Now that more resources are available we are advocating for a triple combination. This is being done in developing countries.â€
However, this is still far from being achieved. “Adopting the new intervention requires the health ministry to revise the current ARV policy guidelines,†said Nankinga, adding, “This would also mean increasing our ARV requirement.â€
According to health ministry estimates, over 20,000 children are born with HIV in Uganda annually. However, using the triple therapy, this could be reduced to just 200 if it becomes available to every HIV positive women.