The local health sector is currently being rocked by a shortage of antiretroviral drugs, intended to treat persons infected with the Human Immunodeficiency Virus (HIV).
Health Minister, Dr Leslie Ramsammy, confirmed this yesterday, but cautioned that everything is being done to address the potentially catastrophic situation. He anticipates that the Ministry will be able to receive its regular supply by Thursday.
According to the Minister, the problem is a countrywide one, but resulted through no fault of Ministry of Health officials. The Ministry has never faced such a problem before and usually receives its antiretroviral stock from Europe in a timely manner, as per order.
However, the situation, the Dr. Ramsammy said, stemmed from a shipment problem which resulted in only one type of HIV drug arriving as at the last arrival date, about two weeks ago.
The health sector currently has sufficient supply of Truvada, but did not receive another drug Efavirenz, which is recommended to treat some patients whose condition requires that they be treated with a cocktail comprising two pills.
As such, the Minister asserted that not all of the patients would be affected by the shortage of the drug, but rather those required to use a combination of pills.
Tenofovir/emtricitabine trademark Truvada, is a fixed dose combination of two antiretroviral drugs used for the treatment of HIV. It consists of 300 milligrams of tenofovir and 200 milligrams of emtricitabine. By combining the two agents into one tablet, it reduces the pill burden and increases compliance with antiretroviral therapy.
Efavirenz combined with the popular HIV medication Truvada, consists of tenofovir and emtricitabine, all of which are reverse transcriptase inhibitors. This combination of three medications was approved by the United States Food and Drug Administration (FDA) in July 2006 under the brand name Atripla and provides Highly Active Antiretroviral Therapy (HAART) in a single potion taken once a day. It results in a simplified drug regimen for many patients.
“For some patients we have a part of their medication but we know that this is a serious thing but, hopefully, it will not be for long,” the Minister noted.
In recognition of the problem, the Ministry had sought assistance from Suriname and was able to borrow a quantity of the much needed Efavirenz to alleviate the situation. That stock is however currently close to being depleted, according to the Minister. As a result, some patients are only being offered part of the recommended treatment.
“This means that if we don’t have both within a few days we could have a bit of a problem because it is never good to have an interruption. We are hoping that in the next day or two that we can get some more drugs.”
According to Dr. Ramsammy, the Ministry is expected to receive assistance shortly from Jamaica or Haiti, to help address the situation. He revealed that although Guyana is scheduled to receive its own stock in a few days’ time, he does not intend to take the chance of waiting on that shipment given the possibility of further prevailing problems.
“Persons have asked why borrow more drugs, but I don’t want to wait, people’s lives are involved here and I don’t want to take that chance of waiting…Two weeks ago our shipment was supposed to be here, so we really can’t take chances. In addition, we are borrowing, and so we will have to send back when we do get our own supply,” the Minister asserted.
Guyana has never experienced a problem with its antiretroviral supply. The Minister attributed this shortfall to the fact that more people are being placed on medication. In order to prevent another such occurrence, the Minister said that the Ministry would seek to reorganise its reorder time as shipment issues are always possible.
Meanwhile, the National AIDS Committee in a statement last evening revealed that it has recently received complaints from persons living with HIV/AIDS (PLWHAs) over the shortage of the two main HIV antiviral (antiretroviral) drugs used in the combination therapy provided by the National Care & Treatment Centre clinic.
The clinic mainly services PLWHAs in Region Four (Georgetown, East Coast & East Bank Demerara) along with those Regions without counselling, testing and treatment sites.
The NAC understands that these drugs (Truvada & Efavirenz) are due in the country within the next week or two, and has been advising PLWHAs to continue visiting or phoning in to the clinic for updates, as well as seeking assistance from other PLWHAs who may have extra drugs to carry them over this period.
The NAC is also encouraging all PLWHAs on ‘first-line’ treatment against using only one of the combination therapy drugs if they cannot access both, since if only one drug is used, HIV could become resistant to it.
“It has been proven that taking two or more anti-retrovirals at the same time makes for more effective treatment in the long-run, vastly reducing the rate resistance can develop.”
The NAC is also encouraging all PLWHAs to continue using complementary therapies where possible, especially in the mind-body category (relaxation techniques, spirituality, massage) and bio-body-based practices in building the immune system (balanced diet, vitamins & minerals, herbal, pre/pro-biotics (yogurt,etc.).
The NAC in its statement also revealed that it is seeking to fast-track a requested meeting with the Programme Manager at the National Aids Programme Secretariat (NAPS), seeking confirmation of the due-date of expected shipment, feed-back of the 2008/2009 annual ARVs supply plan, as well as clarification as to both government and partners (international donors) commitment in guaranteeing sustained treatment to approximately 2,800 persons reportedly on anti-retrovirals.
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