Kenya: Svigtende ARV leverance truer sundhed
Den 16. april 2002
Læger uden Grænser/MSF indgår i "Kenya Coalition for Access to essential Medicines", som den 16. april har udsendt nedenstående pressemeddelelse:
Svigtende forsyninger af prissænket antiretroviral (ARV) hiv/aids medicin truer patienters sundhed
Nairobi, den 16. april, 2002 - Adskillige sundhedscentre i Kenya har rapporteret om tilbagevendende og nogle gange langvarig mangel på prissænket antiretroviral hiv/aids medicin siden de store medicinalfirmaer sænkede prisen på aidsmedicin til patienter i Afrika sidste år. Kenyas Medicin Koalition (Kenya Coalition for Access to Essential Medicines) ønsker dette tilbagenvendende problem bragt til ophør.
Sikre medicinforsyninger er afgørende i antiretroviral (livsforlængende) behandling, ligesom korrekt dosering og punktlig overholdelse af behandlingen er påkrævet for at få medicinen til at virke efter hensigten. Ydermere er der øget risiko for, at patienter, som ikke følger behandlingen - fx. på grund af medicinmangel - risikerer at udvikle former af hiv, som er modstandsdygtige overfor behandling.
Læs mere i nedenstående pressemeddelelse (på engelsk).
REGULAR SHORTAGES OF KEY HIV/AIDS MEDICINES THREATEN PATIENTS´ HEALTH
Nairobi, 16th of April, 2002 - Numerous health centres in Kenya are reporting regular and sometimes extended shortages of discounted antiretroviral drugs since pharmaceutical companies lowered the prices of these AIDS drugs for Africa last year. The Kenya Coalition for Access to Essential Medicines calls for a swift end to this recurring problem.
Regular shortages of reduced-price Videx (25mg) and Zerit (30mg)tablets, produced by pharmaceutical company Bristol-Myers Squibb (BMS), have forced HIV/AIDS patients to switch to alternate medications or interrupt their treatment altogether, putting their health at serious risk.
"Since I started taking ARVs last July, I have not been able to get my regular supply of Zerit two times," relates Otieno, a male adult who has been living with HIV/AIDS since 1992. "One time I could get Epivir as a substitute, but that medicine costs 4,000 Ksh per month instead of the 400 Ksh I pay for Zerit. Another time I went without any substitute for two weeks."
Although the drug company claims to have solved the shortage problem of the last weeks, the medicines are as yet still unavailable to Aids patients in Kenya. The Coalition has been tracking similar shortages for almost a year, and reports that a pattern of regular shortages is emerging at the end of each financial quarter (December, March, June, and September).
Without access to Videx 25mg pills, "we have been obliged to hand out 100mg pills instead, and supply patients with razor blades so that they can cut up the pills to get some approximation of the correct dose," said Dr. John Wasonga of Nairobi´s Mbagathi Hospital.
The problem is not limited to BMS drugs alone. For a period of two weeks in March and April, GlaxoSmithKline´s (GSK) AZT pills were equally unavailable in Kenya. Epivir, another GSK anti-retroviral was also unavailable in August last year.
Several pharmaceutical companies reduced the prices of their AIDS drugs for use in Africa by public institutions, international agencies and non-governmental organizations. These resulted in 50% to 98% decreases in cost. But price reductions without consistent drug supplies are extremely dangerous.
A guaranteed drug supply is crucial in antiretroviral treatment, as correct dosage and rigorous adherence to scheduling are needed for the medicines to work successfully. Furthermore, patients who do not closely adhere to their treatment run a higher chance of developing drug-resistant strains of HIV.
"I have always taken my doctor´s orders about taking my medication on time very seriously," explained Otieno, "When I am not able to get the medicines I need, it is very stressful and I feel very guilty, even though I have tried my best to get the medicines I need."
"In my experience, compliance is not the problem here in Kenya. The problem is that we are not getting regular supplies of the medicines our patients need to tackle HIV/AIDS," stated Dr. Wasonga.
"In the case of Otieno, who is my patient, I am convinced that his 17kg weight loss and our problems stabilising and reducing his viral load [amount of HIV virus in the bloodstream] are due directly to the problems he is experiencing is maintaining a secure supply of these ARVs.," he concluded.
The causes of the supply shortages are two-fold, according to data gathered by the Coalition: manufacturers are not delivering their discounted medicines regularly, and local distributors are not able to keep buffer stocks of these discounted ARVs because BMS only extends credit on its normally-priced ARVs.
The pharmaceutical companies are the first to point out the dangers of an unreliable ARV supply as an argument for them to keep their monopolies and charge high prices, explained Liza Kimbo, Coalition member, "But they are the ones who are proving unreliable and who are undermining patients´ chances to treat their HIV/AIDS successfully."
The Coalition believes that the Kenyan government should make it possible for more than 1 supplier to deliver the same medicines to the Kenya market. Furthermore, local distributors need to have credit extended from the pharmaceutical company for all ARVs, regardless of their price, in order to adequately buffer their stocks and ensure that treatment regimes are not interrupted or upset by risky switches to substitutes.
Seven hundred people die from AIDS-related disease in Kenya every day. HIV/AIDS has been declared a national disaster by the Kenyan government. "Well, here - with these ARVs - is a problem that can be and must be fixed," comments Kimbo. "We need political will from the government to enable a competitive market, and so improve our people´s access to drugs. And we need companies to stop giving discounts with one hand, only to take away the reliability of supplies with the other."
The Kenya Coalition on Access to Essential Medicines includes Action Aid, Cry for the World Foundation, The Association of People living with AIDS in Kenya (TAPWAK), Network for People living with AIDS (NEPHAK), Oecomenical Pharmaceutical Network (EPN), Women fighting AIDS in Kenya (WOFAK), the Society for Woman and AIDS in Kenya (SWAK), Health Action International (HAI) Africa, Nyumbani, International Federation of Women Lawyers - Kenya (FIDA), Médecins Sans Frontières (MSF), DACASA, the Kenyan Medical Association (KMA), and Consumers Information Network CIN), and others, as well as many individuals.
For further information, please contact Ms. Liza Kimbo, Executive Director at Cry for the World Foundation, tel. +254-2-449467, cellphone +254-733-522408, Dr. John Wasonga, Mbagathi Hospital, cellphone +254-722-702324, or Mr. Wyger Wentholt, Regional Press & Information Officer for Médecins Sans Frontières, tel. +254-2-444474, cellphone +254-2-513981.