ARV patients despair amid widespread drugs shortage

Amid the anxiety caused by the widespread shortage of antiretroviral (ARVs) drugs, which has affected scores of South Africans living with HIV/Aids in the past three months, the national department of health yesterday reassured patients that the situation should fully stabilise by mid-November.

But for Mampho Skosana and Mantombazana Dludla of Gauteng, the department’s reassurance holds little weight.

Skosana, who has been taking ARVs for the past 10 years, was recently turned away by nurses at the Nokuthela Ngwenya Community Health Centre in Ekurhuleni due to the drugs being out of stock at the clinic.

For her, weeks of waiting for the drugs have turned into despair and she said she could “not afford to wait any longer”.

“Nurses said there was nothing they could do,” said Skosana.

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Dludla, who has been living with the disease for the past 17 years, said the department’s mid-November may as well be an admission of defeat, “because by then so many people, including myself, would have died”.

For three months, Dludla has been visiting a Tsakane clinic near Brakpan, “but the situation has turned out for the worst”.

“The clinic usually gave me a three-month stock of drugs and I would normally return to top up closer to the time,” she said.

“The last time I visited the clinic, my ARV supply was scaled down to 18 days, which is not acceptable. I have been told by nurses that the clinic has run out of stock.

“The situation is so bad, especially if you have to regularly travel by taxi. It’s a situation that has resulted in several people being fired because of non-disclosure to employers.”

Dludla said public health staff in most clinics in the country were “frustrated because they cannot explain the situation to patients”.

She added: “What has angered us is that the department, despite having foreseen this situation, has failed to communicate properly with staff and patients. The Gauteng health MEC should have notified people timeously and made arrangements with private clinics.

“The consequences are dire for us without the treatment. The treatment may not work in our system anymore, leading to kidney and liver failure.”

Health department spokesperson Popo Maja explained the department’s ARV challenge, saying: “With regard to Abacavir and Lamivudine, the stock has arrived and is being released in tranches.

“Based on the supply plan provided by the contracted supplier, the supply should normalise by mid-November. We noted that the Stop Stockouts Project (SSP) has been providing guidance on alternative agents. However, these options are not feasible since there are insufficient volumes of stock of alternative agents, given the large volumes required by the public sector. The alternative agents, like Stavudine, may not have the safety and efficacy of recommended regimens.

“The SSP and the South African HIV Clinicians’ Society (SAHCS) have indicated that they have received requests for assistance.

“The requests were never channelled to the national department of health to intervene. The clinical guidelines said to be developed by SAHCS are not currently on their website.”

Maja said the active ingredients for most medicines are produced mainly in India and China.

“New legislation in China relating to industrial pollution, has resulted in the closure of manufacturing sites for the production of Lamivudine and Abacavir.

“Consequently, this has affected the production of these two ARVs and has impacted on medicine availability globally, including South Africa.”

– brians@citizen.co.za

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