HIV patients raise alarm over ARV access despite government assurances

People living with HIV are demanding constant supply of quality and standard antiretrovirals (ARVs).

This follows an outcry that there has been shortage of some types of ARVs, forcing individuals to take expired medicines.

There have also been reports of shortages of infant prophylaxis drugs including Nevirapine and Zidovudine, used to prevent mother to child transmission of HIV.

However, the National Aids and STIs Control Programme (NASCOP) and Kenya Medical Supplies Authority (Kemsa) have maintained that there is no national shortage of ARVs.

Head of NASCOP, Andrew Mulwa, maintained there is no shortage of Navirapine.

According to Dr Mulwa, the country’s average monthly consumption of Nevirapine is 44,191 bottles, while Kemsa currently has 176,479.

The stock he said will last for four months.

“We have no shortage of Nevirapine. According to the end-of-May reports, facilities held commodities worth 1.8 months of stock.

In June, Kemsa distributed 102,153 bottles to the various facilities,” said Mulwa.

But despite the assurance, the National Empowerment Network of People Living with HIV/Aids in Kenya (NEPHAK) maintains there is inconsistency in supply of HIV treatment drugs.

NEPHAK Executive Director Nelson Otwoma said a number of people are not able to access the treatment, an issue that risks transmission of the disease, and HIV related deaths.

According to Otwoma, inconsistency in supply of the treatment has been reported for the past three months according to NEPHAK, with individuals forced to take expired ones, for survival.

“What is at Kemsa is not accessible to recipients. We cannot all walk to Kemsa and pick medicines,” said Otwoma.

Otwoma said currently facilities are restocking Nevirapine, a drug taken by newborns to prevent them from acquiring the virus.

“Facilities are re-stocking now and there will be no challenge henceforth but what was reported by NEPHAK members was for April, May and part of June for some counties and facilities,” added Otwoma.

A number of Nevirapine, and Zidovudine for infants have been taken to NEPHAK offices.

Shockingly, mentor mothers said some newborns are being given the HIV preventive syrups that have expired, that doctors tell them they are better, than having nothing.

Even with the restocking of prophylaxis for babies, NEPHAK maintains there is still shortage of Tenofovir Alafenamide Lamivudine (TAFLD), ARVs administered to individuals who are 60 years and above.

“As for TAFLD, the delayed delivery has led to stock-out and now people, including those with chronic kidney disease and even the elderly PLHIV are not being transitioned,” regretted Otwoma.

Individuals already enrolled are given pills for one week, two weeks and one month, instead of the usual three or more months.

“We hope it is sorted soon. We get our updates from members who depend on these molecules daily and through community led monitoring,” said Otwoma.

“We have asked patients to be vigilant and hope nobody will carry home expired medicines,” he added, noting that people are taking expired ARVs because of lack of alternatives.

Contrary, Mulwa maintained there is no stock out of TAFLD.

Mulwa acknowledged that there is delay occasioned by the United States government stopping funding.

With this delay, he said products that were to be delivered in June will be delivered end of July, or start of August.

“To avoid shortages, we recommended temporarily stopping the transition of new patients to the molecule until fresh supplies are available locally,” said Mulwa.

Lack of infant prophylaxis he said could be as a result of in country supply chain challenges.

“Stocks don’t always translate to patients accessing products,” he said.

On accessing expired drugs, Mulwa said that is a quality of issue, and should be addressed by the pharmacovigilance committee.

Kemsa Chief Executive Officer, Waqo Ejersa, dismissed supply of expired ARVs to patients.

Ejersa said Kemsa does not distribute health products that have a shelf life of less than six months.

The responsibility he said shifts to facilities and counties once they leave Kemsa stores.

“Kemsa, by policy does not distribute products that are less than six months.

‘‘The responsibility shifts to facilities and counties after drugs they leave our stores,” said Ejersa.

He maintained that specific medical facilities should explain how the ARVs got to them because ARVs at Kemsa stores are still in-date, and Kemsa has not supplied short shelf life drugs to hospitals across the country.

“Drugs and health products received at Kemsa stores must have at least 75 per cent of their shelf life remaining before they are accepted.

‘‘For example, if medicine is set to last for 10 years, it should have at least a shelf life of seven years.”

Ejersa said once a drug is expired, they become poisonous.

“We have enough supply of ARVs at Kemsa stores. We have also started procuring more drugs,” he said.