DRC: An untapped supply of HIV/AIDS treatment

Photo: Tiggy Ridley/IRIN
DRC's health system has been destroyed by more than 10 years of conflict
kinshasa, 11 December 2006 (PlusNews) - Thousands of people living with AIDS in the Democratic Republic of Congo (DRC) are going without treatment while the production line at a modern antiretroviral (ARV) factory in the east of the country lies largely idle.

Pharmakina has produced generic ARVs since April 2005 in the eastern province of Bukavu, the first pharmaceutical firm to do so in central Africa, but it is now forced to await approval from the World Health Organization (WHO).

"We can produce to a capacity of 180,000 pills a month [but] apart from [a few] private individuals there is no real demand at present," said Dr Pierre Mulema, head of Pharmakina's HIV/AIDS department.

The only other suppliers of ARVs in Bukavu is Médecins Sans Frontieres (MSF), which provides free treatment to more than 600 patients but currently imports its supplies from Holland.

Pharmakina's generic version of a three-in-one drug combination of Stavudine, Lamivudine and Nevirapine, is called 'Afri-Vir'. The Congolese authorities gave the medication the go-ahead in June 2005, allowing Pharmakina to supply the local market.

Dr Andre Adanji, WHO's humanitarian action in crisis focal officer in Bukavu, confirmed the international agency was running tests on Pharmakina's product. "We've already received samples and these have been sent to Geneva for testing," he said, adding that in principle, WHO supported the production of ARVs by Pharmakina, but needed assurances on quality before allowing the product to be exported out of the DRC.

"We have the capacity to produce ARVs to meet the demands of all in the DRC and still export to neighbouring countries," insisted Mulema. "There is a real need in the DRC for good quality ARVs." But with a price tag of US $22 per month, the majority of HIV-positive people in South Kivu cannot afford Pharmakina's ARVs.

South Kivu's health system has been destroyed by more than 10 years of conflict. Rebel groups from neighbouring countries and armed Congolese militia systematically plundered villages and ransacked health centres.

While AIDS awareness levels are improving among the rural population as education campaigns take effect, HIV testing and treatment facilities remain severely limited as trained staff leave the region and the local health authority struggles to replenish supplies.

"We have a serious problem with the provision of ARVs. It's true to say that there are many in need of ARVs who are not receiving the drugs," said Médard Mpinda, acting co-ordinator of the National Multi-Sector Programme For the Fight Against AIDS, the national body responsible for coordinating the country's HIV/AIDS strategy.

Adanji said, however, that realistically, it is much too early for the DRC to be talking of nationwide coverage. "I nearly choked to death with laughter when I recently heard a government communiqué talking of the desire to make ARVs freely available across the whole country."

Pharmakina is urging the government and leading NGOs to get behind the concept of local production and resolve the difficulties of acquiring ARVs. MSF Holland, which currently imports ARVs from Amsterdam, says it was considering procuring drugs from Pharmakina.

"By producing locally we stand the chance of saving thousands of lives simply by saving time and cutting costs," said Mulema. "What really hurts is that we have the ARVs available, that are of a good quality, and there are patients who need ARVs who can't access them."

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