BURUNDI: Outrage and concern over national ARV shortages

Photo: Barnabe Ndayikeza/IRIN
Drug shortages make an ailing health system even more ineffective
Bujumbura, 2 March 2007 (PlusNews) - AIDS activists in Burundi are up in arms over a nationwide shortage of antiretroviral (ARV) drugs, and are demanding immediate action from the government.

Health workers said delays in the government's procurement process had caused the shortages.

"With funds available, it's unbelievable that we can run short of drugs for these simple administrative procedures," said Jeanne Gapiya Niyonzima, a leading AIDS advocate and president of the National Association to Support HIV-positive People (ANSS). "For patients, this is unacceptable."

ARVs are provided free by the government, with the support of the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank and other organisations.

Gapiya told IRIN PlusNews that in February, ANSS ordered for 650 boxes of Abacavir, a first-line ARV, from the government's medical stores, but only received 30 boxes for 208 patients, so each only received a 10-day supply rather than the usual one-month supply.

"Already, patients from some provinces of Burundi were sometimes not coming to collect their monthly intake for lack of financial means [for transport] or poor health," she added. "I guess now the situation will be worse."

Dr Françoise Ndayishimiye, executive secretary of the National Council for the Fight against AIDS (CNLS) said the shortage was due to a delay in the finance ministry's assessment of an order for the drugs, sent in November. The CNLS then had to order an emergency supply of drugs to fill the gap, which barely covered two months.

The council originally had the ability to order drugs worth up to US$500,000 directly from suppliers, but Ndayishimiye said that after a change in procedure about two years ago, they were now forced to go through the ministry of finance.

No one from the finance ministry was available to comment on the issue, but Barnabé Mpbonimpa, minister in the president's office in charge of HIV/AIDS control, denied the severity of the shortage and said some ARVs had already arrived and were at the airport in the capital, Bujumbura.

The ANSS's Gapiya said the shortage of first-line medicines could lead to drug resistance, forcing patients onto expensive second- and third-line regimens, which would also entail additional adherence counselling and monitoring; the country could ill afford the monetary cost and human resources this would require.

HIV/AIDS activists have also complained about the shortage of reagents used in testing for the virus. According to the CNLS's Ndayishimiye, this has lasted since December 2006, again due to the ministry of finance's failure to purchase the chemicals despite requests to do so.

"A person can take years to decide to go for a test, but if he comes and finds he cannot be tested, it is not certain he will come back," Gapiya said. "In the meantime, he will run the risk of contracting the virus or infecting others."

Minister Mbonimpa said the government was expecting a consignment of reagents that would last at least eight months.

Shortages of life-saving medical supplies are not infrequent in Burundi, which is recovering from a 13-year civil war. Throughout 2006, there were shortages of reagents to test for viral load counts (which measure the amount of virus in the blood), and doctors were forced to rely on clinical symptoms to place patients on ARVs.

In April 2006, people living with HIV organised demonstrations in Bujumbura to demand better access to drugs to treat opportunistic infections. The country's healthcare system was all but destroyed in the war, and few health centres have the capacity to handle serious illnesses.

Burundi has an HIV prevalence of about four percent, but only 6,400 HIV positive people are receiving treatment out of an estimated 25,000 who need it.


Theme (s): Care/Treatment - PlusNews,

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