Real & Fake ARVs in Africa
Zimbabwe: Fake ARVs on sale
April 23, 2006
By ANDnetwork .com
Conmem and shady dealers operating from flea markets and undesignated points in Bulawayo, Zimbabwe are selling fake capsules filled with mealie-meal to people living with HIV and AIDS after fooling the patients that they are anti-retroviral drugs (ARVs).
Sunday News can reveal that AIDS patients who have fallen victim to the tricksters are now in danger because the disruption or discontinuation of ARV therapy is often life-threatening.
The problem is being aggravated by some medical doctors, nurses and pharmacists who work in public health institutions who are allegedly stealing incomplete courses of ARV drugs and selling them to desperate patients.
The Matabeleland AIDS Council (MAC) this week urged the public not to buy ARVs from flea markets and unlicensed dealers as they risked buying fake or substandard drugs.
Speaking in an interview with the Sunday News on Friday, the MAC's voluntary counselling, testing, support and care manager, Mr Midian Dube, said many people living with HIV and AIDS have fallen prey to unscrupulous traders who sell fake ARV drugs in the city.
"There are people who are selling these drugs at flea markets and around the city. This endangers the lives of the people who use these drugs unknowingly. The background to this problem is that when ARVs were introduced in Zimbabwe, they arrived in the private sector and most people did not have access to them," he said.
Mr Dube said he first learnt of the scandal when he went to Mpilo Central Hospital where he interacted with many people who told him where they had been buying their tablets.
"During my stay at Mpilo Central Hospital, I interacted with a lot of people who are living with HIV and AIDS who then informed me that there are some people selling ARVs and herbs that are said to cure the disease.
"Many patients said these people get them (ARVs) from South Africa and the UK, but unfortunately these traders have become financially driven to an extent that they fill the capsules with mealie-meal and sell them to unsuspecting victims," he said.
A medical doctor who spoke to the Sunday News on condition of anonymity for professional reasons said a person should start taking ARVs prescribed by a qualified doctor only after testing HIV-positive and when the CD4 count is at 200 or below.
The ARVs are administered in triple-therapy comprising Stavudine, Lamivudine and Nevirapine - commonly abbreviated to Stalanev. The other recommended drugs are Triviri and Triomune.
A person should start taking the drugs at stage four of classification and when their CD4 count is at 200 and below. It costs between US$20 and US$25 for a month's treatment, an amount which translates to between Z$500 000 and Z$625 000.
Mr Dube said some unethical doctors were even selling incomplete courses to unsuspecting patients. But he advised the public not to buy ARVs from unauthorised sources as chances were very high that they were fake.
"These tablets are in three combinations and we have gathered that some private doctors sell one set of drugs. We advise the community to purchase the drugs from Opportunistic Infection Clinics at hospitals and pharmacies. MAC will be organising a meeting with stakeholders to discuss the issue and to come up with the best strategy to curb this corruption," he said.
Mr Dube said the scandal has not yet been reported to the police because MAC is still organising a meeting with stakeholders, including the police.
"We are still in the process of organising the way forward. We will organise a meeting with various stakeholders, who include the police and pharmacies, to come up with strategies to stop this practice. We will also visit the community offering voluntary testing and counselling and create more awareness about this disease and ARVs," he said.
The Deputy Minister of Health and Child Welfare, Dr Edwin Muguti, said he was not aware of the fake drugs but acknowledged that bringing the corrupt dealers to book would be a big struggle.
"We are not aware of that yet. This is corruption and it's very sad that people fall victim to these people. These people are taking advantage of society and it will be a big challenge to stop this corruption," he said.
Dr Muguti said the public should avoid purchasing drugs from unauthorised sources and urged the public sector to improve the supply of ARVs.
"These are prescription drugs, and its dangerous to just buy them from anywhere. There is an issue of resistance and poisoning, these people don't know how these drugs work, these drugs are arranged, designed and prescribed. The public health sector needs to improve the availability of ARVs," said Dr Muguti.
Source : Sunday News
Zambia: Access to ARVs
The Post (Lusaka)
April 21, 2006
There is no doubt that the problem of HIV/AIDS has brought a lot of strain on the medical health care system of our country.
With more than one million Zambians living with this horrible virus, the health care system of the country has surely been overwhelmed. Besides the HIV/AIDS pandemic, our health care system still has to contend with many other diseases such as malaria, tuberculosis, cancer, among others.
With the advent of antiretroviral treatment (ART) in the form of antiretroviral drugs (ARVs), people living with HIV have some hope of living much longer and productive lives. However, much as it is expected that all people with HIV and in need of treatment should have access to ARVs, the reality has been that only a few of them are on treatment. Recently, the government announced that only 50,000 patients were on ARVs. Looking at the numbers of those infected and in need of treatment, this figure is too low if we are to save the lives of those affected.
And we are not surprised that a group of HIV positive Luanshya residents are protesting over the non-availability of free ARVs. And they are asking the government honest and genuine questions. Why should they be compelled or encouraged to know their HIV status if they cannot, after all, be given free treatment once they come out positive? We are not saying that testing should necessarily be attached to treatment or vice-versa. What we are saying is that even as people are compelled or encouraged to go for voluntary counseling and testing, there should be a solution for both those found negative and those who come out positive. Asking people to test is one thing, but providing them with a life-saving or life-prolonging solution thereafter is another. And we believe this is the way the government should be looking at things.
The same goes for the scrapping of user fees in rural hospitals and health centres. Announcing the abolition of fees in health centres in rural areas is one thing, but having the capacity for such a programme is another challenge. Already, there are disturbing reports that despite the government's announcement early this year of free medical services to rural people, the rural hospitals and health centres are failing to cope with demand from patients.
We believe that now that ARVs are becoming a reality in public health treatment, it is time to develop effective approaches to the use of treatments to ensure that all those in need get treatment. Yes, ARVs are only able to reduce the effects of the virus and not to eliminate it. But we now know that they make a vital difference to the lives of those who have access to them. We know that treatment with ARVs strengthens damaged immune systems, thereby helping patients to resist and recover from opportunistic infections. Effective ARV treatment not only reduces the morbidity and mortality figures for HIV but it also reduces stigma and discrimination. We know that when people see that it is possible to live a longer, healthier life with ARVs, they fear HIV less, are more willing to get tested for HIV and are more supportive of people who are using treatment.
HIV-Aids and STDs
This is why it is our view that access to ARVs must be given necessary attention because it is essential for effective health care, especially for HIV/AIDS.
We think that the government should now be working on a programme that will entail that access to ARVs is not limited to a few people. We know that prices for ARVs have over the years gone to reasonable levels, although a lot more needs to be done in this area.
We are aware that failure by manufacturers to price drugs affordably also remains a major barrier to the widespread use of ARVs and other new drugs. We are also aware that donors such as the Global Fund have dedicated some reasonable amounts of money towards the fight against HIV/AIDS. If used properly, and not on meaningless workshops centred on such discussions as reciting how HIV is transmitted, we need to start evaluating the relevance of our approach to ensuring that people living with HIV do actually have access to treatment. By this, we are not saying that other preventive programmes should be thrown to the wind. No. What we are saying is that much as we may have to spend time and resources on campaign messages or strategising on prevention, there are people out there who are daily battling with the real force of this virus, which is threatening their lives and they are in need of treatment to save their lives. Here, we are talking about people who are on the verge of dying because they have no access to treatment. We therefore urge the government to ensure that all barriers that block people from accessing ARVs are removed. We know that social barriers such as stigma or lack of confidentiality are being broken through increased awareness on VCT. We may still have barriers related to availability of finances or resources for the steady and continuous supply of ARVs. Our health system may be lacking in resources or funding for treatment too. We are also mindful of the physical barriers in terms of inadequacy of health care facilities and equipment that are a prerequisite to accessing ARVs. Lack of political understanding or will is also often an overriding reason why access to treatment for HIV is limited. But we think that with effective planning and favourable political will, we can break and bypass all these barriers. By doing that, we will ensure that all those in need of ARVs have access to them.