KENYA: Drug shortages jeopardise patients - NGOs

KENYA: Drug shortages jeopardise patients - NGOs

NAIROBI, 16 April (PLUSNEWS) - The cost of certain HIV/AIDS drugs has
dropped in recent months, but shortages are placing many patients at risk,
says a coalition of NGOs.

Many pharmaceutical companies reduced their prices last year by between 50
and 98 percent for governments, international agencies and NGOs fighting
HIV/AIDS in Africa.

However, the Kenya Coalition for Access to Essential Medicines, which groups
together several NGOs, has accused the drug companies of "giving with one
hand and taking with the other".

The coalition says price reductions have not been matched by consistent drug
supplies. This has in turn made the use of the drugs more dangerous because
they have high levels of toxicity and are usually administered under strict
therapy regimes.

"Our problem is being tied to monopolistic supply," Liza Kimbo, executive
director of the Cry for the World Foundation, a member of the coalition,
told a news conference in Nairobi on Tuesday.

"The pharmaceutical companies accepted to reduce the prices of the drugs,
but they are not willing to back it up with sufficient supply. It is a
question of giving with one hand and taking with another," she said.

GlaxoSmithKline and Boehringer Ingelheim, two of the pharmaceutical
companies with HIV/AIDS drugs on the Kenyan market, suggested on Tuesday
that the shortages were being exaggerated.

The coalition urged the Kenyan government to allow more than one supplier of
the a medicine into the Kenya market.

It also asked for pressure on pharmaceutical companies to extend credit to
local distributors of all anti-retrovirals (ARVs) - including reduced-price
ones - to "adequately buffer their stocks" and to ensure that treatment
regimes are not interrupted or upset by risky switches to substitutes.

According to official figures, at least 700 people die from AIDS-related
diseases in Kenya every day - a health burden which has prompted the Kenyan
government to declare HIV/AIDS a national disaster.

John Wasonga, a doctor with the HIV project at Mbagathi Hospital in Nairobi,
told Tuesday's press conference that the majority of his 15 patients who can
afford to buy ARVs were being forced to default on their treatment due to
the shortage of the required drugs in the market.

As a result, he said, some were suffering severe side effects from frequent
changes in treatment regimes.

Wasonga cited "regular" shortages of reduced-price Videx (25 mg) and Zerit
(30 mg) tablets, produced by pharmaceutical company Bristol-Myers Squibb
(BMS). The shortages, he said, had forced HIV/AIDS patients to switch to
alternate medicines or to interrupt their treatment altogether.

"To get a patient to adhere to a strict therapy is a difficult job," he
said. "To [have them] default for weeks because drugs are out of stock is
making an already difficult job even more difficult."

International medical NGO Medecins Sans Frontieres (MSF), which is
spearheading a global campaign for access to essential medicines, said there
were two reasons for the shortages. Manufacturers were not delivering their
discounted medicines regularly and local distributors were unable to keep
buffer stocks of discounted ARVs because credit facilities were typically
offered on normally-priced ARVs only.

MSF also cited shortages of drugs, such as AZT pills, from GlaxoSmithKline.
It said these were unavailable in Kenya for two weeks in March and April.
Epivir, another GSK anti-retroviral, was also unavailable in August last
year.

"A guaranteed drug supply is crucial in antiretroviral treatment as correct
dosage and rigorous adherence to scheduling are needed for the medicines to
work successfully," said MSF. "Furthermore, patients who do not closely
adhere to their treatment run a higher chance of developing drug-resistant
strains of HIV."

GlaxoSmithkline commercial director for East Africa, William Kiarie, told
PlusNews on Tuesday that his firm was caught off-guard by the surge in
demand for ARVs following the price reductions, and was trying to remedy the
situation by increasing its buffer stocks.

"Obviously, with prices going down, the demand for these drugs multiplied.
Nobody was prepared for this," Kiarie said.

"The impression being created by the coalition is not true. Our biggest ARV
product, Combivir, has never been out of stock. We have only been out of
stock of two items, whose demand was much lower."

Kiarie said GlaxoSmithKline was committed to making its products available
at discounted prices to the Kenyan market. "We feel we have worked hard for
products we don't make any profit from. We have now increased our buffer
stocks, and should not experience any shortages," he added.

Joseph Ng'ethe, local manager for Boehringer Ingelheim, told PlusNews that
his firm had not only reduced the price for its main ARV product,
nevirapine, but had always maintained a constant supply of the drug, which
is used in the treatment of acute AIDS infections and to prevent
mother-to-child transmission of the disease.

"As far as we are concerned, our product has always been on the market,"
Ng'ethe said. "We can guarantee that. It has never been out of stock."
[ENDS]

IRIN-SA
Tel: +27 11 880-4633
Fax: +27 11 447-5472
Email: [email protected]

[This Item is Delivered to the "PlusNews" HIV/AIDS Service of the UN's IRIN
humanitarian information unit, but may not necessarily reflect the views
of the United Nations. For further information, free subscriptions, or
to change your keywords, contact e-mail: [email protected] or Web:
http://www.irinnews.org . If you re-print, copy, archive or re-post
this item, please retain this credit and disclaimer. Reposting by commercial
sites requires written IRIN permission.]

Copyright (c) UN Office for the Coordination of Humanitarian Affairs 2002