Increased cases of drug resistant HIV puts strain on national stocks

Increased cases of drug resistant HIV are contributing to shortages of Abacavier, a drug given to HIV positive people, who would have failed or reacted to initial drug combinations, thereby exerting pressure on traditional stocks of the drug.

Secretary for Health and Child Care Dr Gerald Gwinji said in an interview yesterday that the stock raptures of Abacavier could be because the number of people resistant to the HIV first line treatment had gone up.

Those who would have problems with the first line treatment are moved to the second line treatment which involves taking Abacavier.

Dr Gwinji said at least 35 000 HIV patients were now on Abacavier after failing the first line of treatment.

"As we now monitor closely with new technology such as viral load testing, the issue of resistance and defaulting has suddenly seen a number of patients requiring more second line drugs, therefore, going beyond the stocks that we normally have," said Dr Gwinji.

He attributed the increase of drug resistant HIV to Government's ability to pick up more cases compared to previous years.

"I think the cases are on the increase because of the technologies that we now have to pick up cases not responding to treatment such as viral load testing," said Dr Gwinji.

He said previously, second line drugs were procured with resources from the National Aids Trust Fund, also known as the Aids Levy, because stocks required were manageable.

Government has since re-channelled savings from the Global Fund to Fight HIV, Tuberculosis and Malaria towards procurement of the second line drugs.

Dr Gwinji said the Global Fund was a fall back measure, while engagements with the Reserve Bank of Zimbabwe on foreign currency availability continued.

"We went into a situation where we ran below the minimum level of stocks of Abacavier combinations, which we use as second line treatment, largely due to acquisition of foreign currency because they are purchased by the National Aids Council, but some drugs are now being procured by the Global Fund," he said.

"As we speak, we are expecting a delivery on the 25th of August 2017 (Friday) of quite a substantial amount of Lamuvidine and Abacavier. We are hoping to get about 26 300 bottles and we hope this would fill the Abacavier gap."

Dr Gwinji said another delivery was expected in September.

"We expect that from next week onwards the crisis would be over, but we will not be able to revert back to the three month supplies, we may probably go to a month supply as we continue building on our national stocks," he said.

Government is giving HIV positive people a weeks' supply of the drugs.

HIV activists have since expressed concern over what they view as non-prioritisation of medicines in availing foreign currency, saying HIV resistant cases might increase.

According to NAC, Government, through the Aids levy has set aside $20 million for drug procurement and is waiting for allocation of foreign currency since the beginning of the year.

Community Working Group on Health executive director Mr Itai Rusike said failure to make ARVs available threatened adherence to treatment.

"Treatment for HIV is threatened when ARV drugs are not available, undermining treatment compliance," said Mr Rusike.

An estimated 1,2 million people are living with HIV in Zimbabwe, from which about 800 000 are on ARVs.