News / Health
Zim govt dumps Aids patients
15 Apr 2014 at 12:34hrs | Views
ARVs
President Robert Mugabe's government is so broke that it has ordered HIV/Aids patients on medical aid to buy their own Anti-Retroviral drugs (ARVs) as figures of those needing State assistance swell.
Zimbabwe has 1,2 million people who need ARV therapy.
This is a significant increase from the 600 000 who were either in the queue or already receiving treatment before Zimbabwe adopted the new World Health Organisation (WHO) guidelines at the end of last year.
Albert Manenji, the State-run National Aids Council (Nac) acting chief executive officer, announced plans to slash the price of ARV treatment for people living with Aids and accessing them through medical insurance and other private schemes.
"This response is actually meant to make sure that those with medical aid and those who can pay do not need to queue at the public sector programme," Manenji said during a private-public partnership meeting held in Harare.
"They just go to the pharmacies and buy using medical aid. It means that if we sell $5 million worth of drugs, we would also have created $5 million worth of resources to plough back into the national response.
"This movement will create a gap which other less-privileged people can fill. In terms of stigma and discrimination, it means that somebody can do their business in private without anybody seeing them."
Until now, those benefitting from subsidised treatment have been paying $1 for a month's supply of ARVs.
The push to have people living with HIV buy their own medication is part of a desperate government drive to fight the HIV virus in this country divided by politics which has one of the highest HIV prevalence rates in southern Africa.
Manenji said under the new arrangement, Nac will procure ARVs in bulk for distribution by NatPharm and licensed pharmacies respectively at affordable prices.
NatPharm is charged with the procurement of drugs for all State-run hospitals, and is mandated to guarantee the availability of safe, effective and affordable medical supplies to various public institutions.
"The issue is our resources for national response are actually dwindling," Manenji said.
"We are saying how best can we make sure that Zimbabweans continue to access medicines at reasonable prices?
"We saw that in the private sector, ART medicines are four or five times higher than what they are in the public sector. We sat down with partners and entered into a partnership. We will buy the medicines as Nac at the manufacturing rate, plus the landing cost at NatPharm. NatPharm and pharmacies then put each a mark-up we agreed on."
Pharmacies will get a maximum profit of 25 percent, according to Manenji.
ARVs are selling for between $18 and $50 for a month's supply in the private sector and around $1 in the public sector.
This has pushed many to enrol for the free scheme, stakeholders said.
In November 2013, the ministry of Health and Child Care reported that following the adoption of new WHO guidelines, the number of people requiring ARV therapy had jumped from more than 800 000 to around 1,2 million.
The WHO's updated recommendation is to enrol patients on ART earlier: if their CD4 count falls to 500, rather than the previous threshold of below 350.
Half of those are in urgent need of ARVs.
At least 73 percent of the drugs are supplied by the Global Fund for Aids, Tuberculosis and Malaria, which supports Zimbabwe's ARV programme, which Nac says has disbursed only $21,8 million for the 2014 roll-out.
At least 11 percent of ARVs are supplied by government through the Aids Levy and the remainder from individual purchases, Manenji revealed.
Last year, Nac generated $33, 5 million in Aids Levy contributions, but the tax base has been shrinking due to job losses which are peaking amid donor fatigue hitting the country.
The new initiative is particularly targeting patients who have medical insurance.
Manenji said this way, many people living with HIV who are currently failing to access treatment can be absorbed into the public scheme.
Shylet Sanyanga, chief executive of Association of Health Funders of Zimbabwe (AHFoZ), said the development was positive.
"Due to lower drug costs, this robust system will ensure that medical aid patients continue to access their treatment without fear of exceeding annual limits," Sanyanga said.
"It is expected that there will be no defaulters. The employer will benefit in that fewer man hours are lost through queuing for drugs at public institutions."
Douglas Gwatidzo, secretary-general of the Zimbabwe Medical Association (Zima), said the partnership was feasible notwithstanding the concerns raised around patient follow-up, stock-outs and drug smuggling.
"It's not easy but it is not impossible," Gwatidzo said.
"Zima has received training on follow-up, initiated by Global Fund. On smuggling, I think we are fortunate to have necessary regulations in place including Zimra on one side and the Medicines Control Authority of Zimbabwe on the other."
Zimbabwe has 1,2 million people who need ARV therapy.
This is a significant increase from the 600 000 who were either in the queue or already receiving treatment before Zimbabwe adopted the new World Health Organisation (WHO) guidelines at the end of last year.
Albert Manenji, the State-run National Aids Council (Nac) acting chief executive officer, announced plans to slash the price of ARV treatment for people living with Aids and accessing them through medical insurance and other private schemes.
"This response is actually meant to make sure that those with medical aid and those who can pay do not need to queue at the public sector programme," Manenji said during a private-public partnership meeting held in Harare.
"They just go to the pharmacies and buy using medical aid. It means that if we sell $5 million worth of drugs, we would also have created $5 million worth of resources to plough back into the national response.
"This movement will create a gap which other less-privileged people can fill. In terms of stigma and discrimination, it means that somebody can do their business in private without anybody seeing them."
Until now, those benefitting from subsidised treatment have been paying $1 for a month's supply of ARVs.
The push to have people living with HIV buy their own medication is part of a desperate government drive to fight the HIV virus in this country divided by politics which has one of the highest HIV prevalence rates in southern Africa.
Manenji said under the new arrangement, Nac will procure ARVs in bulk for distribution by NatPharm and licensed pharmacies respectively at affordable prices.
NatPharm is charged with the procurement of drugs for all State-run hospitals, and is mandated to guarantee the availability of safe, effective and affordable medical supplies to various public institutions.
"The issue is our resources for national response are actually dwindling," Manenji said.
"We are saying how best can we make sure that Zimbabweans continue to access medicines at reasonable prices?
"We saw that in the private sector, ART medicines are four or five times higher than what they are in the public sector. We sat down with partners and entered into a partnership. We will buy the medicines as Nac at the manufacturing rate, plus the landing cost at NatPharm. NatPharm and pharmacies then put each a mark-up we agreed on."
Pharmacies will get a maximum profit of 25 percent, according to Manenji.
This has pushed many to enrol for the free scheme, stakeholders said.
In November 2013, the ministry of Health and Child Care reported that following the adoption of new WHO guidelines, the number of people requiring ARV therapy had jumped from more than 800 000 to around 1,2 million.
The WHO's updated recommendation is to enrol patients on ART earlier: if their CD4 count falls to 500, rather than the previous threshold of below 350.
Half of those are in urgent need of ARVs.
At least 73 percent of the drugs are supplied by the Global Fund for Aids, Tuberculosis and Malaria, which supports Zimbabwe's ARV programme, which Nac says has disbursed only $21,8 million for the 2014 roll-out.
At least 11 percent of ARVs are supplied by government through the Aids Levy and the remainder from individual purchases, Manenji revealed.
Last year, Nac generated $33, 5 million in Aids Levy contributions, but the tax base has been shrinking due to job losses which are peaking amid donor fatigue hitting the country.
The new initiative is particularly targeting patients who have medical insurance.
Manenji said this way, many people living with HIV who are currently failing to access treatment can be absorbed into the public scheme.
Shylet Sanyanga, chief executive of Association of Health Funders of Zimbabwe (AHFoZ), said the development was positive.
"Due to lower drug costs, this robust system will ensure that medical aid patients continue to access their treatment without fear of exceeding annual limits," Sanyanga said.
"It is expected that there will be no defaulters. The employer will benefit in that fewer man hours are lost through queuing for drugs at public institutions."
Douglas Gwatidzo, secretary-general of the Zimbabwe Medical Association (Zima), said the partnership was feasible notwithstanding the concerns raised around patient follow-up, stock-outs and drug smuggling.
"It's not easy but it is not impossible," Gwatidzo said.
"Zima has received training on follow-up, initiated by Global Fund. On smuggling, I think we are fortunate to have necessary regulations in place including Zimra on one side and the Medicines Control Authority of Zimbabwe on the other."
Source - dailynews
