HEALTH CRI­SIS

Hu­man rights ac­tivists warn of se­ri­ous threat to the lives of HIV pos­i­tive pa­tients

Move! - - FRONT PAGE - By Bonolo Sekudu

Pa­tients left stranded and at risk as hos­pi­tals and clin­ics run short of ARVs

MIL­LIONS of South Africans liv­ing with HIV are on anti-retro­vi­ral (ARV) treat­ment, they de­pend on this med­i­ca­tion to keep in good health and alive. Or­gan­i­sa­tions on the ground such as the Stop Stock-outs Project (SSP) and Treat­ment Ac­tion Cam­paign (TAC) deal­ing with is­sues re­lated to HIV have warned South Africans about the al­leged loom­ing dis­as­ter in the fight against HIV.

SAD RE­AL­ITY

While th­ese or­gan­i­sa­tions are stern about the sad re­al­ity of anti-retro­vi­ral treat­ment short­ages, the Na­tional De­part­ment of Health has re­futed th­ese claims, say­ing there is no cri­sis. When on ARVs, pa­tients are not sup­posed to de­fault or be in­con­sis­tent when tak­ing their med­i­ca­tion. Fail­ure to fol­low the rou­tine, as it should be, is a threat to their health and lives.

The TAC is con­cerned that if the sit­u­a­tion per­sists, it might just cause pre­ventable deaths. Na­tional leader at TAC, An­drew Mosane, says, “Our com­mu­ni­ties are dying pre­ventable deaths be­cause of short­ages of drugs in the fa­cil­i­ties.”

An­drew says the biggest frus­tra­tion for hu­man rights ac­tivists is that while they can be try­ing to ad­dress the sit­u­a­tion and see a res­o­lu­tion from the govern­ment, peo­ple’s health con­tin­ues to de­te­ri­o­rate.

“If peo­ple are not get­ting their treat­ment for a longer time, it means we are fail­ing them and we are wors­en­ing their im­mune sys­tem,” An­drew says. “In this re­gard, they might de­velop re­sis­tance to the drugs they were ex­posed to and in the pub­lic health­care sys­tem we have min­i­mal choices of sec­ond line drugs which are also out of stock.”

GLOBAL SHORT­AGES

It has been re­ported that this is not just a South African prob­lem but a global prob­lem caused by sup­pli­ers of this life-saving drug.

“The sup­pli­ers of ARVs are fac­ing global short­ages

WE CAN­NOT WAIT FOR AN­OTHER TSUNAMI TO HIT US AGAIN

of im­por­tant in­gre­di­ents for most of the drugs they pro­duce but the De­part­ment of Health knew this be­fore­hand and did not act as they should. So this is the rea­son we are cur­rently in this cri­sis. They should have acted sooner, and we would not be fac­ing this chal­lenge,” An­drew says.

WHAT CRI­SIS?

An­other or­gan­i­sa­tion that has started ask­ing ro­bust ques­tions about the sit­u­a­tion is ad­vo­cacy group, SSP.

SSP is­sued a state­ment say­ing the de­part­ment had not given a clear plan about how it would ad­dress the short­ages.

Act­ing SSP man­ager, Lau­ren Jankelowitz, says “Stocks of sec­ond and third line anti-retro­vi­ral drugs and con­tra­cep­tives have run out across the coun­try, a cri­sis that has been de­vel­op­ing over the past two months.”

Ac­cord­ing to Lau­ren, there have been short­ages in KwaZulu-Natal, North West, Lim­popo, Gaut­eng, the Eastern Cape and Free State, with the North West be­ing the worst af­fected. She says no re­ports have been re­ceived from the North­ern Cape.

But in a news­pa­per re­port re­cently, Min­istry of Health spokesper­son, Popo Maja, was firm in say­ing there is no cri­sis.

Lau­ren has a stern warn­ing. “A ro­bust sup­ply chain and un­in­ter­rupted ac­cess to med­i­ca­tion is cru­cial in end­ing HIV. Stock outs of ARVs in­ter­rupt treat­ment, in­creas­ing the risk of op­por­tunis­tic in­fec­tions, treat­ment fail­ure, ARV drug re­sis­tance and ul­ti­mately death,” she says.

AF­FECTED PA­TIENTS

An­drew says al­though the govern­ment isn’t com­ing out to con­firm this cri­sis, there are many peo­ple who are suf­fer­ing as a re­sult.

“Govern­ment knew, and they did noth­ing to re­spond to any of our calls with re­gards to this sen­si­tive mat­ter. They wanted noth­ing to do with ‘typ­i­cal ac­tivists’ – that’s what the min­is­ter of health (Aaron Mot­soaledi) calls us. But af­ter we re­leased a me­dia state­ment and we were get­ting mo­men­tum they wanted to come on board to dis­cuss the mat­ter be­hind closed doors,” An­drew says.

“We wanted the govern­ment to ac­knowl­edge the stock outs in pub­lic, then af­ter a few in­ter­views they agreed to meet with us and their sup­pli­ers.” The meet­ings were about com­ing up with a plan to curb th­ese stock outs.

“We are still talk­ing to them but also mon­i­tor­ing the sit­u­a­tion at the same time be­cause we just can­not sit back and wait for an­other tsunami to hit us again,” he says.

HIGH LEVEL FRUS­TRA­TION

Ac­cord­ing to SSP and the South­ern African HIV Clin­i­cians So­ci­ety (SAHCS), ef­forts are on­go­ing to try and delve deeper into find­ing favourable so­lu­tions to the prob­lem.

“This in­cludes rou­tine mon­i­tor­ing re­ports, tele­phonic sur­veys of fa­cil­i­ties to mon­i­tor stock outs, and a hot­line where pa­tients and fa­cil­i­ties can re­port stock outs. This in­for­ma­tion is es­ca­lated to the De­part­ment of Health. Fur­ther­more, the SAHCS has de­vel­oped clin­i­cal guide­lines on al­ter­na­tive medicines that pa­tients can use while sup­plies are be­ing re­solved,” the ad­vo­cacy groups say in a state­ment.

SSP says lines of com­mu­ni­ca­tions are open and they are in­un­dated with calls from peo­ple who are ex­pe­ri­enc­ing short­ages in dif­fer­ent parts of the coun­try. The frus­tra­tion is reach­ing high lev­els.

“The min­is­ter of health needs to change his think­ing and lis­ten to the peo­ple who are work­ing on the ground for di­rec­tion,” An­drew says.

“He should be work­ing with civil so­ci­ety to be as­sisted in know­ing where chal­lenges are. TAC is will­ing to work with the De­part­ment of Health.”

De­spite the health min­istry say­ing that there is no cri­sis in the sup­ply of ARVs, ad­vo­cacy groups say pre­ventable deaths may oc­cur if the sit­u­a­tion does not im­prove

An HIV pos­i­tive pa­tient lies on her bed wait­ing for anti-retro­vi­ral med­i­ca­tion to be ad­min­is­tered to her

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