Relief for patients as State resolves row over ARVs

Irene Githinji and KNA

Kenyans living with HIV and Aids heaved a sigh of relief after the national government yesterday resolved the stalemate surrounding Anti-Retroviral drugs (ARVs) distribution, which had left the country staring at a crisis.

Health Cabinet Secretary Mutahi Kagwe said the stalemate has been resolved and the essential drugs now cleared for distribution, even as he assured that patients will receive enough supplies for short periods at a time till regular supply is restored.

Fear was mounting among those who depend on the drugs following delays to clear the consignment at the port of Mombasa.

“The Ministry of Health is cognisant of the regrettable interruption of the multi-month shilling scripting and dispensation of ARVs for the management of HIV. 

The disruption has been occasioned by failure to receive a consignment of ARV donations that was expected to arrive by end of October 2020,” said the CS in a statement.

He explained that Kenya provides ARVs and other laboratory commodities to manage HIV worth Sh25 billion annually through three main sources of funding namely the Government, Global Fund for HIV, Tuberculosis and Malaria and the President’s Emergency Plan for AIDS Relief (Pepfar) through United States Agency for International Development (Usaid).

Kagwe said the management of procurement and supply of ARVs pipeline is done through an annual joint procurement work plan developed by the government in partnership with the donors and as such, for close to two decades, Kenya has never experienced shortage of ARVs.

“Ordinarily, stocks for the country are procured on a regular basis covering extended periods of time. Delays in supply have not been experienced as consignments, even when late, arrive in time to meet the demand for ARVs,” explained the CS.

He said the current scenario was not anticipated and the government only got to know about the likelihood of delayed supply late in January and the Ministry has since sought approvals and cleared the drugs.

Consequently, he said USAID is expected to hand over the same for distribution through the established systems.

The CS also said the Ministry has received some drugs from other pipeline sources and is currently restocking facilities around the country to ensure continuity of supply to patients.

Prevailing shortage

Earlier yesterday, the Council of Governors (CoG) said it had convened talks with Government agencies next Monday to discuss the prevailing shortage of ARVs.

 CoG Health Committee Chairman Anyang’ Nyong’o said the meeting will be between the Council, National Treasury, Ministry of Health and National AIDS and STIs Control Programme (NASCOP) and other relevant stakeholders, which will also be a platform to agree on the process that will initialise preparations of long term measures.

He made the remarks as he called for increased domestic funding and production of ARV commodities.

“The CoG health committee held a meeting with HIV/AIDS high burden counties to discuss the HIV stock out concern.

We are working to ensure that people are not affected,” said Prof Nyong’o in a press conference at CoG offices in Nairobi.

He said the meeting yesterday resolved that ARVs have to be availed to people urgently because there are counties, like Homa Bay, with zero HIV commodities.

“In light of declining development partner support, there is need to increase domestic financing and production of ARV commodities.

Therefore, the Council will convene an urgent inter-governmental meeting on Monday, April 12 to discuss the prevailing situation and agree on the process that will initialise preparations of long term measures,” said Nyong’o.

The council is concerned that a stock out in ARVS means that the viral suppression of the people taking the medicines is compromised and increases their chances of dying due to HIV related complications.

Of particular concern is what Nyong’o said is the serious challenges with paediatric ARV regimen.

“The component of this regimen called Kaletra is mission in totality in the country. This means that children are not accessing the full range of ARVs,” said Nyong’o.

He said shortage of the regimen will lead to treatment failure among children, with the CoG health committee now requesting NASCOP to provide guidelines directing the inclusion of Nevirapine into paedriatic regimen.

“We note that changing of ARV regimen in the short term is not advisable as it will lead to resistance of the drug,” said Nyong’o.

Similarly, he said counties are not able to test for viral load, a situation that presents a gap in the fight against HIV and is like to result to more HIV-related deaths.

He however assured that counties are committed to discussing the sustainability of HIV interventions in the country.

According to Kagwe, Kenya has made significant progress in HIV response as noted through progressive decline in prevalence among adults from a peak of about 10 per cent in the mid 90s to 4.5 percent last year and reduction of new HIV infections from about 75,000 per year in 2010 to 41,000 in 2019.

He also said deaths arising from HIV infections have declined by 64 per cent since 2013.

“With more than 1.2 million people living with HIV on long-term lifesaving medication, the country has one of the largest treatment programs in Africa.

The Ministry remains committed to ensuring a sustained program to save lives and build on the gains achieved so far, improve quality of life and avert new HIV infections while guarding against negative socio-economic impacts of the disease,” he said.