Malawi’s civil society for phasing out of ARVs with stavudine

Three civil society organisations (CSOs) in Malawi have written the Global Fund and the US President’s Emergency Plan for Aids Relief (Pepfar), asking them to help Malawi to phase out antiretroviral (ARV) with stavudine.

The CSOs, including the Malawi Network of People Living with HIV and Aids (Manet+), the Centre for Development of People (Cedep) and Health GAP (Global Access Project) wrote Global Fund general manager Gabriel Jaramillo and Pepfar global Aids coordinator Eric Goosby last week.

“We are deeply concerned that in these current negotiations, the Global Fund and Malawi have not yet generated a way to ensure that Global Fund resources are used to purchase optimised treatment instead of substandard toxic therapies.

“We further call on Pepfar to invest directly in the recurring costs of treatment in Malawi, including paying for antiretrovirals and salaries to ensure sustainability of high-quality care,” reads the letter in part.

The letter follows government’s struggles to scale up uptake of new ARVs regimen after the World Health Organisation (WHO) in 2009 recommended that countries should no longer use stavudine-based regimens for first line antiretroviral treatment because of its negative side effects.

“The Government of Malawi is committed to phasing out stavudine based first line regimens as reflected in updated national guidelines, but has been unable to do so because of costs. It is unacceptable that people with HIV in Malawi are still being subjected to use of this regimen,” reads the statement in part.

In an interview on Tuesday, Cedep executive director Gift Trapence said Pepfar has already acknowledged receipt of their letter and that it has assured them it will respond later.