MoH, are we going to run out of ARVs?
UNaids recently published an article describing stocks of medication for HIV patients could run out in the next two months, because of higher costs linked to lockdowns and Covid-19 border closures but have no fear the risks can be mitigated.
The Unaids survey discovered that the lockdowns and border closures imposed to stop Covid-19 are impacting both the production of medicines and their distribution, potentially leading to increases in their cost and to supply issues, including stock-outs over the next two months.A recent modelling exercise estimated that a six-month disruption of antiretroviral therapy in sub-Saharan Africa alone could lead to 500 000 additional Aids-related deaths.
I worry about Malawi that has been so focussed on elections and possible changes in government…. Ministry of Health, are you making plans to mitigate the possibility and impacts of higher costs and reduced availability of antiretroviral medicines?
The production of antiretroviral medicines has been affected by several factors. Air and sea transport is being severely curtailed, hampering the distribution of the raw materials and other products, such as packaging material, that pharmaceutical companies need to manufacture the medicines. Physical distancing and lockdowns are also restricting the levels of human resources available in manufacturing facilities. The combined result of shortages of materials and workforces could lead to supply issues and pressure on prices in the coming months, with some of the regimens for first-line treatment and those for children projected to be the severest hit.
An array of circumstances are conspiring to add pressure on the overall cost of finished antiretroviral medicines. Increased overhead and transport costs, the need for alternative sourcing of key starting materials and active pharmaceutical ingredients and currency fluctuations caused by the forecasted economic shock are combining to push up the cost of some antiretroviral regimens. It has been estimated that a 10–25 percent increase in these could result in an annual increase in the final cost of exported antiretroviral medicines from India alone of between US$ 100 million and US$ 225 million. Considering that in 2018 there was an HIV financing shortfall of more than US$ 7 billion, the world cannot afford an added burden on investments in the Aids response.
UNaids and partners are working to mitigate the impact. The Global Fund to Fight Aids, Tuberculosis and Malaria (Global Fund) is providing immediate funding of up to US$ 1 billion to help countries to respond to Covid-19 and is expanding the use of its procurement platform to non-Global Fund recipients.
Ministry of Health and partner agencies and organisations—what efforts are you making to address the potential procurement and supply management challenges of antiretroviral therapy caused by the Covid-19?
