Shortage of ARVs drugs in public health facilities has put the lives of over 1, 150, 000 citizens in danger

Health expert and former UPND vice President Dr Canisius Banda has said the shortage of Anti-Retroviral drugs in public health facilities has put the lives of over 1, 150, 000 citizens in danger.

In an internal memo dated 9th September 2022, Ministry of Health Permanent Secretary- Technical Services Pro. Lackson Kasonka has confirmed that there is a shortage of Zidovudine/Lamivudine, an ARV combination agent used as part of a three drug regimen used for managing individuals on second line ART.

Writing to Provincial Health Directors, Senior Medical Superintendents, District Medical Officers and implementing partners, Prof. Kasonka said the Ministry of Health has faced a delay in the shipment of ARVs namely Zidovudine/Lamivudine.

“The Ministry of Health has faced a delay in the shipment of Zidovudine/Lamivudine, an ARV combination agent used as part of a three drug regimen used for managing individuals on second line ART. Consequently, the National HIV Programme has recommended the following as an interim mitigation measure for individuals receiving this commodity combined with either a boosted protease inhibitor (Atazanavire-ritonanvir) or Lopinavi-Ritonavir or Dolugegravir.

Individuals who are virally suppressed on AZT/3TC/bPI and receiving care from health facilities which do not have AZT/3TC in stock should be switched to Tenofovir Disoproxil Furnarate/Lamivudine/Dolutegravir. Please note that individuals supplied with this interim regimen could have their antiretroviral therapy reversed to the standard AZT+3TC+bPI once the AZT+3TC stock status normalise,” Prof. Kasonka wrote.

In reaction, Dr. Banda, the former Ministry of Health Spokesperson, said the Ministry of Health under Minister Silvia Masebo and President Hakainde Hichilema’s reign is killing people in masses.

“Under Silvia Masebo, the ministry of health continues to kill people, it never rains but it pours. The lives of over 1, 150, 000 citizens are now in clear and present danger. This is unprecedented. This is new. This is as bad as it gets. Death for these citizens now looms. The UPND has now made their future uncertain.ARVs have run out. Yes, ARVs. The already beleaguered leadership of Hakainde Hichilema, premised on lies, is now falling apart.The fate is in the foundation. You see, Hakainde Hichilema, using public resources, goes to launch a book for his friend Greg Mills but he doesn’t go to China, our chief creditor.Hakainde Hichilema talks to Volodymr Zelensky, a Western stooge, but he doesn’t talk to Vladimir PUTIN, a member of the BRICS plus.Hakainde HICHILEMA supports The Queen, THEIR Queen, but he doesn’t support William RUTO, an African, even snubs his inauguration. See the pattern?This clear lack of geopolitical sophistication of the UPND government will cost Zambia. The level of naivete in this government borders on treason,” Dr. Banda wrote.

“You see, Zambia has more gold than Britain but most Zambians will now suffer economic austerity because of a paltry USD 1.3 billion from the IMF, their Fund.Fuel will soon become more expensive. Electricity will soon become more expensive. Soon not all farmers on FISP will be supported.The poor in Zambia will soon become poorer, their livelihoods will deteriorate.Now is this what Zambians voted for in August of 2021?Clearly NOT.Isn’t the role of government to improve the living standards of people?Why should a government remain in power when its actions are at variance with the expectations of the people?Zambians are still waiting for fertiliser at K250 maximum.Zambians are still waiting for mealie meal at K50.Students are still waiting for the suspension of their loan repayments as promised.And with no money in their pockets, the cost of living remains unaffordable for most citizens in Zambia today,” Dr. Banda stated.

He continued:”But, dear citizen, if you thought that this was bad enough, then think again. It gets worse. First ARVs.Because of the ill-inspired, bad leadership, yes inept and bad leadership of Hakainde HICHILEMA’s, Zambia has now run out of lifesaving ARVs.Yes, kulibe mankhwala.Yasila._Because of bad leadership [poor forecasting, poor quantification, poor order placements, poor procurement planning, etc] the supply-chain has now failed to perform/deliver.It has collapsed. A key combination of ZIDOVUDINE and LAMUVUDINE, a combination many Zambians take, a combination keeping many citizens alive, has now run out. These are drugs that must NOT run out, drugs which must be taken several times a day, non-stop. The government has stopped this adherence. Bad politics has intervened. This vital combination is now not there.For the first time in the history of its use in Zambia, it is not available.”

Dr. Banda said despite challenges in the Ministry of Health President Hichilema is busy harassing citizens and giving speeches.

“But Hakainde Hichilema is available, busy harassing citizens and giving speeches, and like ‘house negroes’ of old during slavery times, saying strange things like ‘our IMF, our World, Bank.’Because of measures taken by the MMD and the PF, Zambia’s National HIV program is one of the best in the world, and, over the years, it has saved lives.It is exemplary, many other countries have picked its best practices. But under Hakainde HICHILEMA’s watch, this program is now in danger of crumbling. This program is now unwell, critically ill. By 2020, of the 1.3 million Zambians known to be living with HIV, over 1, 150, 000 were on ARVs, nearly all, a most remarkable achievement. Zambians now rarely die from HIV disease.The UPND might soon reverse this key national gain/achievement. In health, a prescription is usually changed because of a patient’s non-responsiveness to a treatment choice, poor treatment outcomes.As examples, done as a matter of science and not politics, this drug change is done in cases of treatment failure because of germ resistance or severe, life-threatening adverse drug reactions. But now LEADERSHIP FAILURE is causing drug regimen/prescription change,” Dr. Banda added.

“Bad leadership is now an indication for regimen change, utterly unprecedented.Facing this critical shortage, and inspired by their profession of saving lives, medical doctors have now been forced to use whatever is available.Desperate times indeed call for desperate measures. Hakainde Hichilema said lies kill.Hakainde HICHILEMA said that liars must be punished. Well, here we are, my man.What do you say now?As if the Kasompe disaster was not bad enough, now actual lives and NOT houses, face demolition. Some people will soon die, Hakainde. You see, not everyone will respond well to these drug combination changes.Some citizens will encounter germ resistance. Some citizens will encounter adverse drug reactions. Some people will just NOT adhere to these new, supply-chain-failure -induced treatment changes.Some people will develop treatment failure.Yes, some people will die. Why isn’t the West helping you, Hakainde HICHILEMA?Why are these friends of yours allowing you to, and watching you fail, my man?Indeed, it never rains but it pours. Mvula ikakuona litsilo siyikata!Come December, Zambia will be in the dark, as no citizen will be able to afford electricity. Umati udziwa uchita, tsono chita!Strangely, the fixer is now fixing himself,” Dr. Banda concluded.

Meanwhile, Ministry of Health Permanent Secretary- Technical Services Pro. Lackson Kasonka has issued a statement saying there is no shortage of Antiretroviral drugs in Zambia.

“Clarification on the status and use of ‘zidovudine + lamivudine’ arv drugs used in second-line treatment of people living with hiv. The Ministry of Health wishes to inform members of the public that there is no shortage of Antiretroviral drugs in Zambia. In the quest to provide safer and more efficacious drugs, the optimization of antiretroviral therapy has since started. To this effect, 98.5 per cent of the 1,229,781 receiving ARVs are now receiving the newer, safer, easier to take and more efficacious dolutegravir containing ARV combinations called Tenofovir disoproxil fumarate/ Lamivudine/ Dolutegravir commonly referred to as TLD or Tenofovir alafenamide / Emtricitabine/ Dolutegravir commonly referred to as TAFED. These drugs are fixed into a tablet and given as one tablet per day. These newer combinations were introduced in Zambia in 2018 and have since led to over 96% of Zambian People Living with HIV receiving ARVs to have the virus suppressed resulting in a healthier and more productive population,” Prof. Kasonko stated.

“However, there still remain about 6,000 individuals who are taking an old ARV drug called Zidovudine which the Ministry of Health has been transitioning from to TLD or TAFED. This drug due to its poor side effect profile has thus faced an increasing low demand world disturbing its global supply chain and leading to its erratic supply in the last two years. Zambia too has faced this erratic supply. To this effect, the Ministry of Health in consultation with the Civil Society Organizations representing People Living with HIV and implementing partners has made a decision to accelerate the transition of individuals on this drug to better, safer and easier-to-take ARVs. The Government remains committed to ensuring people living with HIV in Zambia have adequate access to quality and efficacious anti-retroviral drugs, for a longer healthier life. Therefore, guidance has been provided to health workers to fast-track the transition from Zidovudine-containing ARV combinations to TLD or TAFED in view of new developments, based on scientific evidence generated from the African continent including Zambia. A further reminder is given to dispense a six-month supply of antiretroviral drugs as per standard guidance,” Prof. Kasonka concluded.