The Citizen Observatory for Health (OCS) has been receiving, in recent days, complaints regarding the lack of antiretroviral medication in some Health Units, at the level of Maputo city, Mozambican capital.
According to the users, several types of medication are in shortage, namely: DTG, TDF, Duovir, Atazanavir, Abacavir, Lamivudine, among others.
This type of pill is mostly recommended to patients with HIV/AIDS and other associated health complications, such as a stroke.
One of the patients, speaking on the condition of anonymity to the OCS team, explained that he finds his medication at the 1º de Maio Health Center, on the outskirts of the country’s capital. However, after suffering a stroke, doctors had to change the medicine to ABACAVIR+LAMIVUDINE, the ideal medication for his current health condition.
Since the change in pills, says the source, he can only access a maximum of five of them, as the rest are scarce.
“The amount of pills I used to take before my stroke was enough for a month. But now, almost every week, I have to go to the health centre. It is difficult to get around frequently because of my current condition, as I don’t always have someone to help me”, the patient complained.
The patient further explained that on a Friday, possessing only one pill, he asked his wife to go to the health centre, but she was unable to access the medication “she was told that there was no medication.”
Therefore, she was forced to plead, explaining that her husband’s life was in danger since he had only one pill for the remaining days, even taking into account that the antiretroviral treatment must be followed to the letter and without any interruption.
After that, the pharmacist on duty gave him three pills, recommending that he should return on Monday to have access to more medication.
The complaints about the lack of antiretroviral drugs also include the Alto-Maé Health Centre, a place that our team visited.
“We always start the treatment with the DTG. After a month, the patient undergoes tests to see if he or she is still on the same line or not. We can say that 2 out of 10 people, who undergo tests, may change their line. This means that especially ABACAVIR is prescribed to patients who have been diagnosed with another health condition, be it stroke, kidney failure, and other liver problems. I want to believe that because of the small number of patients who use it, there is limited importation”, our source said, without necessarily guaranteeing that this is the real cause of the shortage.
Overcome Situation
In order to verify the veracity of the denunciations, the Citizen Observatory for Health contacted the competent authorities, specifically the Directorate of Health Services of the City.
Nilsa Zucua, head of the HIV program at the Health Directorate, acknowledged “that there was indeed a small delay in the arrival of the plane carrying the medicine to the country, but the situation was overcome.”
“As you know, the medicines are imported into Mozambique. Weeks ago, we had a delay in their arrival, which created a small disruption in the Health Units. But the situation was overcome and the Health Units already have the orientation of how they should proceed”, Zucua said, adding that “we no longer have this problem. These are things that really happen; in the same way that paracetamol is sometimes missing. Everything also has to do with the lack of coordination at the Health Unit level, compromising, obviously, the availability of medication.
According to Zucua, there are several factors behind the non-availability of a certain medication.
“The only thing that I can clearly state is that this problem is overcome”, she reiterated.
It should be noted that the antiretroviral treatment follows two therapeutic lines, namely: the 1st and the 2nd, and the first-line ART is composed of 1””pill (“2 in 1” TDF+3TC) and 1 DTG pill, used simultaneously, in a single daily dose (at the patient’s preferred time, always at the same time, with or without food).
The head of the HIV program, who further explained that ABACAVIR can be administered in two lines, but has some peculiarities in the first line, in which some users cannot take a particular drug.
“The Abacavir is not given only in the 1st or 2nd line, but in one or the other line, and many times it has its peculiarities in the 1st line, which has to do with some users who cannot take a certain drug, in this case, the TDF, because of a certain condition related to renal failure”, she said.
