ARVs shortage: 'I fear we might die, I do not have money for drugs'

At least over 50, 000 women living with HIV receive ARV prophylaxis to prevent transmission. [Mercy Kahenda, Standard]

Kenyans living with HIV will shortly be forced to buy ARVs as the impasse between the government and donor agencies continues. Many health facilities have ran out of drugs even as a consignment with Sh1.2 billion worth of HIV drugs is still held at the port of Mombasa since it was shipped this January by USAID.

The Kenyans suffering include patients like 59-year-old TJ. He has been on ARVs since he was diagnosed with HIV in 1999 when the virus was a 'death sentence'. His wife had succumbed to the disease while their five-year-old daughter had contracted it at birth.

At the time it cost about Sh20, 000 every month to buy ARVs in private hospitals and chemists. TJ, who was also battling TB and pneumonia, was forced to sell his car and a piece of land to afford the ARVs.  

Things changed when donors began providing free supplies in 2004. Since then, TJ has been replenishing his stock at the Academic Model Providing Access to Healthcare (AMPATH), in Eldoret town alongside his now 20-year-old daughter and his current wife.

The free HIV drugs have helped avert over 630, 000 deaths in a dozen years to 2017 according to the National Aids Control Council (NACC). What is more, uptake of ARTs doubled to over 1.3 million Kenyans in seven years to 2017.

At least over 50, 000 women living with HIV receive ARV prophylaxis to prevent transmission to their newborn children.

But AMPATH, which serves nine counties, began running out of stock three months ago leaving the lives of people like TJ hanging in the balance.

“For more than 20 years, I have been living a healthy life, because I holistically take my medicine, I however fear for my life, and also risk infections, if I fail to receive the drugs, as there is no regular supply of the ARVs,” laments TJ who will have challenges raising Sh8, 000 monthly for the drugs without which “I fear we might die because I do not have money to buy them.”

AMPATH Eldoret branch, serves over 70, 000 people in Bungoma, Busia, Elgeyo Marakwet, Kisumu, Nandi, Trans Nzoia, Uasin Gishu and West Pokot. Uasin Gishu has the highest number at 28, 100, followed by Busia at 19, 645, 8, 071 in Trans Nzoia and 6,096 from Kisumu. Elgeyo Marakwet and West Pokot have 1, 232 and 1, 502 patients respectively.

Shortage of ARVs at AMPATH and nationally have forced patients to replenish stock every two weeks.

Prof Sylvester Kimaiyo, Chief of Party at Ampath says “it is worrying, if patients will not receive ARVs, because this will affect their viral loads and risks infections, more so, with Covid-19 pandemic.”

Prof Kimaiyo added that AMPATH also had run short of HIV testing reagents, due to fluctuation supply by Kenya Medical Supplies Agency (Kemsa).

Forty-one-year-old Brian* from Pioneer Estate in Eldoret has been on ARVs for 20 years. He visits AMPATH every two weeks but which he says “forces patients to travel from far and congest the facility, a health hazard as such risk us from contracting Covid-19.”

Before donor support, says Brian, it would cost him Sh70, 000 monthly for medication which is a throwback to the 1990s when “ARVs were for the rich because they were very expensive. I am worried, without supply most people will end up dying, with some contracting infections.”

The Pharmaceutical Society of Kenya (PSK) CEO Dr Daniella Munene told The Standard that Kenya should invest in self-sufficiency for antiretroviral therapy and other treatments required in HIV as “we cannot continue to depend on donor aid.”

Kenya currently has an acute shortage of pediatric, adult ARVs and septrins that prevent opportunistic infections among people living with HIV. Nyanza is among the worst-hit regions despite cases having dropped from 24 to 17 per cent in the last five years in areas like Ndhiwa, Homabay County, according to Médecins Sans Frontières (MSF), pegging the decline to improved access to testing, treatment and a higher quality care for HIV patients in the sub-county.