This escalating
expenditure is occurring against a backdrop of dwindling global donor support,
placing immense pressure on the nation’s healthcare resources.
The exorbitant
cost of drug resistance tests, required to determine suitable third-line
treatment, further exacerbates the financial strain.
While
first-line treatment remains relatively affordable, rigorous adherence is
crucial to mitigate the catastrophic expenses associated with advanced
regimens, which divert funds from other vital treatment programmes.
Dr Owen
Mugurungi, Director of Aids and Tuberculosis (TB) Unit in the Ministry of
Health and Child Care, underscored the substantial financial burden of
third-line treatment.
“The challenge
with third-line treatment is that it is expensive to manage. First-line costs
US$6 to US$8 per month, while the third line goes into hundreds of US dollars
and even thousands per month per person.
“It means you
have to go by resistance; if you are now resistant to the drugs that we use on
you in the first and second line and that drug is not registered here in
Zimbabwe or it is not available here, it means we have to source it for you.
“Considering
the three-in-one combination (TLD) that we use for first-line treatment is
US$8, treatment for the third line is US$86-US$90 per month, which is 10 times
higher and that’s expensive. So, we try as much as possible to limit or reduce
the chances of people getting to the second line and third line of treatment,”
said Dr Mugurungi.
Dr Mugurungi
said that while it is easy to determine the cost of treatment for those in the
first and second line of therapy, it is not the same for the third line.
“We have a
standard cost for ARVs because it is a three-in-one combination for the first
line, but for the third line, they are separate treatments. The biggest cost is
with the drug resistance testing; it entails that we test, which drugs you are
resistant to and, which drugs your infection is sensitive to and so on. So, it
is not standard and it is very expensive to do these processes that can spill
into thousands.”
Dr Mugurungi
said the 603 patients on third-line medication is too large a number,
considering the associated costs of their treatment, and noted that the
availability of the drugs is also a challenge and is not always guaranteed.
“It is
important to note that the less a drug is used, the less it is also produced,
making it extremely expensive to buy. If we had one million people on a
particular drug, manufacturers also lower costs as there is a huge demand, but
producing special drugs for a very small population also increases the costs
significantly, and that is why third-line drugs are very expensive to buy.
Their availability is also not guaranteed, always looking at small numbers
required,” he said.
Dr Mugurungi
revealed that people are developing resistance to first and second lines of
treatment due to myths and misconceptions.
“One of the
most obvious reasons is knowledge and behaviours. We have had people who have
been told it is not HIV they are suffering from but something else to do with
spiritual and traditional things. They are told to stop taking their ARVs. That
misinformation is dangerous, and we know that the media can assist in
addressing some of those myths and misconceptions, which will make it difficult
for people to continue taking their medication,” he said.
Dr Mugurungi
further revealed how resistance to ARVs comes about.
“If you have a
headache or malaria, which you are supposed to get treated for, get treated.
However, in a few days, some people stop taking medication because they have
side effects or they forget or they have challenges in getting medication.
“For people
with diabetes, hypertension and others, there are days that one can forget and
you can be forgiven because once you take your medication for diabetes your
sugar levels go normal. But for HIV, when you forget or are unable to get your
medication or the medication gets lost, the virus changes its morphology. At
the end of the day, the virus becomes resistant to the medication that you are
taking,” he said. Chronicle
0 comments:
Post a Comment