'Unstable supply' of HIV drugs draws concern | ABS-CBN

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'Unstable supply' of HIV drugs draws concern

'Unstable supply' of HIV drugs draws concern

Jeffrey Hernaez,

ABS-CBN News

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A college student takes advantage of the free HIV testing program being conducted by the local government of Quezon City as part of its HIV awareness and prevention campaign on Sept. 13, 2019. Jire Carreon, ABS-CBN News/File
A college student takes advantage of the free HIV testing program being conducted by the local government of Quezon City as part of its HIV awareness and prevention campaign on Sept. 13, 2019. Jire Carreon, ABS-CBN News/File

MANILA — As scientists continue to work towards a cure for HIV, its current treatment that involves taking medications every day helps Persons Living with HIV or PLHIV live longer, healthier lives and reduce the risk of transmission.

The treatment called antiretroviral therapy (ART) is provided by the government for free to Filipino PLHIVs.

However, advocacy group Network Plus Philippines, which is the national network of organizations of PLHIVs and people advocating for HIV/AIDS awareness, has been receiving reports of PLHIV community members in various regions receiving only "one bottle of ARV or even less" when refilling their ARV medications in the HIV treatment facilities.

Elena Felix, a convenor of Network Plus Philippines Inc., said the clamor from the community started sometime in May 2023.

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"We usually receive ARV refills for three months. Multi-month dispensing helps to avoid hassle of having to go back to the hospital. Now, there are those who get only one bottle, and the community is beginning to worry," she said.

What is worrying, she added, is that doctors and treatment hubs are not clear on whether the stocks are sufficient or if there is a shortage.

CONSISTENT TREATMENT NEEDED

Felix cited an instance in 2014 when ARVs were delayed at the Bureau of Customs. She said they needed to lobby at government offices and hold rallies for the medications to be released. Then, in 2018, ARVs were given out once a day at treatment hubs.

"Ang laki ng impact nito sa amin, kaya iyon 'yung ini-lobby namin [noon] na multi month dispensing tapos ganito 'yung mangyayari," added Felix, who was diagnosed with HIV in 1994.

Dr. Van Phillip Baton, service for all adviser of UNAIDS Philippines, explained that ARV is a combination of 3 medications put into 1 pill.

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A Person Living with HIV needs to take it at least once a day to keep the viral load low at an undetectable level as that will enable PLHIVs to have a normal lifespan.

It also lessens the viral load, which prevents the virus from being transmitted to his or her partner or even to the unborn child of a pregnant PLHIV.

“If ever matigilan even for a short amount of time 'yung regular treatment of taking of the medication, there's a very big possibility na tataas immediately 'yung viral load, so what would that mean if ever the person living with HIV doesn’t use protection in sexual intercourse, there's a very high possibility na maka-transmit siya even if undetectable siya previously, puwede siya maka-transmit ulit," Baton said.

He said it could also lead to other infections such as tuberculosis.

HIGH DEMAND, ADEQUATE SUPPLY

In a statement, the Department of Health assured the public that the current and the incoming antiretroviral stocks would be able to cover all patients until April 2024.

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“The initial tranche (58,000 bottles) of the FY 2023 DOH-procured TLD is expected to arrive in the country by the end of June and is expected to cover all current patients, estimated new enrollees, and estimated shiftees based on the updated TLD transition plan until the rest of the tranches (Tranche 2: 243,000 bottles by July 2023 and Tranche 3: 292,000 bottles by September 2023) are delivered,” the statement read.

The DOH also said there is a reorder of 25% of the total procurement (146,000 bottles), which will be facilitated to ensure adequate supply until next year and it will facilitate early procurement for 2024 to make sure that there will be no gap in the supplies in the facilities.

The DOH said that low stocks of antiretroviral drugs, particularly Tenofovir-Lamivudine-Dolutegravir (TLD), could be attributed to unprecedented increase in the use of TLD among PLHIV prior to the targeted full-scale rollout of the transition from their existing regimens.

“In accordance with the Philippine TLD Transition Plan, treatment-naive patients as well as those who developed adverse drug reactions in their current regimens (i.e., efavirenz) were prioritized for transition to TLD in 2020 to 2022.

However, as the PLHIV community became more aware of the promising superiority of TLD over other regimens through word of mouth, social media, learning sessions with support groups, and information dissemination by the treatment facilities, there was notable increase in the uptake of TLD across the facilities.

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Dr. Jojo Feliciano, OIC - Executive Director of the Philippine National Aids Council, said that they are trying to validate the occurrences of the supply problem reported by the PLHIVs and they are validating and helping to report supply shortage incidences to the DOH.

MONITORING ACTIVITIES

As a reaction to the DOH statement, Felix said she appreciates the government’s response and its strong relationship with the PLHIV community but is still looking for reassurance with regard to supply and is asking the agency to look into their distribution system.

In a statement, Network Plus Philippines together with its 40 strong member organizations demanded concrete response coming from the PNAC and DOH on how they will address this issue with immediate and long-term solutions and appeals to the PLHIV community to continue reporting these similar events in the CLM (Community-led Monitoring) platforms: commusta.ph and PLHIV Response Center to collect evidence and have clearer picture on the impact of this dwindling supply of TLD and other ARV regimen on a more personal and facility level.

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