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Zimbabwe: ARV price hikes a concern for people living with Hiv/Aids
IRIN News
October 24, 2005

http://www.irinnews.org/AIDSreport.asp?ReportID=5361

BULAWAYO, (PLUSNEWS) - Zimbabweans living with HIV/AIDS are grappling with a dramatic increase in the price of anti-AIDS drugs, which has quadrupled in the past three months.

Mtungamili Tshabangu, 34, a widower who teaches at Luveve High school in the southern city of Bulawayo, started taking antiretroviral (ARV) drugs this year, which he bought from a local pharmacy every month.

At the beginning of 2005 his monthly course cost about Zimbabwe $200,000 (US $7.60) - now the price has soared to an average of Zim $1.3 million (US $50).

His modest monthly income of around Zim $2.5 million (US $96) allows him to buy the medication, but leaves him with little to support himself and his two children.

"It was possible when I started in January - not now. It is sad that my salary is not enough to pay for my healthcare needs," he told PlusNews.

Zimbabwe, with the world's fourth highest rate of HIV infection, is going through a severe economic crisis with serious fuel and food shortages due to recurring drought and the government's controversial fast-track land redistribution programme, which have disrupted agricultural production and slashed export earnings.

A month's supply of a fixed-dose combination of antiretrovirals (ARVs) went up from Zim $200,000 (US $7.70) to Zim $450,000 (US $17) in July, and now costs up to Zim $1.2 million (US $46) at most pharmacies.

Price hikes in the private medical sector in September forced Tshabangu to register at a local clinic providing free ARVs, but the health facility was not without its problems, he noted.

The Mpilo Opportunistic Infections Clinic at the Mpilo General Hospital is experiencing drug shortages. Tshabangu has been unable to get cotrimoxazole - an antibiotic that treats opportunistic infections - since the beginning of October, and it is also unavailable in the private sector.

A critical shortage of ARVs is looming, as local drug manufacturers are struggling to raise enough foreign currency to import the raw materials needed to manufacture the life-prolonging medicines.

Healthcare workers have expressed fears that by the end of October about 300,000 people on ARVs countrywide could be unable to obtain the medication they need and put their lives at risk.

David Parirenyatwa, Zimbabwe's Minister of Health and Child Welfare, told PlusNews recently that the government's treatment programme was still selling the drugs at the same price - Zim $50,000 (US $2) - and would continue to be heavily subsidised by the state, protecting patients from price fluctuations.

But Parirenyatwa acknowledged that the public rollout of ARVs would also feel the pinch. "I anticipate that patients in the private sector will be jumping over to the public sector, so we need to expand our capacities to be able to absorb them," he noted.

Notsikelelo Malaba, a print finisher at a Bulawayo company, is now considering signing up for the government's ARV rollout.

"It is difficult for many of us to spend that much just on medication because of our special needs, especially regarding diet - you do not just eat anything. So I think if I save more on my medical bills by getting free ARVs from the government, I would be able to concentrate on food," she reasoned.

Nothando Mutongwizo, who has been receiving her medication from a government hospital, has noticed the impact that the influx of HIV-positive patients is having on the public healthcare system.

"It has been a struggle over the past three months or so - at one stage I went for a week without taking cotrimoxazole. I did not fall sick for missing my schedule, but it is always frightening to go without drugs, even for a day," said Mutongwizo, whose husband is also on treatment.

Chairman of the Zimbabwe Network for People Living with HIV/AIDS (ZNPLWHA), Benjamin Mazhindu, has urged employers to provide drugs to their workers, and raised concerns about shortages of essential drugs such as cotrimoxazole. "It is not there in hospitals and in pharmacies. We are dry, dry!"

Mazhindu, who spends Zim $4.6 million (US $176) on his medication each month, warned that the situation might deteriorate by the end of November if enough foreign currency was not allocated to the local ARV manufacturer, Varichem Pharmaceuticals.

Nevertheless, he was optimistic that the national treatment programme would improve now that Zimbabwe had been granted US $105 million by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the government announced last week that it had allocated US $1.9 million to ARV treatment at public health facilities.

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