Disruptions in HIV Drug Supplies and Funding Endangering Patients' Lives

Recent disruptions in the supply of anti-retroviral (ARV) drugs and
other essential medical items in at least six African countries are
putting HIV patients' lives at risk, said the international medical
humanitarian organization Doctors Without Borders/Medecins Sans
Frontieres (MSF) today, in advance of the International AIDS Society
Conference in Cape Town, South Africa.

Funding gaps and supply management problems have led to the delay,
suspension--or risk of suspension--of the supply of life-saving HIV drugs
in recent months. The inaction of national governments, donors, and
their partners must end and they must take urgent and concrete
measures, said MSF.

The consequences of disruptions in funding and supplies are potentially
catastrophic: if the start of new patients on treatment has to be
suspended or delayed, then the lives of many in urgent need of drugs
are at risk. For people already on treatment, the interruptions or
lowering of dosages will lead to treatment failure and a higher risk of
developing drug-resistance. Disruptions are having a direct impact on
MSF's HIV programs.

In South Africa, the government budget for health was cut due to the
global financial crisis; finding alternative funding seems difficult in
the short term.

"All around us, clinics stop enrolling patients because there are just
not enough ARV supplies," said Eric Goemaere, MSF head of mission in
South Africa. "The waiting lists are growing by the day, risking that
patients die before they start ARVs. It's unbelievable that a
relatively well-functioning ARV program has been allowed to be crippled
in the space of just a few weeks. MSF will not be able to fill the
gaps, and we seriously question why we should have to do so, in view of
declared international commitments."

In Malawi, delays in funding disbursements from the Global Fund for
AIDS, Tuberculosis and Malaria have already caused worrying shortages
in ARV supplies. As a result, ARV stocks are running dangerously low in
several health facilities. In order to avoid further ruptures, the
Ministry of Health, with the help of MSF and other NGOs, is currently
re-distributing ARV supplies to different districts. MSF has also had
to buy additional backup stocks, to ensure a steady supply for patients
in its projects. For now, MSF is able to start new patients on
treatment, but there is a real risk that this will have to slow down.

MSF teams in Uganda, the Democratic Republic of Congo, Zimbabwe, and Guinea are also seeing stock-outs and disruptions.

Disruptions are a result of a shortage of in-country funding and delays
by donor governments in fulfilling their commitments. Major
international funding institutions such as the Global Fund for AIDS,
tuberculosis and malaria and PEPFAR face budget caps or uncertainty in
the replenishment of funding. Country level supply management and
procurement issues compound the problem, as any delays in funding place
the supply chain in danger.

"MSF is extremely concerned about the lack of effective action from
governments, their partners, and international donors in assuring the
continued funding and supply of ARVs and other medical items for
treatment," said Meinie Nicolai, MSF director of operations. "They are
playing with fire: no ARVs means no HIV/AIDS treatment. Governments and
donors must respond to funding and supply problems urgently and
effectively."