Zimbabwe is grappling with severe disruptions to the supply chain of tuberculosis (TB) dr+gs, resulting in alarming shortages at public health facilities. Experts warn that the sudden termination of treatment due to these shortages could significantly impede effective disease control. With free TB treatment and care in the country, the lack of essential dr+gs may give rise to multi-dr+g resistant TB and increased fata@lities.
The World Health Organisation reports that 10 million people worldwide are afflicted with TB annually. Despite its preventable and curable nature, the disease claims the lives of 1.5 million people each year, making it the leading cause of d3ath from infectious diseases globally.
According to recent reports, a survey conducted by source revealed that essential TB dr+gs, including Rifampicin, Isoniazid, Ethambutol, and Pyrazinamide, are in short supply at various public hospitals in Harare and Chitungwiza.
These four dr+gs are typically combined during the initial two-month phase of TB treatment, with Rifampicin and Isoniazid being the primary medications used in the continuation phase, which lasts at least four months. Despite Zimbabwe’s notable achievements in reducing TB cases between 2015 and 2019, this publication discovered that TB dr+g shortages exist in Harare and Chitungwiza’s council and government health centers.
“I collect my TB dr+gs at Tariro clinic in Hopley, but the last time I checked with them, they were not in stock,” said a TB patient in Hopley.
“However, I am told the dr+gs are now there.”
A nurse at a Chitungwiza Municipality-run clinic conceded that at some point the council clinics ran out of TB dr+gs.
“We got a few supplies recently, but around February the dr+gs were nowhere to be found.”
This publication also established that Harare City Council health institutions received their allocation of TB dr+gs recently, but sources said the drugs are finding their way into the black market where they are sold.
“Council has just received TB dr+gs that have been in short supply lately, but most of these dr+gs are no longer in stock as we speak,” said a source within the Harare City Council health department.
Harare City Council health services director Prosper Chonzi could not be reached for comment yesterday.
Public health expert and medical doctor Johannes Marisa said TB dr+gs were critical and should not be in short supply.
“We should not run short of TB dr+gs lest we develop dr+g resistant TB, multi dr+g resistant TB and even d3ath,” he said.
“We should thrive as a nation to stock TB dr+gs and I am not sure where the supply chain is cut.
“The ministry should address the supply issue as a matter of urgency.”
Marisa, who is also the president of the Medical and Dental Private Practitioners Association of Zimbabwe, said a number of TB patients, particularly in Ruwa, were failing to get the dr+gs from public health facilities in the area.
However, the National Pharmaceutical Company (NatPharm), a state-owned enterprise mandated to procure, store and distribute medicines and medical supplies to public health institutions, said TB dr+gs were in stock.
“Our duty as NatPharm is to procure, store and distribute medicines and medical supplies to nearly 1 800 public health institutions across the country,” NatPharm spokesperson Munyaradzi Musiiwa said.
“Our distribution is informed by the Zimbabwe Assisted Pull System that helps us distribute dr+gs as ordered by district pharmacies under the Health and Child Care ministry.
“When you order dr+gs, we don’t give you at once considering that most health facilities do not have proper storage facilities.
“Procurements are done quarterly, but we have room for what we call emergency orders where we can process and deliver dr+gs in six hours.
“As for TB dr+gs, just like ARVs we have them in stock, and we distribute them as per orders from the health facilities.”
Musiiwa said NatPharm did not control the management of drugs beyond health facilities.
Investigations carried by source revealed that TB dr+gs were being sold on the black market or at private clinics.
“I want to make it clear, TB dr+gs are not sold, they are given for free at public health institutions,” said Newman Madzikwa, the director of pharmacy services in the Health ministry.
“TB patients are not given prescriptions, but they can get their dr+gs free of charge from the public health facilities because private clinics do not treat TB.
“I want to encourage people to seek services at public health facilities and desist from buying dr+gs on the black market or backyard clinics.”
Madzikwa said his ministry was going to issue a press statement to that effect.
Peter Shiri, a National TB Programme officer in the Health ministry said the shortage of TB dr+gs was a result of supply disruptions.
“Yes, sometimes we have these shortages, but not that the country does not have the dr+gs, just because of supply disruptions,” he said.
“We have adequate TB dr+gs in the country, but there are factors that are considered first in the supply chain that might cause delays, disruptions and at the end of the day, the shortages.
“There are issues around proper storage of dr+gs that are also considered.”
Shiri told journalists attending a National Aids Council-convened workshop recently that TB remains one of the biggest k!ller diseases in the country, especially among people living with HIV.
SOURCE : THE STANDARD
