Africa-Press – Zambia. The Ministry of Health has clarified that there is no shortage of Antiretroviral Drugs in Zambia as suggested by some media reports. Permanent Secretary for Technical Services Lackson Kasonka explains that the ministry has just faced a delay in the shipment of Zidovudine, an ARV combination agent used as part of a three drug regimen used for managing individuals on second line Antiretroviral Therapy–ARV-.
Professor Kasonka notes that only about 6,000 individuals who are taking an old ARV drug called Zidovudine which the Ministry of Health has been transitioning from Tafed may be affected and due to its poor side effect profile, it has faced increasing low demand disturbing its global supply chain leading to erratic supply in the last two years.
In a statement, the permanent secretary says in the quest to provide safer and more efficacious drugs, the optimization of antiretroviral therapy has since started with 98.5 per cent of the over 1,200,000 receiving ARVs who are now receiving the newer, safer and easier tablets.
He said the Ministry of Health is however in consultation with the civil society organizations representing people living with HIV to accelerate the transition of individuals on this drug to better and safer ARVs.
Yesterday, the Ministry of Health Permanent Secretary for Technical Services Lackson Kasonka disclosed in statement that, the Ministry has faced a delay in the shipment of Zidovudine/ Lamivudine (ZDV/3TC) 300mg/150mg an ARV combination agent used as part of a three-drug regimen used for managing individuals on second line Antiretroviral Treatment (ART).
Consequently, the National HIV Programme has recommended the following as an interim mitigation measure for individuals receiving this commodity combined with either a boosted protease inhibitor (bPI) Atazanavir-ritonanvir (ATV-r) or Lopinavir-Ritonavir (LPV-r) or Dolutegravir (DTG).
The Permanent Secretary has since instructed that Individuals who are virally suppressed on AZT/3TC/bPI and receiving care from health facilities which do not have AZT/3TC in stock should be switched to Tenofovir Disoproxil Fumarate/ Lamivudine/ Dolutegravir (TLD) or Tenofovir Alafenamide/ Emtricitabine/ Dolutegravir (TAFED) while maintaining the bPI component.
“The Combination regimen must be TLD or TAFED plus LPV-r or ATV-r,” he said
Mr Kasonka noted that individuals supplied with this interim regimen could have their antiretroviral therapy reversed to the standard AZT+3TC+Bpi once the AZT+3TC stock status normalizes. He added that for individuals on AZT+3TC+DTG in all facilities, guidance is given that they be permanently switched to TLD or TAFED.
Mr Kasonka disclosed that for individuals on AZT+3TC+bPI with a high viral load, enhanced adherence counselling (EAC) plus genotype testing while being moved to the interim therapy of TLD or TAFED plus LPV-r or ATV-r.
Mr Kasonka cited that these recommendations are based on the current evidence of the use of DTG with a recycled nucleoside reverse transcriptase inhibitor (NRTI) backbone deduced from the VISEND, NADIA and 2SD trials.
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