SD runs out of TB drugs

MBABANE – About 10 000 patients receiving treatment for tuberculosis (TB) are at risk of contracting the deadly MDR-TB strain, which is a multi-drug resistant form of TB.

This is a result of the shortage of medical drugs to treat ordinary TB.
This newspaper has established that the drugs got used up in August last year.
The next consignment ordered from abroad will only arrive in Swaziland on February 25, 2010.

The drugs are mainly available from the TB Centre in Manzini but the XDR is not available, an extensively multi drug-resistant following the shortage of TB drugs in the country’s health institutions.

Swaziland already has the highest rate of new TB cases in the world and the emergency of these new strains would greatly worsen the situation.
The shortage was experienced from the days leading to Christmas.
This was almost the same time that the country’s politicians awarded themselves E11 million worth of increased allowances.

While the politicians celebrated their big pay, government failed to purchase the essential TB drugs.
As a result of the shortage, these patients are now evolving to the more life threatening strain of TB, the MDR-TB and XDR-TB.

These new strains have high rates of mortality and are now claiming the lives of Swazis in droves.
Since the shortage began in August last year, over 50 deaths have been reported.
There are now fears that the over 10 000 patients will soon develop the drug-resistant strain.
The problem with this, according to doctors, is that the strain is highly dangerous and infectious. It is also difficult and much costlier to treat.

Currently, there are close to 300 patients who have been diagnosed with MDR–TB.
The strains of TB that do not respond to the common treatment used in the earliest stages (called ‘first-line’ drugs) and XDR-TB do not respond to even the more expensive next step used in cases of resistance to the first regimen of drugs. These are called second–line drugs.

On average, full treatment of MDR requires medication worth over E40 000 per patient.
The treatment goes on for 24 months of consistent treatment everyday - by injection and tablets.
This TB strain could infect anyone who happens to inhale the airborne disease.

“You could be infected even if you are travelling by bus or at your clinic. TB is all around us so we are all affected even if we do not realise it,” said Paula Akugizibwe from AIDS Rights Alliance of Southern Africa, an organisation that conducts training and advocacy to improve the prevention and treatment of TB.

Paula said what complicated this issue was the fact that many countries were still far behind with infection control, which is the simple practices that can be carried out in any place to prevent the spread of any strain of TB.
Such preventative practices could include having good ventilation and masks in clinics.

“By investing in these measures and in good drug supply, government would actually save a lot of money down the line,” said Akugizibwe.

15 new cases of MDR-TB per MONTH

 MBABANE - The last three weeks have been a struggle for most TB patients who travel every day to the TB Centre in Manzini, only to be told that the centre has no drugs.

The effects of the drug shortage are now showing.
According to Themba Dlamini, the country’s TB Management Programme Director, the institution is recording more than 15 new cases of Multi Drug Resistant TB per month.

Dlamini says the country currently has about 300 cases of MDR but due to the drug shortage the number will rise.
A total of 10 000 patients are on treatment for the ordinary TB strain.
If the Ministry of Health fails to come up with a quick solution to this problem, all the TB patients in the country might emigrate to MDR,

Another complication is that it is difficult to diagnose and treat the disease.
Health workers are exposed to a greater risk because they interact with these patients everyday.
Another doctor who declined to be identified said: “What is sad is the fact that people are unknowingly exposed to MDR because of government negligence to do a simple thing, which is to purchase drugs.  

“More resistance will no doubt occur in places like rural Swaziland because the people, the healthcare infrastructure, the government, and the economy are plagued by the damage done by the HIV/AIDS pandemic, as well as drought, poor government response, and lack of awareness.”
The doctor said relatives of TB patients, care givers and health professionals who interacted with patients everyday were at huge risk.

One more month till drugs arrive

MBABANE - Drugs for the treatment of TB and destined for the country have been purchased but will only get here at the end of February.

This means that TB patients have no option but to wait and pray.
“They should pray that by the time they arrive, they would still be alive,” said one pharmacist who told this newspaper that his pharmacy had run out of stock of the TB drugs.

By the time they arrive, most of the over 10 000 patients whom their lives are depended on them may have contracted MDR-TB.
This is because if treatment is interrupted, patients no longer require the first line of treatment.
According to documents sourced from the Ministry of Health and Social Welfare, the drugs were purchased in India for around E354 571.
These are two suppliers in India, namely Lupin and Svizera.
The consignment from Lupin consists of 1 063 boxes of TB drugs while Svizera supplied a total of 6 611 boxes of different drugs.

The drugs were ordered on August 31 last year, but are still in India even today.
This is confirmed by documents in our possession.
According to a shipment schedule which this newspaper got hold of, as of Friday, the drugs had already been packed, ready to be dispatched.

They were inspected and given a clean bill on September 17, 2009 and were scheduled to be dispatched from India’s Mumbai Airport on January 12, 2010.
The drugs were initially scheduled to arrive in the country on January 22, 2010.
This did not happen and there was no explanation of the delay.
According to the document, a further inspection was conducted on the drugs and was completed on December 28, 2009.

It was then estimated that they would have been dispatched from India on February 17, 2010 to arrive in the country on February 25.
As of today, the drugs are still in India yet another inspection is being conducted on them.
It is estimated that this inspection would be completed by January 20.
If the drugs pass this inspection, they will depart from Mumbai Airport on February 17, 2010 and arrive in the country on the 25th of the same month.