COTE D'IVOIRE: Political crisis affects supply of ARVs
Treatment interruptions can lead to drug resistance,which the country's health system is not equippd to deal with
ABIDJAN, 4 February 2011 (IRIN) - As Côte d'Ivoire's political stalemate
drags on, NGOs are becoming increasingly concerned about its effect on the supply of life-prolonging antiretroviral medicines.
"The street protests, blockades and other problems have disrupted the supply of antiretrovirals (ARVs) in different areas; patients in Abobo District on the northern side of Abidjan were only able to buy drugs at the end of January," said Yaya Coulibaly, president of the Ivoirian Network of People Living with HIV (RIP+), an umbrella organization for 65 NGOs fighting HIV/AIDS in Côte d'Ivoire.
"The phone has not stopped ringing for several days. There is anxiety and constant stress among HIV/AIDS patients," he added. "We fear that events here are having an impact on their mental health and aggravating the pandemic in Côte d'Ivoire," he told IRIN/PlusNews.
Coulibaly said he believed the situation was more critical in areas controlled by the former rebels, the Forces Nouvelles.
"Only the Public Health Pharmacy is supplying drugs in these areas. Unfortunately, vehicular access is blocked to the south. We have learned that in Danané, in the far west, ARVs could only be provided two weeks ago, after a two-month wait," he said.
RIP+ executive director Claude Bayeto expressed fears that treatment interruptions could lead to drug resistance, which the country's health system was not fully equipped to handle.
"If there is no improvement and the crisis continues, we will stop taking in new patients and deal only with those we already have," he added. "And if nothing improves, we must fear a disaster."
|The phone has not stopped ringing for several days. There is anxiety and constant stress among HIV/AIDS patients
The last shortage of ARVs in Côte d'Ivoire was in 2005. People living with HIV/AIDS were hit by a three-month break in supplies.
Antiretroviral therapy was made free of charge by the Ivoirian government in August 2008. In 2010, an estimated 104,000 Ivoirians were on ARVs, largely due to funding from the US President's Emergency Plan for Aids Relief and other international organizations fighting HIV/AIDS.
Support from another key donor, the Global Fund to Fight AIDS, Tuberculosis and Malaria
, which has approved grants worth more than US$290 million to Côte d'Ivoire, has also been affected by the crisis. Contacted by IRIN in Geneva, the Fund confirmed that: “Due to the political instability the Global Fund has taken measures to safeguard its stocks and funds in Ivory Coast, but continues allowing procurement and distribution of life saving drugs against HIV virus and malaria.” The Global Fund is also authorizing implementers to carry on essential operational activities on a case-by-case basis.
The World Bank
, which also pledged an estimated $20 million to fight AIDS in Cote d'Ivoire, has closed its offices in Abidjan as a result of the crisis.
"We have assurances that the Global Fund will fund emergency programmes. The money, we learn, is available," said RIP+'s Bayeto. "But some sites backed by the World Bank will very soon be in trouble. We are in the second year of project implementation and closure of this office is a concern."
Nathalie Sadia Gahaley, executive director of the NGO Lumière and Action, has also warned of serious consequences for patients if donor support is compromised.
"We have already been affected by the withdrawal of donors, because we did not foresee it," Gahaley told IRIN/PlusNews. "We have around 35 people living with HIV/AIDS who receive breakfast and lunch so they can take their medicines. But now we are running out of supplies. And I am not sure we can honour our obligations to our patients who have to eat well in order to take their antiretrovirals."
She said the situation was particularly difficult in areas where there had been outbreaks of violence."When there were street demonstrations, patients in trouble spots were unable to reach us to get their food rations. Now we only get around 20 regular visits for food. We are appealing for a humanitarian corridor to be set up by those who make decisions among international humanitarian organizations."
Margueritte Doffou, director of The National Fund to Fight AIDS (FNLS) said her organization was looking into solving the situation.
"At the moment FNLS funds are not being used to purchase ARVs," RIP+'s Coulibaly said. "The fund was awaiting the completion of the elections to benefit from taxes on tobacco and airline tickets... Unfortunately, the situation is not normal. We have to find something else," he said.
HIV-positive Sévérine Tanoh, a 29-year-old dressmaker from Abobo, is worried. "The [political] events occurred at the beginning of my treatment. I stuck it out. There were only three days when I didn't have any ARVs. Now everything is back to normal," she said.
"ARVs are my second breath of life; I therefore appeal to all parties to be responsible, and guarantee our survival," she added.