Then there is the question of the over burdened Drugserv publicly aided pharmacies that are already pressured by crowds sometimes as early as 5 or 6am at their branches; one has to join a long line and or effectively bribe a security or others to hold a space in extreme cases (apart from knowing someone inside). They also have drug shortage challenges as the Cross Roads and Portmore branches according to checks are out on Truvada and or EFV and Atripla, the main drugs. Combivir AZT which is still prescribed for some patients is also low but seemingly not as the other items. The other rarer types and brands appear to be not as impacted as the main treatments. While the drugs are cheap it can be frustrating the wait but the technocrats who oversee these things live in unimpeded comfort as they can afford better treatment experiences in the health systems or fly to overseas centres, so who cares really?
The issue also came up for mention on radio on August 4 during the check mail section of the daily show “At Your Service” hosted by the popular Mr Darby, the persons who texted in did not want to be identified by were clear as to their frustrations. Some are stuck with repeat prescriptions unfilled or the available drugs that may also be on the slip are supplied and a reissued prescription is handed to the persons involved to go elsewhere. Also of concern are the other items some clients normally would get such as iron tablets in the form of ILV or Feso4, B-complex capsules, staggered dosages of Bactrim and certain creams such as Clotrimazole, Betnovate cream and Fluconozole for persons with skin issues as the immune systems are compromised and or may have other running conditions such as diabetes.
Why aren’t said powerful HIV/LGBT outfits that control the cogs of prevention are silent on certain things? Items such as the expected switch over from tenofovir dixoproxil fumarate, TDF to tenofovir alfadamide where studies have shown better absorption of the latter in far less dosages (300mg versus 10mg) hence better CD4 and viral load results but the old generation ARVs or CART are still being dispensed. All of a sudden treatment naive patients are now the ones who can use the latter, despite the studies showing very little deleterious effects from the migration. TDF bleeds into the bloodstream so from a typical 300mg tablet maybe just over50% of that gets where it needs to go inside the cell cytoplasm. Then there is already ticklish question of adherence which can be frustrating in a sense for social and outreach workers, if not doctors and adherence staff. Persons do not take their meds on the basis of judging that they have no underline visible issues so they take chances or as a friend of mine hinted recently he is tired of swallowing pills, in other words treatment fatigue.
While the drugs maybe ‘free’ is not every impacted person can literally find the money to travel to the suggested pharmacies as they tend to be located far from the clinics the patients attend. For example in St Catherine persons from as far as Old Harbour or further are being told to go to a pharmacy in Kingston off Washington Boulevard. Again while the charge of $300 per bottle of one month’s supply the transportation cost to get there for some is debilitating as many persons are unemployed. The grants that would flow to assist persons in some sort of training or stipends for some are also all but dried up. Some persons would also be able to request basic food assistance such as rice, peas such items are becoming rare according to reports.
Why is it that the inventory systems have slipped that stocks have been allowed to go to such low levels is strange to me, persons have also been staggering their dosages to one tablet in the case of Atripla every other day so as to stretch the stock which is not recommended as yet despite a recent study citing the same drug suggesting three days dosages can provide the same results. One doctor who was contacted on the matter strongly cautioned that persons who are practicing such staggering should stop.
See a previous entries:
I hope that the powers that be can act quickly especially owing to the present ZIK-V infections and related possibly debilitating challenges such as GBS, HIV positive patients cannot afford that kind of exposure due to staggered treatment by shortages only to lead to CD4 counts falling. Some concerns were raised recently in a space of falling CD4 counts in MSM as well prior to the shortage coming into effect. I hope some change can come soon to alleviate the problems and concerns.
Peace & tolerance