A number of antiretroviral drugs are in short supply in parts of Tamil Nadu. Running on low stock, some antiretroviral therapy (ART) centres are disbursing drugs for a duration of 15 days instead of one to three months for many persons with HIV/AIDS, who are under treatment.
Several people living with HIV/AIDS (PLHA) who are on ART and non-governmental organisation (NGO) members said that some antiretroviral drugs were in short supply. Official sources in the Health Department confirmed that there was indeed a shortage of tenofovir disoproxil, lamivudine, dolutegravir (TLD), Abacavir and Lopinavir.
“As per national guidelines, each ART centre should maintain the stock necessary for three months. But nowhere in the State is this three-month stock maintained. There is a shortage of abacavir and lopinavir. There have been instances of a paediatric drug being given to adults,” an official source said.
Recently, an elderly woman, who was on ART for the last few years, said an ART centre in Chennai issued medicines for a week and asked her to return for a refill. “When I asked why they were issuing drugs for such a short duration, they told me there was no stock. The next time, my refill was for a week again, and later for 15 days. I have a job, and it is difficult to make frequent visits for refills,” she said.
A network member said such shortages of some drugs occurred on and off for the last four to five years. “Last week, a woman was given a paediatric dose of abacavir. She had to take 10 tablets, 60 mg each, to match the adult dosage of 600 mg,” he said. When a patient was given so many tablets, he/she might skip dosages.
A PLHA said that earlier, patients on ART received medications for up to three months based on treatment adherence.
“Last month, I received drugs for 15 days citing lack of stock. Many patients are daily wage labourers, and they find it difficult to travel to the government hospital once every 15 days for refills. Some of them have stopped taking drugs,” another PLHA said.
Issuing medications for shorter duration has put persons such as truck drivers, outstation labourers and widows in a tough spot. “Truck workers used to get medications for three months. If PLHAs are made to make frequent visits for refilling their drugs because of low drug stock, this could result in low treatment adherence of the life-saving treatment,” a source said.
Sources added that the National AIDS Control Organisation (NACO) continued to supply drugs through the Central Medical Services Society but the stock was not sufficient. In such cases, NACO has clearly stated that local purchases can be made by all States to maintain the required stock position.
Some suggested that the inventory position could be put up on the website of the Tamil Nadu State AIDS Control Society (TANSACS) for the information of the beneficiaries. The Tamil Nadu Medical Services Corporation should be roped in to procure drugs and streamline the supply.
However, an official of TANSACS said that there was no shortfall of antiretroviral drugs. When asked about drugs being issued for 15 days, he said he would look into it.
