RITM: PLHIVs may not receive ARVs next week

Time to panic?

Dr. Rosanna Ditangco, research chief at the Research Institute for Tropical Medicine-AIDS Research Group (RITM-ARG, one of the treatment hubs in the country), highlighted the dire situation faced by Filipino people living with HIV (PLHIV) after she reportedly said that the distribution of antiretroviral medicines (ARVs) may be stopped due to processing delays.

In a letter sent to the Department of Health (DOH) Secretary, Dr. Enrique Ona, dated September 2, HIV activist Pozzie Pinoy of the Red Ribbon Project, quoted Ditangco for saying that if the ARVs that are currently being held by the Bureau of Customs (BOC) will not be released by Friday, September 5, then “HIV treatment will totally stop all over the country.”

The Project Red Ribbon claimed receiving insider information that “BOC is requiring DOH to pay P5 million for the tax of the shipment (i.e. ARVs)”, and that “the said shipment has been in the storage of BOC since August of this year.”

DIRE SITUATION 

The number of HIV and AIDS cases in the Philippines already reached 19,915 as of July 2014, the National Epidemiology Center of the Department of Health (DOH) reported. And from January to July this year alone, the number of Filipinos living with HIV who are on antiretroviral therapy (ART) reached 7,172.

Obviously, the numbers are expected to rise, considering the continuing growing number of new cases reported by the DOH.

ON DEAF EARS

This issue was actually raised as early as February of this year, when PLHIVs started receiving limited supplies of ARVs from their treatment hubs. In a blog post by Pozzie Pinoy, Ditangco was quoted as saying that most Philippine HIV treatment hubs give out supplies for only either two weeks or one month, because of the delay in the delivery of meds to DOH.

After two weeks, Ditangco reported that the DOH will already deliver the ARV supplies to the respective treatment hubs.

Interestingly, according to Dr. Jose Gerard Belimac, head of DOH’s National AIDS/STI Prevention and Control Program, there is no delay in the procurement of ARVs, just as there is no “official pronouncement from the DOH to the treatment hubs to control [the distribution of ARVs] because of a delay in the procurement [of ARVs],” he said in an exclusive interview by Outrage Magazine.

Dr. Belimac also assured that “this is something we are trying to resolve, to ensure the continuity of treatment for PLHIV.”

What is not as discussed is the delivery of ARVs that differ from what PLHIVs use, with changes made to regimens of PLHIVs without medically sound reasons.  As a PLHIV whose medicines were changed last March stated, “the ARVs given (to) me were changed because there’s no stock of my usual ARVs. (The doctor said), no choice.”

ABNORMAL SITUATION?

Despite all these pronouncements about the availability of supplies, the fluctuating supply of ARVs continued in the next months. Different PLHIVs from different treatment hubs complained about the insufficient (from two weeks’ to one month’s supply, depending on the hub), ARVs given to them every time they get a refill.

Ditangco, in an interview by Outrage Magazine last April, said that “ang ARV supplies natin ay wala naman talagang problema. Nagkaroon lang tayo ng abnormal situation because nagkaroon ng miscalculations in ordering (our ARV supplies do not have problems. We’re just having an abnormal situation because of miscalculations in ordering). There’s no need to cause unnecessary panic among PLHIVs.”

But panic is what is happening now.

During those months of notable ARV shortage, Project Red Ribbon actually purchased four boxes of Lamivudine and Tenofovir, a two-in-one mix of the two drugs.

“If there is no problem, why is it that we are buying from other countries to supplement the problems with the stocks? And we were able to release it from the (BOC) in just one week, as opposed to what other people saying that it’s hard to release it from Customs. The PLHIV community is panicking for the past months now. The DOH has not been transparent with its programs when it comes to ARV medicines,” Pozzie Pinoy stressed.

Also, even as the DOH continues to deny that there is a problem with the supply of ARVs in the Philippines, one by one, treatment hubs started borrowing ARV supplies from other hubs that have “enough supply”.

Ditangco was in fact quoted by Pozzie Pinoy as saying that RITM-ARG, in the last two weeks, has been lending their ARV stocks to other HIV and AIDS treatment hubs in Metro Manila and in the provinces because of the shortage.

DELAY = DEATH

Last August 26, different LGBTQIA organizations from all over the Philippines – including Ladlad Caraga Inc., The AIDS Treatment Action Group Philippines (TATAG), REDx, Northern Mindanao Advocates, and The Well Philippines – wrote a letter to the BOC for it to provide a clearer picture on the following issues:

1. What and how much were the duties and taxes imposed for the particular shipment?
2. What is the basis of computation for duties and taxes levied against the imported ARVs?
3. What is the cause of delay for the release of life saving ARVs to DOH?
4. Is the agency taking any steps to expedite the release of ARVs to DOH?

To date, no response has been received, no matter the urgency of the issue.

Pozzie Pinoy is appealing to the DOH and the BOC to do something about this life and death situation.

“I am pleading and begging you, on behalf of the entire PLHIV community and the entire country, to please look into this matter immediately and find a quick solution to this problem. What we can do now is to call for the attention of your department, and of the BOC to take action before this gets out of hand,” he stated.

Outrage Magazine is one with the PLHIV community in demanding that the Department of Health look into this matter as soon as possible and address this issue immediately.