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[e-drug] Mozambique debate on ARVs

E-DRUG: Mozambique debate on ARVs
---------------------------------
[Are African Health Ministries ready to discuss ARV use strategies?
Politicians seem to know what they want...
Copied as fair use from http://allafrica.com/stories/200103270371.html
Thanks to Pharm-policy for spotting this. NN]

Renamo Demands Anti-retroviral Drugs

Panafrican News Agency (Dakar)

March 27, 2001 

Maputo, Mozambique 

Opposition legislators on Tuesday demanded that the Mozambican
government import anti- retroviral drugs to prolong the lives of people
living with the incurable HIV/AIDS.

They were speaking in a debate following the presentation of a report on
the HIV/AIDS epidemic given by Deputy Health Minister Aida Libombo.

Libombo had not ruled out the use of anti-retrovirals, but said these
should be imported from Brazil and India, which have ignored the patents
of the multinational drug companies, and are producing their own,
relatively cheap versions of the drugs.

However, the Renamo legislators had different views to hers.

"Brazil and India? Perish the thought! Buy them from the industrialised
west !, said some members of the former rebel movement.

One of them, Amade Mussa thought there was no reason not to buy western
anti-retrovirals. He suggested that if the government wanted drugs from
Brazil or India, there must be "hidden financial interests" involved.

Gania Mussagy demanded, not only the import of anti- retrovirals, but
also their distribution free of charge "so that the poor can live
longer".

"Why has the government prohibited the import of anti- retrovirals ?",
inquired Jose Palaco. He called on the private sector to import these
drugs, and to distribute them "according to the laws of the market."

But a Ministry of Health document, which the Renamo benches seem not to
have read, pointed out that anti-retrovirals are drugs "which require
specific training in their use".

They produce a range of secondary effects, which can include fatigue,
vomiting, mouth ulcers, diarrhoea, headaches, muscular pains and much
else.

As a result, in Europe about 15 percent of patients abandon treatment
with anti-retrovirals because they cannot stand the side effects.

The ministry insisted that doctors must have detailed knowledge of these
drugs and their side effects, and the patients must be highly
disciplined in taking them.

If they were not taken in the right amounts and at the right times, "we
will induce resistance to the drugs, and the therapy will fail
completely", it added.

Use of these drugs also implied "strong and specialist laboratory
support", the Ministry document said. "This support involves very
sophisticated and expensive equipment for certain examinations which the
country does not currently possess".

Then there is the cost of the drugs. Even using the Indian or Brazilian
versions, to treat 350,000 AIDS patients would cost 15 million US
dollars a year.

On top of that, a further 3.5 million dollars should be spent on
treating the opportunist infections that many of these patients will
still suffer.

These figures do not include the laboratory and other indirect costs -
at 200 dollars per patient per year. These would total a staggering 70
million dollars.

The cost of treating 130,000 infected pregnant women to prevent them
passing on HIV to their babies, and of dealing with their opportunist
infections is put at 16 million US dollars a year, minus the indirect
costs.

The Mozambican government does not have the money for this. The total
Health Ministry budget for drugs of all types is just 30 million US
dollars a year.
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