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Aids patients reject bitter ARVs

The Uganda Coalition for Access to Essential Medicine (UCAEM) has asked government to withdraw and cease use of non-film coated tenofovir and lamivudine, dubbing the drug combination as notoriously bitter.

The drug was recalled by National Drug Authority (NDA) in January following widespread complaints by people living with HIV. However, the ministry of Health recently reintroduced this medicine alluding to an apparent shortage of the non-bitter version of the medicine. This has raised questions about drug adherence.

“Based on the evidence from patient experience we gathered nationwide when this bitter medicine was being used in 2013, people living with HIV will more likely stop taking treatment than use this medicine,” said Margaret Happy, the advocacy officer of the International Community of Women in East Africa (ICWEA), in a press statement dated September 4.

“This will cause chaos and harm to the national response; people will be at increased risk of developing drug resistance, or even disease progression if they go without treatment, or try multiple times and fail to tolerate this drug.”

A dosage of the non-coated drug containing 30 tablets costs about $5 (about Shs 12,800) – just a dollar cheaper than the film-coated ones. UACEM noted that any cost-saving the country may try to be making from using this bitter product will be outstripped by the cost of having to enroll people on second-line treatment.

This is because their first-line treatment might fail due to treatment interruptions. The coalition urged the Health ministry to make emergency procurement for the acceptable, film-coated version of the product and send out a circular to all the service providers to stop dispensing the contentious drugs.

The mandate of NDA as a regulatory body is to ensure that the drugs on the market are safe, efficacious, of good quality and user-friendly.

“In line with its statutory mandate, NDA has, therefore, decided to recall the uncoated products from all health facilities and have them replaced with the coated one,” Gordon Sematiko, NDA’s executive secretary, recently communicated.


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