Zimbabwe: Zim Hit By TB Drug Shortage

Parirenyatwa Hospital (file photo).
5 October 2020

The Ministry of Health and Child Care has raised alarm over the shortage of Tuberculosis drugs essential for HIV/TB treatment.

In a letter by the Permanent Secretary of Health and Child Care, Air Commodore Dr Jasper Chimedza addressed to all Provincial Medical Directors, Dr Chimedza indicated that the government is facing a shortage of Rifabutin 150mg tablets used in the treatment for TB/HIV co-infected patients.

"The country is currently faced with a shortage of Rifabutin 150mg tablets used in the treatment of Drug sensitive Tuberculosis (DS-TB) among TB/HIV co-infected patients on second line antiretroviral therapy (ART)," he said.

Dr Chimedza said the shortages are associated with active pharmaceutical ingredient quality issues at the manufacturer level.

"The next shipment delivery is expected in mid-2021. Based on the current stock levels of the commodity, the country will be stocked out by end of November 2020," he added.

Tuberculosis is one of the top ten killers in the world, according to the World Health Organization (WHO). The infectious disease is particularly dangerous for people living with HIV and AIDS.

Dr Chimedza recommended clinicians to stop initiating all new patients on Rifabutin based on regimen.

"Clinicians are recommended to initiate patients on a Rifampicin based regimen (2RHZE/2RTRH), substitute Atazanavir\Ritonavir (LPV/r) either give LPV/r twice daily (double the dose) or increase Ritonavir to 400mg (super boosting),"

Dr Chimedza also recommended the clinicians to monitor closely for potential adverse effects due to the high dosage.

TB is one of the leading killers of people living with HIV. People who are infected with HIV are 20 - 30 times more likely to develop active TB.

The risk of death in co-infected individuals is twice that of HIV infected individuals without TB. They are the most likely to suffer from the shortages.

Lack of access to medication may also lead to a weaker immune system making way for other opportunistic diseases.

Shortage of TB medication presents serious problems for the healthcare sector already under-resourced with human capital due to ongoing job action over salaries.

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