Kenya: Shortage of Key Drugs Threatens War On Covid-19

(file photo).
20 August 2021

Kenya's fight against Covid-19 faces a major hurdle after it emerged that key antiviral drugs Remdesivir and Actemra are virtually out of stock.

The acute shortage of the drugs, which are crucial in the treatment of patients with severe cases of the viral disease, comes at a time the country is recording a surge in infections, with more than 1,000 patients in the intensive care unit and the positivity rate at a high of 15 per cent.

According to data from the Pharmacy and Poisons Board (PPB), there are only 2,000 vials of Remdesivir in the country, spread among a handful of importers.

The latest wave of infections, driven by the highly transmittable delta variant, which was first reported in India, has increased demand for the drugs and strained services at major referral hospitals.

With the drugs out of stock at the stores of major suppliers, all indications are that all is not well even as the Health ministry races to expand vaccine protection.

"We issued a few more permits last week for the importation of the drugs and already we have 1,300 vials of Actemra 80mg and 400mg for Roche Pharmaceuticals at the airport awaiting clearance," Dr Fred Siyoi, the PPB Chief Executive Officer said.

Remdesivir has been found to speed up recovery of severely ill Covid-19 patients, though the World Health Organization has questioned its effectiveness.

The drug also reduces the duration and severity of illness.

The PPB approved the drug for emergency use on Covid-19 patients and permitted five Kenyan companies to import and supply it to hospitals.

Global shortage

In most private hospitals across the country, Remesdivir goes for Sh7,000 per vial while Actemra, which is considered the most expensive drug in the treatment of severely ill patients, retails at Sh180,000 per vial.

A patient can be given two vials a day, depending on the severity of the disease and length of stay in the ICU.

Yesterday, Roche Phamaceuticals, the manufacturer of the arthritis drug Actemra, admitted they were finding it difficult to keep up with the drug's demand.

The firm does not have any 200mg and 400 mg vials of the drug and expects the same fate for its 80mg supply by the end of the week.

While more shipments are due by the end of August, the firm has warned that its stock may run out earlier given the high rate of infection.

The global shortage of the rheumatoid arthritis drug, also known as tocilizumab, could grow more acute in the coming weeks or months.

Roche said in a statement on Monday that the demand has shot up 400 per cent compared to the pre-Covid period.

"Actemra sales jumped 32 per cent in 2020 to $3.12 billion. The drug has already reaped Swiss Franc 1.64 billion ($1.79 billion) in 2021, up 17 per cent compared with the same period a year prior," a Roche half-year report stated.

The shortage comes amid slow uptake of Covid-19 jabs.

Fully vaccinated

As of Wednesday, a total of 1,393,905 Kenyans had received their first dose, with only 760,920 fully vaccinated.

Fifty-six per cent of those who had received the first dose were males and 44 per cent females, with 55 per cent of males and 45 per cent females being fully vaccinated.

The highest proportion of the fully vaccinated population was in Nairobi County at 8.2 per cent and the least was in Marsabit County 0.3 per cent.

Healthcare workers formed the highest proportion of those who were fully vaccinated at 68.2 per cent, followed by those aged above 58 years at 64 per cent. Other categories included teachers (59 per cent) and security officers (58 per cent). The proportion of matatu crew and others who were fully vaccinated was only 41 per cent.

Since March 13, 2020, when the first case was confirmed in Kenya, more than 224,400 cases and 4,378 deaths have been recorded, working out to a case fatality rate of two per cent. Of the positive cases, 217,819 cases (97 per cent) were local transmissions and 6,580 (three per cent) related to foreigners.

On Wednesday, the country reported more than 1,500 cases, with more than 161 patients admitted in various hospitals across the country.

Surging numbers

Data from the Ministry of Health paints a bleak picture especially for Nairobi County and its environs, where three-quarters of the cases have been reported on a daily basis.

A spot check revealed Kenyatta National Hospital and Mbagathi Hospital were full and not admitting patients.

"What worries me is that we cannot get oxygen for patients in need," a nurse told the Nation.

Kenyatta University Teaching, Referral and Research Hospital has recalled all the nurses from leave to deal with surging numbers.

According to a statement signed by the hospital's director of nursing services Edward Omondi, the ICU, emergency and general isolation wards are stressed.

"The administration is working hard on recruitment to appropriately place nurses in these units. All the leaves shall be temporarily frozen until further notice," said the statement.

Mr Omondi, however, clarified that they were still admitting patients.

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