The shortage of some antiretrovirals has resulted in their being distributed in one-week rations instead of the customary monthly dosage - or sometimes, not at all. The drugs in short supply are lopinavir and ritonavir (Aluvia) and emtricitabine and tenofovir (Truvada).
According to Tony Hron, program development manager at Jamaica AIDS Support for Life, the organization's clients have complained since last November that they were unable to get the drugs at some public pharmacies. "These drugs require 90 to 95 percent adherence," said Hron, further noting that noncompliance will result in a rebound of the virus.
Dr. Kevin Harvey, head of the National HIV/STI program, admitted that lopinavir has been rationed due to inclement weather in the United States and Europe, which grounded flights and delayed arrival of the drugs from India in November and December. Rationing was instituted to prevent patients from running out entirely, Harvey explained.
According to Harvey, a shipment has since come in and will be distributed soon. "The stock is still not up to where it should be, but we are hoping another supply will come in February, and so by the end of February everyone should be able to get their full supply," said Harvey.
An anonymous member of the Jamaica Network of Seropositives noted that the intermittent shortage has been more severe since the beginning of January. Some members cannot afford weekly bus fare to collect the rations, and it is difficult to have prescriptions filled in other parishes not as badly affected, he said.
Adherence could be improved, Hron said, if patients with a history of compliance were given two months' supply at a time.
The current situation also raises the question of whether Jamaica is prepared to locally distribute lifesaving drugs in the wake of a natural disaster, he added.
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