The Sunday News
GOVERNMENT is working towards a full scale rolling out of the more efficient Fixed Dose Combination (FDC) Anti-Retroviral Therapy (ART) by the end of this year which is expected to enhance drug adherence for people living with HIV, an official has revealed. The Fixed Dose Combination combines three drugs, Tenofovir, Lamivudine and Efavirenz, into one.
With the introduction of the FDC people on HIV treatment would now be taking one tablet a day, which lessens the drug burden and enhances adherence to treatment among people living with the virus.
People living with HIV are receiving treatment in Government and council medical institutions and are taking five drugs daily, two in the morning and three in the evening.
Director, HIV/AIDS & STI unit in the Ministry of Health and Child Care Dr Owen Mugurungi told Sunday News last week that the country was now moving towards rolling out the drug on a large scale to cater for people on HIV treatment.
Dr Mugurungi said the FDC was being administered to pregnant women, people with co-infections of HIV and TB and a few other special cases of individuals who would have reacted to the current drug regiments.
He said the Ministry of Health and Child Care was introducing the FDC in phases and would want to clear the current stock of drugs, which he said would last for the next six months, before switching to the FDC and rolling it out on a large scale.
“At any given point we have stocks that are not less than six months’ supply. We estimate that the current stocks will last us until November this year and that is when we will switch to the FDC.
“We have already started administering the drug but we are doing it in phases. We are administering the drug to special cases while the rest continue using the existing stocks. After the current stocks run out that is when in our next procurement we will switch to the FDC.
“Our target is to start rolling out the FDC by end of year. By November this year I’m sure we will be there,” he said.
Dr Mugurungi, however, said the ministry was faced with a number of challenges in its endeavour to switch from administering the multiple drug HIV treatment to the FDC.
He highlighted lack of resources as the chief impediment.
“When we launched the latest WHO guidelines on ART we mentioned that our aim was to move towards one pill a day in Zimbabwe. However, there are challenges and chief among the challenges are resources.
“The procurement cost of the one pill a day is higher than the current regiment, which means as a country we need to mobilise more financial resources for us to be able to meet our target. We are working with our partners on the resource mobilisation part and I’m confident we will meet our target,” he said.
Experts say the FDC is faster acting and has fewer side effects compared to the drugs being administered in the country.
Dr Mugurungi concurred adding that the FDC worked easier on pregnant women and reduces pill burden to people on treatment thereby increasing adherence to treatment.
He said side effects such as nausea were also not common among people on the FDC.
“Taking one pill a day is obviously easier compared to taking three or four. It helps reduce the pill burden especially for people who are on TB treatment. The FDC has easier and better outcomes on pregnant women and obviously less side effects.
“The one pill a day also helps enhance adherence because a person no longer has to take tablets twice a day but just once which is less burdensome.
“Another challenge that people on HIV treatment are facing because of the current regime is that of losing or running out of one of the drugs when they have travelled and ending up taking say two instead of the prescribed three drugs, which obviously has effects of creating a resistant strain of the virus. The one pill a day will go a long way in addressing this challenge,” he said.
There are 1,4 million adults living with HIV countrywide and of that figure 955 000 are receiving ARVs, with the remainder still on the waiting list.
At least 156 718 children between 0-14 years are living with HIV with 46 319 of them receiving ART.
Zimbabwe commenced its ART programme in April 2004, with the National Aids Trust Fund being the major source of funds.
