ARVs at centre of tax row have four months to expire

Some of the HIV drugs brought into the country early this year have less than four months to expire, even as the Ministry of Health and the donor engage in a tug-of-war on who should distribute them, the Nation has learnt.

The drugs, imported in February, have been lying at the Port of Mombasa for almost six months now. They were donated by the United States government through its aid agency USAid, and are yet to be taken to county hospitals due to a standoff over taxation and the mode of distribution.

Kemsa scandals

The Ministry of Health is said to have preferred Kemsa as the distributing agent for the drugs, a suggestion USAid is said to have opposed due to the scandals that have rocked the agency in the past couple of months. 

The anti-retroviral drugs (ARVs) are said to have a short shelf-life of between 18 to 24 months, something that makes the delays even worse for patients.

Speaking to an official who sought anonymity because he is not allowed to give details to the media, revealed to the Daily Nation that some of the drugs at the port have less than four months to expire.

This means that the drugs have to be released and distributed as fast as possible to the patients, who should not take a big amount of drugs since they will go bad before they are used.

“There are several drugs at the port, but what I know, some of them will expire very soon. If we had released the drugs in January, then the patients could be using them by now, the stock would have been used by the time of expiry,” said the officer.

However, as it is now, the officer said, it might not be a good idea to give the drugs to patients.

Storage charges

The donors had earlier hinted at moving the drugs to another country, citing the remaining shelf life of the drugs and the storage charges accruing.

However, the Nation has since learnt that the drugs have not been cleared for exportation to another country, which means they will still continue lying at the port.

By the beginning of this month, the storage charges had amounted to over one-quarter of the total cost of the drugs (which is how much?)

The United States Embassy indicated that should the consignment be cleared by the Kenyan government, then they will be moved to a USAid-contracted warehouse in Nairobi and will be prepared for disbursement.

“If the clearances do not arrive, the US will need to determine whether it is cost-efficient, given the remaining shelf life, to keep the medicines in storage near the port or move the medicines to other countries where they are also needed,” the embassy had earlier said.

The Ministry of Health had insisted on Kemsa distributing the drugs, a decision USAid has opposed, instead selecting its own entity – American firm Chemonics – to procure and distribute the donations to Kenya.

Medical crisis

Governors have since asked the government to sidestep Kemsa, in the distribution of HIV/Aids and TB drugs and engage counties, to avert a crisis in the devolved units. 

The council of governors yesterday said a number of counties were facing a possible medical crisis as a result of the impasse between the government and donors over the manner of distribution of the drugs, a situation they said could result in catastrophe if not resolved.

The governors said the standoff could adversely affect the fight against HIV/Aids and TB, as patients are likely to develop resistance to the drugs.

“Over the past 20 years, HIV commodities have significantly been supported by the US government and the global fund. These commodities include ARVs, laboratory consumables, reagents, and HIV testing kits,” CoG vice-chairman James Ongwae said.

“There is a likelihood of a looming shortage of these commodities from July 1, posing a potential crisis in the continuity of HIV care and treatment of 1.1 million Kenyans living with HIV. This, therefore, means that their health will be compromised and they risk dying due to increased HIV-related infections and massive drug resistance,” he added.

The governors now want the government to consider a local solution to the problem to avert such a stalemate in the future.

“In the long-term, both levels of governments need to discuss sustainable HIV interventions and how we can reduce dependence on donors on such critical matters. We need to look internally and begin to rely on ourselves in the procurement of these critical commodities,” the governors said.

The county bosses have also asked the national government, through the Ministry of Health, to speed up the enrolment of county hospitals into the NHIF scheme, as part of the universal health care programme.

Mr Ongwae said a number of counties had already identified a number of hospitals within their regions that would be registered into the scheme, and asked the Ministry of Health to quicken their registration with the national scheme.

“The list of health facilities from counties will be forwarded to the NHIF to ensure that they are contracted in the exercise that is set to begin on July 1,” said Mr Ongwae.

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