One out of every 8 people living with HIV or AIDS in Battambang, Banteay Meanchey and Siem Reap provinces received expired antiretroviral drugs from government-run clinics during the first three months of this year, according to a new survey.
Conducted by a team of 14 researchers and based on responses from 257 HIV-positive participants, the survey was carried out last month after researchers heard reports from local health care NGOs in Banteay Meanchey province that expired medication was being distributed to their clients.
“It is fact that expired and nearly expired HIV medication had been distributed to PLHIV [people living with HIV] in Cambodia,” the survey, which was conducted by the Advanced Research Consultant Team and the HIV/AIDS Cooperation Committee, states.
It adds that 13.3 percent of all those questioned had received expired drugs.
Pieter Van Maaren, the vice-chair of the Cambodia Country Coordinating Committee, an umbrella organization of NGOs, said that the study had serious limitations.
“The findings concern a small sample of PLHIV and cannot be generalized to the rest of Cambodia,” said Mr. Van Maaren, who is also the World Health Organization representative in Cambodia.
Nonetheless, the survey highlighted a number of deficiencies that led to a temporary shortage in the generic HIV/AIDS medication Coviro during the first quarter of this year, according to Dr. Ly Penh Sun, the deputy director of the Ministry of Health’s National Center for HIV/AIDS, Dermatology and STD (NCHADS).
Though it is NCHADS policy not to distribute expired drugs, medical research has shown that Coviro, a combination of Lamivudine and Stavudine, is still effective treatment for six months after it expires, Dr. Penh Sun said.
In November, NCHADS became aware of a looming shortage in HIV medication and notified procurement officials with the Global Fund to fight AIDS, Malaria and Tuberculosis, which funds about 90 percent of Cambodia’s HIV/AIDS treatment programs, according to Dr. Penh Sun.
Global Fund then informed NCHADS that it would not be able to provide new medication for 12 weeks—not soon enough to avoid allowing some of the medication to expire in January and February, Dr. Penh Sun said.
“[Global Fund] have been changing their management and taking no action,” he said.
Seth Faison, spokesman for Global Fund, said in an email Tuesday that “there were significant management changes at the Global Fund in early 2012,” but that “by November that was well behind us.”
“Before seeing it [the survey], we were aware of accusations early this year about some patients getting medication that were one or two months past expiration date. We contacted the principal recipient [NCHADS] immediately to discuss what could be done. We had already last December asked the principal recipient to instruct all service delivery points not to issue drugs which were to expire in Feb/March.”
But Dr. Penh Sun said a number of doctors did not follow the directions and gave patients two-month supplies of HIV medication, some of which was set to expire within a month.
The expired stocks of medication were replaced in March by new medication from Global Fund, and patients who were given expired medication have been supplied with new drugs, according to Dr. Penh Sun.