key: cord-0716520-b8bikj8d
authors: Ullah, Irfan; Hassan, Wardah; Tahir, Muhammad Junaid; Ahmed, Ali
title: Antiretrovirals shortage in Kenya amid COVID‐19
date: 2021-06-24
journal: J Med Virol
DOI: 10.1002/jmv.27134
sha: 539fc1e83bf50cd47be989239e21b155ac8e103e
doc_id: 716520
cord_uid: b8bikj8d

nan

To the Editor, The human immunodeficiency virus (HIV) continues to be one of the major public health challenges around the world. While proper treatment is crucial, statistics show that only 67% of patients with HIV are adherent to antiretroviral therapy (ART). 1 Thus, highlighting nonadherence or shortage of antiretrovirals. Specifically, seven medications are at a higher risk of shortage: tenofovir, efavirenz, zidovudine, lopinavir, ritonavir, abacavir, and darunavir. 2 In sub-Saharan Africa, it is estimated that 25.7 million people are living with HIV but only 64% of this population are taking ART; its shortage may even lead to 500 000 additional AIDS-related deaths. 3 This raised the concern about access to ART treatment during the COVID-19 pandemic. Moreover, as per the United Nations agency, millions of people may be at increased risk of HIV transmission. Therefore, regarding essential health services during the pandemic, World Health Organization has successfully developed interim guidance that showcases emergency preparedness and response plan. 4 Like other countries in sub-Saharan Africa, Kenya is also suffering from an ART shortage. As of 2019, 1.5 million Kenyans are living with HIV. Nearly 42 000 new HIV infections and 21 000 AIDS-related deaths are reported. 5 However, ever since the pandemic started, treatment for children and lab testing kits have been significantly running low in stock. 6 Consequently, acquiring HIV medications became a problem due to decreased ART supply; thereby, leading to the development of resistance to certain medications and an overall increase in HIV-related deaths. According to African news, the main reason for the current shortage of HIV drugs is the coronavirus pandemic, along with the hoarding in customs warehouses due to the surge in government taxation. 7 As a result, according to the chief executive officer at Blast (an organization for young people living with HIV patients), patients are more likely to skip doses of their treatment as amid the COVID-19 pandemic it is unfeasible for them to travel to the clinic every week, taking leaves from work, paying for transport, and hence exposing themselves to the virus. This, however, has severe repercussions, as the Civil Society Organizations warned that missed doses may further increase the chances of mother-to-child and sexual transmission of HIV. In addition to that, the disrupted treatment also leads to certain opportunistic infections, such as tuberculosis, pneumonia, and diarrhea; thereby, adding to the overall suffering of already debilitated HIV patients. 8 Further ahead, as stated by the United Nations Children's Emergency Fund, the leading cause of death in children in Kenya was HIV in 2008, where only around 27%-30% of children were receiving HIV treatment. 9 In an already deprived zone of HIV medications, its current shortage is adding to the vulnerability of the HIV pediatric population. 

The authors declare that there are no conflict of interests. 

Updated: COVID-19 could cause a shortage of HIV meds this summer. POZ

The cost of inaction: COVID-19-related service disruptions could cause hundreds of thousands of extra deaths from HIV. UNAIDS

World Health Organization. Maintaining essential health services: operational guidance for the COVID-19 context interim guidance

People in Kenya say lives at risk as HIV drugs run short

A cry for help!: HIV/AIDS patients in Kenya decry ARV drugs shortage

Supplies run low as Kenya and US standoff over HIV drugs by Sara Jerving. devex

UNICEF. HIV attributable deaths in children aged under 5 in ESAR

Increasing antiretroviral drug access for children with HIV infection

Differentiated HIV care in sub-Saharan Africa: a scoping review to inform antiretroviral therapy provision for stable HIV-infected individuals in Kenya