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Jakarta Post

Indonesia turns to Global Fund to ensure ARV stock

  • Gemma Holliani Cahya

    The Jakarta Post

Jakarta   /   Wed, January 23, 2019   /   04:32 pm
Indonesia turns to Global Fund to ensure ARV stock Illustration of medicine (Shutterstock/File)

Amid rising concerns about the availability of antiretroviral (ARV) therapy drugs following a failed drug tender, the government has given assurances that stocks are enough until the end of this year.

The Health Ministry’s pharmaceutical and medical devices director general, Engko Sosialine Magdalene, said that although the government had failed to procure the drug, people should not worry because there was enough stock of fixed-dose combination ARV medication that contained tenofovir, lamivudine and efavirenz (FDC TLE) in one tablet.

In December, Engko said the ministry had received a grant of 220,000 bottles of FDE TLE from the Global Fund, an international funding organization that fights AIDS, tuberculosis and malaria. One bottle contains 30 tablets, which are enough for one month.

“Don't worry and don't panic. Stocks are enough for the next five to six months [...] 220,000 bottles can last until May for users of FDE TLE,” Engko told reporters.

The government failed to meet an agreement with state-owned pharmaceutical companies PT Kimia Farma and PT Indofarma, which had been appointed to import the drug, sparking anxiety among users of the drug about the possibility of a looming drug crisis. 

The drug suppresses the virus and prevents fatal infection.

Read also: People with HIV/AIDS face drugs scarcity

Engko gave assurances that there would be no drug crisis. She said the ministry was preparing to procure more ARV drugs for distribution after May.

“The budget allocation for ARV drugs is ready for 2019. We will try our best, so before May, at least in April, we will have the drugs,”

“If there is another delay in procurement, we have prepared an alternative measure in which we will receive a grant of 564,000 bottles [of FDE TLE] from the Global Fund,” she said.

Engko also denied there was a scarcity of the drug in several areas.

“There is nothing like that. We have a system in place to monitor the availability of drugs in every province. Monitoring in January shows there is no absence of the drug in any region,” she said.

FDE TLE is the most commonly used drug among people with HIV/AIDS in Indonesia. According to the Indonesia AIDS Coalition (IAC), about 48,000 people, or 42 percent of people with HIV/AIDS, rely on FDE TLE.

IAC executive director Aditya Wardhana said the Health Ministry had failed to address the main issue behind the unstable drug supply and the failed tender for FDE TLE, which she claimed was caused by Kimia Farma and Indofarma overpricing the drugs.

Kimia Farma sources the ARV drug from Indian pharmaceutical company Hetero Drugs while Indofarma purchases from Mylan, which is based in the United States.  

The IAC has criticized the way the government procures ARV drugs, saying it makes them the most expensive the world. The IAC claims the drugs can be purchased for almost 25 percent less outside Indonesia.

“Overpricing the medicine is likely to make the next tender fail, unless the government agrees with the high prices set by the companies,” he said on Tuesday.

The budget allocated for ARV treatment has increased every year. In 2017, the Health Ministry allocated Rp 1.19 billion (US$84,673) to fund ARV treatment for 112,054 people with HIV. The allocation increased from Rp 243 million in 2015 and is predicted to reach Rp 1.8 trillion by 2020.

Of the ministry's fund allocations for drugs, ARV medication has been allocated the second-highest amount after vaccines.