Poku Rebecca A, Owusu Adobea Yaa, Mullen Patricia Dolan, Markham Christine, McCurdy Sheryl A
a The University of Texas Health Science Center at Houston School of Public Health , Houston , Texas , USA.
b Institute of Statistical, Social, and Economic Research, University of Ghana , Legon , Ghana.
Afr J AIDS Res. 2017 Sep;16(3):231-239. doi: 10.2989/16085906.2017.1364275.
Drug stock-outs are an unfortunate yet common reality for patients living in low and middle income countries, particularly in sub-Saharan Africa where trouble with consistent stock of antiretroviral medications (ARVs) continues. Our study takes a snapshot of this problem in Ghana. Although the country launched its antiretroviral therapy (ART) programme in 2003, progress toward realising the full benefit of ART for treated individuals has been limited, in part, because of stock-outs. In Ghana's Greater Accra region, we conducted semi-structured interviews with 40 women living with HIV (WLHIV) and 15 individuals with a history of HIV-related work in government or non-governmental organisations, or healthcare facilities. We used repeated review with coding and mapping techniques to analyse the transcripts and identify common themes. Stock-outs of ARVs result in inconsistent administration of therapy, increased indirect medical costs for WLHIV, and negative labelling of patients. Inefficiencies in drug supply, poor coordination with port authorities, inadequate government funding and dependence on international aid contribute to the stock-outs experienced in Ghana. Although using ARVs produced in-country could reduce supply problems, the domestically-manufactured product currently does not meet World Health Organization (WHO) standards. We recommend focused efforts to produce WHO standard ARVs in Ghana, and a review of current supply chain management to identify and mend pitfalls in the system.
药品短缺对于生活在低收入和中等收入国家的患者来说是一个不幸但却常见的现实，尤其是在撒哈拉以南非洲地区，抗逆转录病毒药物（ARV）持续供应不足的问题仍然存在。我们的研究对加纳的这一问题进行了简要描述。尽管该国在2003年启动了抗逆转录病毒疗法（ART）项目，但在使接受治疗的个体充分受益于ART方面取得的进展有限，部分原因是药品短缺。在加纳大阿克拉地区，我们对40名感染艾滋病毒的女性（WLHIV）以及15名在政府、非政府组织或医疗机构有艾滋病毒相关工作经历的个人进行了半结构化访谈。我们使用反复审查并结合编码和映射技术来分析访谈记录并确定共同主题。抗逆转录病毒药物短缺导致治疗管理不一致，增加了感染艾滋病毒女性的间接医疗成本，并给患者带来负面标签。药品供应效率低下、与港口当局协调不佳、政府资金不足以及对国际援助的依赖导致了加纳出现药品短缺情况。尽管使用国内生产的抗逆转录病毒药物可以减少供应问题，但目前国内生产的产品不符合世界卫生组织（WHO）标准。我们建议在加纳集中力量生产符合WHO标准的抗逆转录病毒药物，并对当前的供应链管理进行审查，以识别并修复系统中的缺陷。
