Infrastructure to Administer Antiretrovirals Lacking in Ivory Coast
Although the Ivory Coast is considered "relatively well-off compared to its impoverished West African neighbors," the cost of HIV medications remains higher than most citizens' total annual incomes, the AP/Contra Costa Times reports. Even with manufacturers' price breaks for sub-Saharan Africa, HIV drug combinations cost between $85 and $110 per month, out of range of "some of the poorest patients," who pay approximately $14 per month for the medicines through a government-subsidized program. However, only about 1,000 of the one million HIV-positive citizens receive treatment through the program. In addition, some patients are not adhering to antiretroviral drug regimens, creating the potential for the development of drug-resistant HIV strains. After following 11 HIV patients in 1998 and 1999, Auguste Blibolo, a medical researcher at Abidjan's Institute for Development Research, found that none of the patients stuck to their regimens without missing "at least a few days of treatment," and nine patients "repeatedly" went without pills for more than a week at a time. Although patients in Western countries also occasionally miss doses, the situation in the Ivory Coast is "aggravated" by the lack of information about how HIV treatments work and a "severe shortage" of medical personnel and centers to administer the drugs. Although Abidjan has 18 medical centers, only four centers serve the remainder of the country, "forcing patients to travel far over bad roads." According to Nicole Boni, head of the UNAIDS initiative in the Ivory Coast, interruptions in drug supply, due to "political turbulence" and "government delays in releasing money" for new orders, has also contributed to patients' noncompliance to the drugs (Zavis, AP/Contra Costa Times, 6/19).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.