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Shortage of drug-resistant tuberculosis medications ends

The Ministry of Public Health on Saturday said it has brought to end a shortage of drug-resistant tuberculosis (TB) medications

Director of Pharmacy Oneil Atkins on  said there is no need to panic. “All TB patients would be adequately treated,” Mr. Atkins was quoted as saying in a Public Health Ministry statement.

There was a recent shortage of Ethionamide, part of the cocktail of drugs used to treat those special TB patients. Emergency supplies of this key drug arrived in Guyana this week and were distributed to patients, Dr Jeetendra Mohanlall, Manager of the National TB Programme, confirmed.

Explaining the recent shortage, Dr Mohanlall said the National TB Programme is pushing for quality second line medication for Guyana’s drug resistant TB drug resistant patients and due to some global challenges the delivery was delayed. The programme had to resort to emergency supplies which arrived beyond the expected time of delivery.

The four second line drugs used to treat these drug-resistant TB (DR-TB) patients are sourced from South Korea, Japan India and Cyprus, through the Global Drug Facility ( GDF) Dr Mohanlall said.

He also reiterated that the medicines will be enough to treat  “all drug-resistant TB patients for another year”.

This is the first time in four years that we “had a brief interruption” of one of the medications for patients, the National TB Programme Manager said.

According to Mohanlall, the National TB Programme has made great strides in the programmatic management  of the multi drug resistant TB (MDR-TB). He said there is a dedicated Focal Point Person, Dr Eshwar Ghanshiam, and Guyana has implemented nine of the 10 recommendations by PAHO/WHO’s Green Light Committee given in 2016.

He pointed to increased screening in Guyana to identify all possible drug resistant TB patients noting that while there were 150 screenings in 2014 this figure jumped to 1,540 in 2017,

.Mohanlall noted that of the 2015 cohort of drug-resistant TB patients, 40 percent successfully completed the two-year  treatment. This figure climbed to 60 percent in 2016.

The 2017 cohort of DR-TB patients are continuing treatment.

Other strides in the sector include improving the management of patients. With this accomplishment,  “there needs to be more dedicated resources in the Direct Treatment Observe Short-course (DOTS) programme to do daily visits to patients,” Mohanlall pointed out.

“Even doctors attached to the TB Programme visit patients in their homes with the mobile teams that are established,” he said.

He said TB patients generally have socio-economic challenges and they need psycho-social support in their management.

To strengthen his position, the National TB Programme Manager is strongly advocating boosting the social protection of these patients which he said, “is in line with the END TB Strategy”.

Although Guyana has a 90 percent coverage of DOTS there are still many challenges presented by defaulting patients such as drug addicts, the homeless and the internal migrant population such as miners and loggers.

In 2017 it was observed that a fifth (20 per cent) of the TB patients also habitually abuse drugs and alcohol.

“These can be difficult to manage under the DOTS strategy and there are some who need  to be in specialised care facilities such as TB Step Down Care Unit set to be commissioned in the first quarter of 2019,” Mohanlall said.