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Shortage of STI drugs, general medications affecting service delivery

Chikumbe: suppliers took long time to deliver stocks

By Lovemore Khomo

Ministry of Health has admitted that shortage of Sexual Transmitted Infections-STI drugs and general medication has affected the work of health facilities in the country.

Public Relations Officer-PRO for Ministry of Health Adrian Chikumbe acknowledged the shortage in an interview following sentiments by Journalists Association against AIDS- JournAids made on Tuesday, 19th September 2023 during media dialogue on STI landscape analysis in Lilongwe.

JournAids disclosed that there is shortage of STI drugs and unavailability of updated data on information that could be for public consumption.

“We are aware of the shortage of medication in some of our facilities, and not only on STIs. This is due to long and time overdue that suppliers take to fill up the stocks.” reacted Chikumbe.

He however told this publication that at most of STI patients fail to come out and pronounce their challenges and a number of them prefer to attend to private health facilities.

Regarding data availability, the Ministry of Health PRO disclosed that there is an intervention to digitize the data to enable improved statistics availability through National Health Reporting Systems.

“This will improve both safeguarding and timely transmission of data on general health issues, not only on STIs.” He said

The 2015/16 MPHIA shows significant under diagnosis of STIs in Malawi among HIV-positive males aged 15-64 years, 16% reported to have had a genital ulcer, 5% have had abnormal discharge from the penis, but only 6% had been diagnosed with an STI in the 12 months preceding the survey.

Among HIV-positive females aged 15-64 years, 12% reported to have had a genital ulcer, 11% to have had abnormal discharge from the vagina, but only 7% had been diagnosed with an STI in the 12 months preceding the survey.

In 2018 the recorded cases of STIs were 395,583, from 267,862 in 2016, an increase of 48%. The rate of HIV status ascertainment among STI clients increased from 69% in 2016 to approximately 87% in 2018, representing an 18% increase and nearly meeting the 90% target.

HIV yield among STI clients halved between in 2016 with 6% and 3% in 2018. Coverage of syphilis screening among antenatal women increased from 75% in 2016 to 84% in 2017, followed by a minimal decrease in 2018 by 2%.

Meanwhile, Programmes Officer for JournAids, Dingaan Mithi expressed concern over neglected fight against STIs due to the persistent shortage of drugs.

Mithi: We need reforms and bring in STI policy

Mithi said the purpose of STI landscape analysis is understanding needs to incorporate advocacy on STI vaccines and diagnostics into current and future prevention advocacy programs and inform and help to shape future advocacy efforts and collaborations.

In addition, the landscape analysis focuses on understanding the needs of sexually transmitted infections like chlamydia, gonorrhea, hepatitis B, herpes simplex virus (HSV), human papillomavirus (HPV), syphilis, and trichomoniasis.

“Shortage of drugs for STIs it’s a heavy burden that needs much attention for all stakeholders including policy makers and holders in order to deal with the infections accordingly.” explained Mithi.

He added, “We need some reforms and reviews on overarching STI regulations, so that we get up-to-date data on dealing with STIs.”

Mithi however explained that Ministry of Health’s guiding regulations on STIs is an overdue because it was adopted six years ago, hence need to restructure it and come up with a tangible policy document.

Currently, STI treatment coverage in Malawi is at 41% with low HIV testing rates of 49% in STI clinics and a significant number of patients access private health facilities. And care seeking behavior for STIs patients was recorded at 42.68%.

According to World Health Organisation-WHO on HIV, viral hepatitis and sexually transmitted infections collectively cause 2.3 million deaths and 1.2 million cases of cancer each year, and continue to impose a major public health burden worldwide.

More than 1 million people are newly infected with sexually transmitted infections each day, and 4.5 million with HIV, hepatitis B and hepatitis C, each year.

“Although progress has been made in all three disease areas, the global response is off-track and most global health targets for 2020 were missed.” reported WHO.

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