Demand for ARVs gives rise to grey market

The illegal sale of anti-AIDS drugs in Malawi was endangering the lives of many HIV-positive citizens who were desperate to access affordable treatment, a health official told PlusNews. "Our major concern is that people are selling immune boosters and multivitamins, and cheating [HIV] positive people by saying they are antiretrovirals (ARVs)," Dr Bizwick Mwale, director of Malawi's national AIDS commission, told PlusNews. The provision of ARVs in the country is still done on a "small scale" and only about 3,000 people are accessing the drugs in the public and private sectors. An estimated 780,000 people in Malawi are living with the virus. There were "only two institutions" dispensing ARVs in the country, and the prices charged by pharmacies put the drugs out of reach for most Malawians living with the disease. This has led to a proliferation of fake drugs being sold in the country's parallel market. "People are desperate. It is very difficult to get ARVs in Malawi, so if someone sells them drugs at half the price... what can they do?" he asked. The National AIDS Commission had witnessed reported cases of patients on ARV therapy who had interrupted their treatment to buy "stimulator machines" which claimed to prolong lives, Mwale noted. Since attempts by authorities to crack down on the illegal sales of such drugs have proven unsuccessful, the government has now switched tactics and scaled up public awareness of treatment. "We are urging people living with HIV/AIDS to seek treatment at registered health facilities - particularly ARV treatment. They cannot allow themselves to be robbed of their health and their money," he said. Mwale called for the country's medicines regulatory body to "work hard to make sure registered clinics provided government-endorsed drugs". "Even patients are obliged to know what treatment is safe and effective. If they are not sure, they should rather ask health care workers," he said. Monitoring the drugs sold in the private sector, however, was still a major challenge. "We are not in control of drugs going into the private domain," Mwale admitted. "It's unfortunate if people are going to ride on sick people and not give [them] appropriate care," he added.