Editorial: Make Alternatives to ARV Drug Available
Following a recommendation from the World Health Organization, Indonesia has rightfully taken a problematic antiretroviral drug from the market. However, it now turns out patients continue to be given the drug — Stavudine or d4T — because it has been stockpiled, and possibly because it is cheaper than alternatives.
Apparently the drug in question works by interrupting DNA and RNA synthesis, both in HIV’s replication as well as healthy cells’ regeneration. But irreversible side effects — such as liver toxicity, body deformation due to swelling and displacement of bodyfat (children developing hunchbacks and men growing breasts), peripheral neuropathy (numbness) and hearing loss in patients — have been discovered.
The WHO, in reaction to the findings, recommendated a phase-out, but the Health Ministry is now admitting that new patients are still being given the potentially harmful substance. Stavudine is cheaper than its alternatives, which may also be a factor in deciding to continue prescribing the drug.
To make matters worse, the drug is also part of the so-called “triple cocktail” branded as Triomune Baby or Triomune Jr. and which is used for infants and children.
In the fight against HIV/AIDS, this group of patients is particularly vulnerable.
Experts say the drug isn’t necessarily all bad, citing the successful treatment of children, but unlike adults, children — let alone infants — can hardly be expected to make an informed decision about what risks they are willing to take.
Alternative drugs that meet all key international standards need to be made available as soon as possible for people living with HIV/AIDS in Indonesia, with the group of children and infants being prioritized.
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