BRAZIL: Medical charity Doctors Without Borders says treatment for millions of Chagas patients risks being halted as supplies of a Brazilian drug are running out due to lack of government planning and coordination

Record ID: 737741

  • Title: BRAZIL: Medical charity Doctors Without Borders says treatment for millions of Chagas patients risks being halted as supplies of a Brazilian drug are running out due to lack of government planning and coordination
  • Date: 15th October 2011
  • Summary: RIO DE JANEIRO, BRAZIL (OCTOBER 6, 2011) (REUTERS) (SOUNDBITE) (Portuguese) MEDICAL COORDINATOR FOR DOCTORS WITHOUT BORDERS, CAROLINA BATISTA, SAYING: "Unfortunately, we've already had to slow diagnosis in the national programmes of Bolivia and Paraguay's Health Ministries, and also in the Doctors Without Borders' programme. In Paraguay, we even had to suspend diagnosis because we don't have enough drugs to guarantee."
  • Embargoed: 30th October 2011 12:00
  • Keywords:
  • Location: Brazil, Brazil
  • Country: Brazil
  • Topics: Health
  • Reuters ID: LVA4U7NA44XVOJFWNYV4QAZ6JCST
  • Story Text: Millions of people with Chagas disease risk going untreated in the near future as drug supplies get scarce and demands increase, the international group Doctors Without Borders (MSF) reported last week.
    The Paris-based medical humanitarian organization said stocks of benznidazole are running out and Brazilian authorities in charge of manufacturing the medicine have lingered to deliver new lots.
    The Chagas disease is caused by a parasite transmitted by the infected faeces of blood-sucking bugs. It can also be contracted through transfusion of infected blood, by organ transplantation or congenitally from an infected mother to her foetus.
    In most cases, symptoms are absent or mild, but can include fever, headache, enlarged lymph glands, muscle pain, difficulty in breathing, swelling and abdominal or chest pain. In later years, the infection can lead to sudden death or heart failure caused by progressive destruction of the heart muscle.
    MSF reported that the Brazilian government lab LAFEPE said in August that it wouldn't be able to hand 820,000 pills to the organization's health programmes in Bolivia and Paraguay.
    Production in LAFEPE has been halted for more than 20 days due to lack of pharmaceutical ingredients, raising concerns of a serious drug shortage in the coming months.
    The laboratory is currently the world's only licensed producer of benznidazole, a drug initially developed by Swiss company Roche and which is widely used to treat children and adults infected with Chagas.
    Medical coordinator at Brazil's MSF unit, Carolina Batista, said authorities have been unsuccessful in managing the drug's production.
    "Production has already been disrupted. At this moment, the drug is not being produced because there has been bad coordination. Raw materials are not ready yet and even though the laboratory has the capacity to produce, it doesn't have the materials needed to finish producing the drug. So, there is a gap. I think the Ministry of Health has failed to assume the leadership in order to fulfil this commitment and guarantee the drug not only to Brazil, but to the world," she said.
    In 2003, LAFEPE won licenses to manufacture benznidazole and Roche transferred its remaining pharmaceutical ingredients to the Brazilian laboratory as it stopped producing the drug.
    The lab's activities are currently halted because it is waiting for a new batch of active ingredients, which are now going to be made by Nortec Quimica, a Brazilian private company.
    LAFEPE has dismissed shortage concerns saying it has 273,000 benznidazole pills in stock and that Nortec is due to deliver 40 kilograms of ingredients in November, which would let them produce around 400,000 pills by the end of the year. Moreover, 280 kilos are expected until the end of 2011 and another 600 kilos in the beginning of 2012.
    MSF says that even though the medicine might be ready in time, there would still be many legal issues to solve, regarding licenses and tests, that could take up to 12 months.
    This long process could leave thousands of people without medicine in Bolivia, for example, where the MSF says it only has enough pills to last until the next year's first months.
    Secretary of Science, Technology and Strategic Products in Brazil's Health Ministry, Carlos Gadelha, said demands indeed were higher than expected and authorities were working to meet them.
    "We are hearing about this situation now and we are working to map this demand in order to be prepared and to set strategic stocks, since nobody else produces this drug. We are aware of the responsibility that the Brazilian government has assumed, that we have assumed, in doing a global health action," he said.
    Authorities have pledged to speed up legal processes and Health Ministry's officials will gather with LAFEFE and Nortec's directors, and members from the National Health Surveillance Agency (ANVISA) next week.
    Batista said that in some countries authorities have already established contingency plans to avoid a drug shortage.
    "Unfortunately, we've already had to slow diagnosis in the national programmes of Bolivia and Paraguay's Health Ministries, and also in the Doctors Without Borders' programme. In Paraguay, we even had to suspend diagnosis because we don't have enough drugs to guarantee," she said.
    In the past years, public health programmes to treat the tropical disease expanded and demands of the benznidazole have risen sharply.
    An estimated 10 million people are infected worldwide, mostly in Latin America where Chagas disease is endemic. Every year, the disease kills around 12,500 people.
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