MASERU — Lesotho has run out of special chemicals to test blood for diagnostic purposes, the Lesotho Times can reveal.
For the past two months the country’s 18 laboratories have been without the crucial chemicals which are scientifically known as reagents.
Health officials this week told the Lesotho Times that the country has been without reagents used to measure the CD4 count for people living with HIV and Aids because of financial problems.
Other reagents in short supply include those used to test the functionality of the liver and kidneys.
A company which has been supplying the reagents to Lesotho stopped deliveries because it had not been paid.
This has had severe impact on people who are currently on Aids medication and delayed those that have to be enrolled for the same treatment.
Before a person is put on HIV treatment their CD4 count is supposed to be measured by testing their blood.
The result of that test will determine if they should be put on treatment or not.
But because of the lack of the reagents these tests have been put on hold.
That means some people could have failed to be enrolled on the treatment programme even though they urgently need the medication.
They will have to wait until the government buys the reagents.
The problem is that as they wait longer for the treatment, their condition might worsen.
Yet the impact of the lack of reagents goes far beyond that.
Once a person is on HIV medication their CD4 count is supposed to be measured frequently to monitor progress.
A CD4 count will determine if the medication is working or if it has to be changed.
It is through a CD4 count that doctors can determine if a person’s immune system is being boosted by the medication.
Further tests that also require the same scarce reagents are used to analyse how organs like the liver and kidneys are reacting to the medication.
The medications produce toxins that are supposed to be cleaned out of the body by the liver and the kidneys.
But in some people the liver and the kidneys might fail to clean the toxins and they themselves are damaged.
The results of that failure are serious complications that might be life threatening if not detected and treated early.
To check if the liver and kidneys are functioning well during the HIV treatment laboratory scientists use tests which require the same reagents which are in short supply.
That means unless the reagents are found soon many people in Lesotho will have to wait longer before these tests are done to determine the side effects of the medication.
In the meantime, some people who are on these medications might have to continue taking them even though their bodies might not be responding well to them.
Lesotho has about 270 000 people living with HIV and 25 percent of those are on treatment which requires close monitoring through tests which depend on the reagents.
For a country with an HIV prevalence rate of about 23 percent the lack of the reagents is a major setback in the fight against the disease which is currently claiming an estimated 20 000 lives every year.
So far the disease has spewed around 200 000 orphans and there is a danger that this number could rise if some people are not tested and put on medication early.
The Ministry of Health’s acting laboratory services director, Motsamai Mothabeng, confirmed that there has been a shortage of reagents in most of the government’s 18 laboratories for the past two months.
Mothabeng said most hospital laboratories ran out of the reagents because the government had failed to pay for more supplies.
He added that the delay by Global Fund, the main donor, to disburse the pledged funds has worsened the situation.
“The problem was caused by the shortage of money to buy the reagents.
“The problem started at the beginning of this year. But the ministry had to collect all the savings from other departments to continue to buy the reagents,” Mothabeng said on Tuesday.
“That money also ran out eventually and it was an even bigger problem when the donors delayed giving the money.”
He said the impact was felt at the beginning of June when Scientificgroup, a South African company, stopped supplying the reagents because of the outstanding monies that the ministry had to pay.
“Soon most laboratories ran out of the reagents. It is regrettable to say people were not given the needed services since then.
“Only critical cases were sent to South African laboratories.”
Mothabeng said the reagents for liver and kidney tests have been supplied and the “situation is now back to normal”.
On the reagents for CD4 count tests Mothabeng said he was hopeful the problem “will be resolved by next week as the outstanding balances have been paid and orders have been made”.
“The first consignment should have come in yesterday (Tuesday).
“The National Drug Service Organisation (NDSO) will receive the order batch. We are hopeful that by next week the laboratories will be fully functional. This has been most unfortunate to happen,” he said.
He said that government has been struggling alone without additional donor funds.
“We cannot afford all we need with our budget alone. When the donors delay the disbursement of their pledged funds we have problems.”
In Lesotho HIV patients should be put on ART when their CD4 is under 350.
However, the World Health Organisation (WHO) recommends that a person who has a CD4 count of 350 and above can be initiated on ART if their clinical stage is 3 to 4, the most advanced HIV stages that lead to Aids.
This information can only be known through the help of reagents in the laboratories.
A nurse told this paper they have not been able to access the blood test results because of the shortage of reagents.
“We have had to send people home because we cannot have the information on their blood samples. It is very important to get the necessary information before you put someone on ART,” said the male nurse who refused to be named for professional reasons.