By Special Correspondent
Every day, before thinking about many other things, Rahma Abdallah has to think about one important thing: her medication.
Living in Chanika, Dar es Salaam, Rahma is one of the people living with sickle cell disease who depend on hydroxyurea to help manage the effects of the condition.
She takes two tablets of the medication every day, with each tablet costing her Sh2,000.
“It is very challenging, especially when you do not have a job and have to depend on relatives,” she says.
For many people living with sickle cell disease, hydroxyurea is not just an ordinary medicine.
It can play an important role in their lives, particularly by helping to reduce some of the complications of the disease and recurring episodes of severe pain.
That is why news that Senegal has begun producing the medicine has been received with renewed hope among some people living with sickle cell disease and health stakeholders across Africa.
Rahma sees the development as something Africa can be proud of.
“Senegal starting to manufacture it is a good step because the price of the medicine may eventually decrease, allowing more of us to access it,” she says.
A STEP OF HOPE FOR AFRICA
Dr. Collin Kanza from the Sickle Cell Centre at Muhimbili describes Senegal's move as a major achievement in the fight against sickle cell disease in Africa.
“It is a very significant step. Senegal has fewer sickle cell patients compared to some other African countries, yet it has managed to achieve something this important.
“We have an even greater need for these medicines. Clearly, there is something we can learn from and emulate from their example,” he says.
According to the World Health Organization (WHO), Tanzania ranks fourth globally and third in Africa among countries with a high burden of sickle cell disease.
Data from Tanzania's Ministry of Health indicate that between 11,000 and 14,000 children are born with the disease in the country every year.
Treatment for this inherited condition is long-term, and the availability of essential medicines at affordable prices can make a significant difference in the lives of patients and their families.
Senegal's move also opens a broader conversation about Africa's capacity to invest in the production of essential medicines needed by its own people.
Currently, some medicines used by sickle cell patients in Tanzania continue to be supplied through manufacturing and distribution systems outside the African continent, including hydroxyurea.
If hydroxyurea production expands across Africa and the medicine becomes available to other countries, many patients hope that its cost could decrease while access improves.
... BURDEN
Tanzania's Ministry of Health has included hydroxyurea among medicines available through health insurance coverage.
For Felister John, the parent of a sickle cell warrior living in Kigoma, having health insurance for her child has made a significant difference.
She says that before she was able to obtain health insurance for her child, her family faced enormous challenges because she had to pay out of pocket for medication and medical care.
“But after getting insurance, things began to change. Now, some of my child's medical expenses can be covered through health insurance,” she says.
However, for families that cannot afford health insurance, the burden of sickle cell disease can be even heavier.
Julieth Mombuli is among those who struggle every day to ensure that her child receives the necessary medication.
“I often find myself unable to manage everything. I am both the father and the mother. His father denied that this was his child, claiming that I had the child with another man outside our marriage, which is not true.
“So I have no other choice. It hurts me, but he is my child, and I cannot leave him to suffer alone. I run small businesses, and sometimes I have to go without things myself just to make sure my child gets his medication.”
She says that when her child takes hydroxyurea, his condition improves significantly, as the medication helps reduce recurring episodes of severe pain.
For Julieth, finding money for medication is part of the daily struggle of raising a child living with sickle cell disease.
THE NEED ...
Veronica Mrema, Communications Officer for the Sickle Cell Disease Patients Community of Tanzania (SCDPCT), says the organisation has been helping some children living with the condition obtain health insurance.
“But the need remains enormous. For example, from January this year until now, we have only been able to provide health insurance to 36 children through the support of one stakeholder.
“We still have many others on our list whom we have not been able to reach because the need is so great,” she says.
Veronica says these efforts depend heavily on support from various stakeholders.
“We are able to help when we receive contributions from stakeholders that enable us to provide health insurance coverage.
"Some stakeholders also help us purchase these medicines, which we then distribute free of charge to some sickle cell warriors in need.”
She says that, in this context, Senegal's decision to begin producing hydroxyurea deserves great recognition and carries significant meaning in the fight against sickle cell disease.
“What Senegal has achieved has brought us great comfort. It is a major step, and sickle cell warriors, parents and caregivers have received the news with great joy,” she says.
WILL THE PRICE GO DOWN?
For patients who have to purchase their medication every day, the biggest question now is whether the production of hydroxyurea within Africa will eventually reduce its cost.
People living with sickle cell disease in Tanzania are hopeful that if Senegal reaches sufficient production capacity and distributes the medicine to other African countries, including Tanzania, the cost of purchasing it could decrease significantly.
For Rahma, who currently buys two tablets every day, that hope carries enormous meaning.
Producing medicines within Africa could mark the beginning of a long journey towards making essential treatment more affordable and accessible to more patients.
Senegal's move, therefore, is not simply a story about a pharmaceutical factory. For sickle cell patients like Rahma, parents like Felister and Julieth, and organisations working to support patients in Tanzania, it represents something much bigger.
“It is a sign of hope that one day, the medicines essential to their lives may become more readily available and affordable for many families,” Veronica says.
For Africa, this could be the beginning of building the capacity to produce more of the essential medicines its people need, rather than continuing to depend on hope coming from far away.
Chapisha Maoni