Benício Toureiro, 23 years old, was hospitalized at the end of September at the Nereu Ramos Hospital, in Florianópolis, because of the pain he felt from the sores caused by monkeypox (monkeypox or mpox).
Two months later, the boy became the 13th victim of the disease in Brazil. The country is the second with the highest number of deaths and cases in the world and whose response to the outbreak is seen as inefficient by specialists.
Hospitalized with the disease, Benicio spent 50 days waiting for tecovirimat, the only medicine that has been shown to be effective against the virus in the world.
The product is also the only one approved, on an emergency basis, by the National Health Surveillance Agency (Anvisa).
Brazil received the first batch of the drug in August, but has not been able to guarantee a frequency in sending new stocks to meet demand.
In Cuiabá, a 27-year-old patient was admitted to the Hospital Universitário Júlio Muller on September 21. His condition evolved with renal failure, shortness of breath, tachycardia, among other symptoms. On October 4, the medical team requested tecovirimat from the Ministry of Health.
But the medicine did not arrive and the boy died on November 8, according to the Health Department of Mato Grosso. “The patient did not use the medication because it was not available at the Ministry of Health. The request was on the federal government’s priority list,” said the folder.
Among the three Mpox victims registered in Minas, only two had access to tecovirimat, despite all having symptoms eligible for treatment, according to the protocol developed by the ministry itself.
In Rio, the drug was offered to two of the five patients who died from complications of the disease.
In São Paulo, which concentrates most of the cases in Brazil, with more than 4,200 confirmed infections, only one of the three patients who died was treated with tecovirimat.
The State Department of Health did not say, however, whether the drug was requested for the other two.
Risk
The medicine is essential to stop the spread of monkeypox in humans, especially in those who have some type of immunosuppression, such as HIV, transplantation or recent chemotherapy.
In August, the ministry said it had obtained the first batches of the medicine, after donating it from the manufacturer, SIGA, and said it was negotiating with the Pan American Health Organization (PAHO), the branch of the World Health Organization (WHO) on the continent. , to receive new shipments.
“We tried with public bodies, with the mayor, with people from the Public Ministry, with whom we could. But everyone said that, unfortunately, it was like that, it would have to wait”, says Brunna Toureiro, 31 years old, Benício’s sister.
She and her father, freight driver Amabilio Ferreira, 57, contacted acquaintances in the United States, where the drug has been available since August.
Criteria
In August, when the first batch was delivered, the federal government said that tecovirimat distribution criteria would be up to the ministry’s Emergency Operation Center for monkeypox.
But these parameters are still not clear even to the medical teams that order the treatment. In Espírito Santo, a patient has been waiting for treatment since October 17 and, according to the local Health Department, “there is still no forecast for sending”.
Rio Grande do Norte already had access to the medicine for two patients. One of them was requested on October 15th and waited 35 days. In the second case, it was ordered on December 3 and arrived only three days later.
Benício’s tecovirimat only arrived on November 19, after Hospital Nereu Ramos negotiated directly with the producing laboratory.
“If we had waited for the Ministry of Health, maybe we wouldn’t even have gotten this treatment,” said Eduardo Macário, superintendent of Health Surveillance in Santa Catarina.
The request was made to the federal government on October 7. After running out of response or delivery forecast, the hospital was able to contact the drug manufacturer, who donated five treatments for compassionate use.
As the ministry had to intervene in the import process and Santa Catarina only had Benicio in the queue, according to Macário, the other four were redistributed to other states.
“It was difficult, because the ministry does not have a strategic stock. The treatments that arrived were completely consumed”, he points out.
“What worries us and all states is the absence of this strategic stock. If it existed, it might not have taken 30 days for the medicine to arrive.”
According to Macário, the recommendation for using tecovirimat is “as soon as possible”. Most recent studies and research indicate that signs of improvement begin to intensify after 14 days of treatment.
Benicio died on the tenth day of medication. He couldn’t resist a widespread infection. During the 50 days that Benício waited for the tecovirimat to arrive, monkeypox spread wildly throughout his body.
Note
In a statement, the ministry said it had received 28 treatments against Mpox, through a donation from the WHO and the manufacturing laboratory. The last batch, with 16 treatments, was received in November and used in ten eligible patients.
The criteria for compassionate use of the drug are: positive laboratory result with visible injury or hospitalized patient with the severe form. For this second group, the presence of encephalitis, pneumonitis, skin lesions with more than 250 eruptions on the body, among other signs, is taken into account.
“The Ministry of Health is in contact with PAHO/WHO to acquire more treatments, in addition to contacting other countries to verify the possibility of donations”, he added.
The information is from the newspaper O Estado de S. Paulo.
Source: CNN Brasil
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