Country Strives to Meet HIV Targets

from All Africa

The Times of Zambia (Ndola)

By Bob Sianjalika
Ndola

THE presence of HIV and AIDS has posed big challenges to all countries including Zambia, and the call for universal support is just inevitable.

As the year 2015 draws near, every country is striving to meet most, if not all, of the eight Millennium Development Goals (MDGs) in line with the United Nations set targets.

For Zambia, it has particularly made tremendous strides in getting to the universal access to anti-retroviral therapy (ART) through various initiatives both from the Government and partner stakeholders.

Some ART became available in the private sector in Zambia as early as 1996, which was soon after they became accessible in the West.

The number of patients on ART in Zambia by 2003 was estimated at just over 1,000 but lately over 100,000 people have had access.

The Government took a policy decision to introduce Anti-retrovirals (ARVs) in public hospitals with over K12 billion being made available to purchase drugs for up to the initial 10,000 People Living with HIV/AIDS (PLWHA).

The ART project started with just an initial small number of patients but the response was overwhelming, prompting the Government to broaden it and encompass it as one of the major programmes under the Ministry of Health.

This programme involved the phased implementation of the programme starting with Lusaka and Ndola, before spreading to other provincial capitals.

National treatment guidelines and training manuals have been developed including human resource capacity-building where doctors, nurses, laboratory technicians, pharmacists, counselors and nutritionists have been trained.

Currently, the human resource development has been continued by the Government in order to ensure that the HIV/AIDS problem is fully addressed.

Zambia has actually taken several deliberate measures to influence policies at all Governance levels so that HIV/AIDS is squarely fought.

Several partners have come up to the aid of Zambia in mainstreaming the HIV/AIDS programme to ensure the attainment of the Universal Targets on ART and the general elimination of the scourge.

Recent studies curried out in Zambia indicate that of the estimated 16 per cent HIV/AIDS infected people, over 70 per cent of them need to be put on ARVs.

Although HIV has spread throughout Zambia and to all parts of society, some groups are especially vulnerable - most notably young women and girls.

HIV/AIDS has worst hit those in their most productive years with families disintegrated while thousands of children have been left destitute.

The impact of AIDS has gone far beyond the household and community level as all areas of the public sector and the economy have been weakened, and national development has been greatly affected.

Responses to HIV and AIDS in Zambia have for many years aimed at preventing transmission; to care for those who are infected and affected and to reduce the personal, social and economic impact.

Since late 2002, the Goverenment has been engaged in an ambitious ARV treatment programme. Today, HIV prevalence remains at a very high level.

Reducing the number of new infections while scaling up the provision of treatment to so many thousands in need poses a massive challenge to the Government and the international community.

Yet it is a challenge that must be met if Zambia is ever to have a better future. With all the efforts that the Government has made in ensuring the eradication of HIV/AIDS, more and more people are now on ART.

According to the National AIDS Council (NAC), over 129,000 are currently on ART in Zambia as at March 2007. This statistics indicate a progressive rate especially that such initiaves were only developed under six years ago.

And besides the increase in the number of people accessing ART, Zambia has also seen enhanced activities in health centres with the establishment of over 883 Voluntary Counselling and Testing (VCT) centres by 2006.

Professional bodies in the health sector such as the Zambia Medical Association (ZMA) have equally raised concern at the pace Zambia was moving in trying to meet targets such as the universal access to ART.

The ZMA says of the estimated 900,000 people living with HIV/AIDS in Zambia, about 150,000 to 250,000 require ART. Zambia has made strides in the number of people and sites requiring ART.

From just 10,000 people on ARVs in 2004, to over 27,000 in mid 2005 and about 120,000 by mid 2007, this is a commendable effort though it still remains short of the numbers of people requiring ARVs.

ZMA president Swebby Macha says great effort should also be made to increase the percentage of people who know their HIV status.

Currently, only 14 per cent of the population has tested for HIV, a situation which is unfortunate especially that the conditions for one to be on ART are that he or she should know the HIV/AIDS status.

The ZMA also noted that even some of the medical staff were shunning VCT and needed to be constantly reminded of its importance especially that they should be role models.

Dr Macha said there are still several challenges that Zambia was facing in the health care delivery system although hope should never be lost.

Just in December 2007, several Mazabuka residents in the Southern Province of Zambia lodges complained to the Ministry of Health over the shortage of ARVs in most hospitals.

Just these developments suggest how much efforts still remain for Zambia to attain Universal Access on ARVs.

Zambia's Health Minister Brian Chituwo has, however, reiterated that the Government is on track on the attainment of the Universal access to ARV but admits that more efforts need to be stepped up.

Mr Munene Hang'andu, 46, tested positive to HIV/AIDS in 2001 and says, initially, the access to ARVs was not easy because of the price attached to it.

He said despite testing positive, he stayed for over three years without taking ARVs until the Government introduced them in 2006.

"Although ARVs are supplied for free in all public institutions, we still can't get them on time because they run out before the next collection date comes," he said.

Similarly, Joshua Sinkamba of Nakonde says the demand for ARVs in the district is overwhelming, especially that some people resorted to future stocking despite being discouraged from doing so.

The challenges exist but hope is not lost. The answers will be found but not in a single day.

At the end of the day, one would say that progress has been made but it is also equally true that there are still some people in Zambia that still believe that HIV/AIDS does not exist and as such would not accept any ARVs despite being advised to do so.

Other factors hindering Zambia's progression rate in meeting the universal targets on ARV access include the medical induced stigma where some clinics are specifically established to offer ART.

Despite testing positive to HIV, some people would still shun such hospitals for fear of being stigmatised.

On the other hand, there are still some people in Zambia that have had no access to either information on the availability of the ARVs or lack access to them despite being in need.

Therefore, stigma, ignorance and arrogance remain Zambia's biggest challenge in meeting the universal targets apart from inadequate financial resources to meet the public demand.