Zimbabweans on ARV uptake doubles

The number of Zimbabweans on anti-retroviral therapy (ART) has almost doubled to over half a million

while 115 577 are on the waiting list to start the life-saving treatment.

This is a massive jump from the recent 300 000 who were receiving the treatment through the Government-subsidised anti-retroviral (ARV) programme in 2010.

In an interview with The Sunday Mail last week the director of the HIV, Aids and Tuberculosis Unit, Dr Owen Mgurungi, said 320 320 are  women.

Unfortunately due to the low uptake of ARVs amongst children, only 41 441 youngsters are benefiting from this programme while a mere 9 942 children are on the waiting list.

The Clinton Health Access Initiative (formerly Clinton Foundation) has been the sole funder supporting the paediatric formulations since 2006.

"The figures appear to show women as the biggest beneficiaries of anti-retroviral therapy, meaning that men have other avenues of getting the drugs. Most of them have been absorbed by the private sector through their medical aid facilities," said Dr Mgurungi.

It costs US$7 per person per month to access the treatment.

The increase in ARV uptake follows the adoption by the country of the WHO guidelines that require treatment to commence for people living with HIV when their CD4 count reach 350. Zimbabwe used to initiate treatment at a lower CD4 count of 200.

While the Government has been lauded for successfully fundraising  from international partners to supply the ARV drugs, it has been criticised for failing to adequately fund the programme.

"The biggest ARV support comes from the Global Fund which is supporting 193 500 people taking ARVs through the Government programme.

"This translates to 44 percent of the total number of people on ART. Government, through the Aids levy is catering for 100 000 people who account for 23 percent of the total.

"The United States is providing support for 80 000 people (18 percent), with the British DFID supporting 43 324 people (10 percent) while the Expanded Support Programme (a basket fund supported by financing from Britain, Norway, Sweden, Canada and Ireland) is providing for 23 989 (five percent)," said Dr Mgurungi.

He said Government needed to do more to ensure that Treasury funded the procurement of ARV drugs instead of solely relying on international partners who might decide to pull out any time.

According to the Ministry of Health and Child Welfare ARV programme (2012-17) update report, Zimbabwe's estimated number of people living with HIV is 1 134 919 with 980 061 being adults. The total of those who need anti-retroviral treatment is 611 264 with 518 810 adults and 92 454 children.

"Paediatric ART coverage remained at 43 percent, way below the universal access target of 85 percent," read the report.

Dr Mgurungi lamented the low uptake of the treatment by children.

According to statistics provided by the Ministry of Health and Child Welfare the  children lag behind in accessing ART, and this has become a cause for concern among policy makers. As of December 2011 there were 141 initiating and 441 follow-up sites for ART in Zimbabwe with a view to continue the decentralisation.

"But there is a hindrance to this. While it is our wish to have every public health site offer ART, we are hindered by the critical shortage of doctors. ART is initiated by a doctor, which means, centres that don't have doctors can't provide the programme.

"In some cases district hospitals have a doctor each and these are expected to do rounds in the hospital and in the surrounding health centres. This becomes a challenge," said Dr Mgurungi.

The ART programme commenced in Zimbabwe in April 2004, with the National Aids Trust Fund being the major source of funds. A massive funds mobilisation is credited with the increase in the number of people accessing the drugs.