Over 100 000 HIV+ children fail to access ARVs

Nearly 100 500 children living with HIV in Zimbabwe are failing to access anti-retroviral treatment (Art) due to a shortage of skilled manpower to administer medication and inadequate laboratory capacity. The situation has raised fears that the affected children risk succumbing to opportunistic infections.

According to a recent National Aids Council (Nac) report, 100 426 out of 167 431 children failed to access treatment last year.

In 2012, only 46 319 received medication, leaving 104 937 suffering from various ailments, including opportunistic infections.

Information gathered last week indicates that paediatric Art coverage is only 46 percent while adult coverage is over 80 percent. It is understood that Nac is working with the Ministry of Health and Child Care to also leverage child access to 80 percent.

Latest statistics show that the number of children dying from HIV-related infections has declined by over 60 percent over the last decade.

However, there are concerns that the obtaining problem could lead to increased deaths.
The Ministry of Health and Child Care national co-ordinator of mother-to-child HIV transmission prevention (PMTCT), Dr Angela Mushavi, said paediatric Art remains a challenge in Zimbabwe mainly due to lack of qualified personnel.

"Most rural areas lack trained health personnel to initiate children on Art. Usually, nurses at these sites rely on doctors to initiate the children. Another challenge slowing down Art coverage is delayed testing; most children are only tested after falling seriously ill. "Once an HIV test is confirmed positive, all children less than five years old should be initiated on Art without any delays, while older children need a CD4 count to determine if they need to start."

Dr Mushavi said paediatric Art coverage was also low as only a few facilities offer treatment.
Efforts are, however, being made to ensure more health institutions provide treatment to children, pregnant women and breastfeeding mothers, she said.

Contacted for comment, the ministry's director of the HIV, Aids and Tuberculosis Unit, Dr Owen Mugurungi, said problems were also being encountered after testing as only two centres have the capacity to examine blood samples. He advocated decentralising blood sample tests, adding that paediatric drugs were available countrywide with stocks projected to cover the next 18 months. "We have the capacity to draw blood samples from infants to test for HIV. However, the main problem is that there are only two sites that assess the blood samples; one at Mpilo and the other in Harare.

"These two sites at the end of the day are overwhelmed with blood samples from across the country. This, in turn, slows down Art initiation for children under five.

"The laboratory equipment is too complicated for an ordinary health practitioner to operate. Therefore, there is need for more partnerships to mobilise funds to train human resources as well as purchase the equipment."

Nac monitoring and evaluation manager Mr Amon Mpofu said paediatric Art should be promoted through awareness campaigns. He said results from blood samples are now being relayed faster via the mobile phone short message service

"The majority of children living with HIV today got it through transmission at birth. The introduction of the Option B plus (treatment method) is the greatest step towards eliminating HIV transmission from mother to child," he said.

Under Option B plus, pregnant and nursing women living with HIV are required to take anti-retroviral drugs to prevent transmitting the virus to their children.