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HEALTH-SOUTHERN AFRICA: One Million People Need AIDS Treatment

Moyiga Nduru

JOHANNESBURG, May 29 2007 (IPS) - About one million people in need of anti-retroviral (ARV) treatment are yet to receive it in four southern African states, according to Medicins Sans Frontieres (MSF), a global nongovernmental organisation specialising in medical services.

On the African continent, some 70 percent of people who need ARVs do not have access to the drugs.

The campaign to put pressure on governments to speed up the delivery of ARVs to millions of Africans in need of the life-prolonging drugs is gathering momentum, with MSF being the latest to add its voice to the crusade.

While the number of people receiving ARVs in Africa has increased to 1.3 million today, about 70 percent of those estimated as needing treatment in Africa are not getting it, the MSF said.

More than one million people in South Africa, Mozambique, Malawi and Lesotho need AIDS treatment but are not getting it, according to the MSF’s new report, ‘‘Confronting the Health Care Worker Crisis to Expand Access to HIV/AIDS Treatment”, launched in Johannesburg last week.

In Lesotho, only 17,700 people out of 58,000 have access to treatment. In Malawi, 59,900 people receive treatment as opposed to 169,000 people who do not. In Mozambique, a similarly dismal situation exists as only 44,100 people have been covered, out of 237,000.

In the more developed South Africa, only 265,000 out of 983,000 people have access.

This is happening at a time when AIDS drug prices have gone down and global funding for HIV/AIDS has increased from 2 billion US dollars in 2001 to about 8.3 billion dollars, MSF said.

‘‘The main barrier to expanding antiretroviral therapy in these four countries today is the shortage of heath care staff to care for an increasing number of patients,” Eric Goemaere, MSF head of mission in South Africa, told journalists at the launch.

This has resulted in the unnecessary loss of lives. For example, Lesotho with its population of around 1.8 million has 23,000 deaths a year due to HIV/AIDS, MSF said.

The problem is compounded by doctors being overwhelmed by AIDS cases due to the magnitude of the epidemic. Of the four countries surveyed, only Malawi and Lesotho allow nurses to deliver and manage ARVs.

‘‘In Mozambique, nurses do not prescribe ARVs. If they are allowed to provide them, we can save many lives,” Daniel Nhantumbo, MSF medical technician in Mozambique, told journalists.

His colleague, Pheelo Lethola, an MSF field doctor in Lesotho, agreed. ‘‘More people will die if we rely only on doctors, especially in rural areas and in the mountains,” she said.

In the MSF report, Emily Makha, a 70-year old nurse at Kena, a rural clinic in western Lesotho, talks about providing ARVs. ‘‘As the only nurse here, I have to do the work of at least four nurses. I take blood samples, do both ante-natal and post-natal cases and handle curative care for general patients, the delivery of babies and so forth.

‘‘If I have to go somewhere, the clinic remains closed. Most nurses have left for the United Kingdom or South Africa. As a matter of fact, if I was younger, I would also have gone now,” Makha was quoted as saying in the MSF report.

‘‘Providing HIV care in rural clinics depends on nurses, but they cannot cope with the number of patients,” Lethola said. ‘‘Consultation times are too short, and sick patients suffer needlessly. When nurses suffer, patients suffer.”

Presently, ARVs are the only available hope for millions of people living with HIV/AIDS. ‘‘If properly delivered, a patient should feel well and lead a relatively normal life within six months,” Goemaere said.

The MSF’s call for increased access to ARVs follows on a march held a month ago in South Africa’s commercial hub of Johannesburg. Dozens of civil society activists participated, led by the international charity Oxfam.

They were demanding that the 53 African Union (AU) health ministers, who were meeting in Johannesburg at the time, prioritise the World Health Organisation’s 2010 target for achieving universal access to prevention, treatment and support to address HIV/AIDS, tuberculosis and malaria on the continent.

Campaigners attribute the delay in providing treatment to a lack of political will. ‘‘Governments need to be pressured to address the issues around ARV delivery and distribution,” Regis Mtutu of the Cape Town-based Treatment Action Campaign (TAC), told IPS in an interview at the time.

‘‘Eight million Africans are dying from HIV/AIDS, TB and malaria every year. We want to stop this,” he said

In 2001 African heads of state met in Abuja, the capital of Nigeria, and committed 15 percent of their national budgets to health as part of the African Common Position on Universal Access. ‘‘Six years down the line only two countries – Botswana and The Gambia û have met this promise,” said Mtutu, who took part in last month’s procession in Johannesburg.

In another meeting in May 2006 in Abuja, heads of states agreed to targets for ARV coverage and prevention of mother-to-child HIV transmission of at least 80 percent by 2010. Mtutu insisted that individual countries’ targets should be ‘‘be equivalent or greater to the targets set” in Abuja in 2006.

Currently, most countries on the continent have less than 30 percent treatment coverage and only three countries in Africa have greater than 50 percent coverage.

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