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Friday, September 26, 2003 - Web posted at 8:44:58 GMT AIDS drugs roll out LINDSAY DENTLINGERTHE long-awaited roll-out of anti-retroviral drugs by Government for people infected with AIDS has finally begun, with 157 patients countrywide already receiving the treatment. |
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This figure excludes the number of pregnant women receiving nevirapine to reduce mother-to-child transmission of the disease. The roll-out follows a two-year pilot programme at the Katutura and Oshakati State hospitals and State hospitals in six regions have been given the go-ahead to begin treating patients. The drugs are being dispensed free of charge. Strict guidelines for the administering of the drugs, as well as the counselling and treatment of patients, have been drawn up by the Ministry of Health and Social Services. So far 232 health workers have been trained to administer the treatment, with many more still to undergo training. Laboratories of the Namibia Institute of Pathology in the North and South have also been upgraded to test for HIV and measure the CD4 count, which tests the state of a person's immune system. Patients accepted on the programme - which is life-long - must meet strict criteria, including being a Namibian citizen, being resident at the same address for at least five months, having a reliable support system and access to proper nutrition. Potential patients also have to go to extensive counselling sessions to ensure they are suitable candidates for the treatment. The regions where the roll-out has begun are Khomas, Oshana, Kavango, Karas, Erongo and Caprivi. Details of the programme were revealed publicly for the first time in the National Assembly yesterday. Deputy Health Minister Richard Kamwi said the official dispensing of ARV therapy in these regions had begun in July. He was responding to a question tabled by Congress of Democrats MP, Rosa Namises. While activists and non-governmental organisations working with people living with AIDS have criticised Government for its slow response in introducing treatment, Kamwi yesterday cautioned that the roll-out had to be done carefully to minimise the creation of drug-resistant HIV strains. This could happen if the ARV therapy is incorrectly prescribed or if patients do not strictly adhere to instructions about taking the medicine. "Starting ARV therapy is a process necessitating several hospital outpatient clinic visits," he said. "It is never an emergency. Patients must meet both clinical and social criteria, including having a stable lifestyle, being able to return for follow-up visits, be committed to lifelong ARV therapy and behaviour change and have an identified treatment support person," said Kamwi. The main ARV therapy being administered consists mainly of Stavutine, which is also known as D4T and Lamivutine - better known as 3TC - as a first line of treatment. According to the Deputy Minister, 29 people in Khomas, 101 in Oshana, 10 in Kavango, 12 in Karas and five in Erongo are already receiving the treatment. Although Caprivi is among the regions where treatment is available, no patients have yet started the therapy. Many more people are expected to start treatment soon, with about 101 people registered so far in Khomas, 410 in Oshana and 34 in Kavango, Kamwi said. He cited the complexity of the treatment, a lack of doctors and the need for regular laboratory tests, as the reasons for excluding the treatment service from clinics at present. About 230 000 people in Namibia are estimated to be infected with HIV-AIDS, but not all of them are eligible for ARV therapy as treatment is dependent on the state of their immune system. "Treatment of opportunistic diseases is the most important aspect of HIV-AIDS care when a patient is acutely ill with some life-threatening condition," Kamwi said. The major limitation confronting the health system with respect to HIV-AIDS and the provision of ARV therapy is the small number of staff to take care of the growing number of patients falling seriously ill. There have also been calls for HIV-AIDS activists to be provided with treatment, to ensure the long-term sustainability of their work in eradicating stigma and discrimination against the disease. But Kamwi was adamant that they would not receive preferential access to treatment. "It does not matter whether a person has come out or not. There are very clear criteria that need to be met for a person to be included in the treatment programme". |
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