'Funds do not meet demand'

HARARE - “I am so grateful to be standing in front of you today. I know that I owe my life to God who gave his people the wisdom to manufacture life-prolonging drugs.

“When I came here last year, I looked like I would not last the following day, my CD4 count was 14 and I had no energy but look at me today,” said a woman who testified at Harare Hospital’s Opportunistic Infections Clinic recently.

Nothing about the confident manner in which she conducts herself betrays that she is living positively with HIV, the virus that causes Aids.

“I know that the timely intervention of the antiretroviral (ARV’s) drugs saved my life and today I am healthy and I have resumed my cross-border trading business,” she said.

The woman is a beneficiary of government’s intervention efforts to secure affordable drugs to people living with HIV/Aids.

The drugs are readily available to people living with the disease that is considered to be one of the world’s number one deadly diseases and can be accessed at most public health institutions.

According to the National Aids Council (Nac), there are 510 health centres where patients can access HIV and Aids services.

The woman who was overwhelmed by emotion told scores of people waiting to be served at the OI Clinic that she wished such interventions had come in time to save her only sister.

“My elder sister died of this disease in 2000 when the drugs could only be accessed by people who could afford them,” she lamented.

Her story however, is one among many stories of people who have benefitted from subsidised ARVs.
The life-prolonging drugs now come at affordable prices at most public hospitals because of the generosity of donors like the Global Fund and Pepfar.

Interventions like the Aids levy which enables taxpayers to contribute to the fight against the disease has also helped cushion the burden.

The services are however, not limited to Harare Hospital alone but can also be accessed at Wilkins Hospital and Chitungwiza Hospital and Howard Hospital in Chiweshe among other health care centres.

The Opportunistic Infections Clinic (OI) situated at Chitungwiza Hospital, currently has 14 000 people including 500 children on ARVs.

The clinic services at least 800 patients and close to 50 new clients a day with a skeletal staff of three doctors and a handful of nurses.

This unfortunate situation is a direct result of dwindling funding for HIV and Aids programmes.

While the Global Fund, a public-private multi-billion dollar international financing organisation which provides countries with grants to fight HIV/Aids, Tuberculosis and Malaria continues to be the largest donor for HIV/Aids programmes in the country, the funds still do not meet demand.

Organisations working with people living with HIV/Aids say the available funds are not enough to eradicate the disease and create a generation free from HIV.

The dwindling of funding is connected to the socio-political environment in Zimbabwe among other external factors.
Over the years, the county’s reputation in the Western countries, who are the majority of donors took a nose dive because of the human rights situation over the past decades.

The fight against HIV/Aids was further affected by the state of affairs in 2008 when government banned some NGOs.

In the same year, some NGOs that were working in HIV/Aids programming had to suspend their activities during the run-up to the controversial June, 2008 presidential election runoff.

The global economic crisis has also affected the release of funds to fight the disease with donor countries cutting back on funding.

This revelation comes amid claims by the Global Fund that Zimbabwe is among the 20 nations the Fund which was established in 2002 is focussing on.

The Global Fund however, cites “technical reasons” for not availing the funds that Zimbabwe needs.

Zimbabwe has about 2,3 million people living with the disease, while neighbouring Zambia has 980 000 people affected.

Zambia however receives $187 per person affected as compared to the $4,50 spent on Zimbabwe per person.

But in light of all of these negative factors, Zimbabwe’s prevalence rate has actually dropped from 23,7 percent in 2001 to 13,7 percent in 2010.

This development could have been necessitated by the fact that in the face of dwindling funding to fight the deadly disease, government had come up with alternative means to avert the crisis.

The crafting of the national Aids policy and its implementation in 2000, saw the birth of Nac, an entity tasked with spearheading the fight against the disease.

The introduction of Aids levy on taxpayers is also credited with assisting people living with HIV/Aids
Nac has however, failed to operate at full capacity because the resources are inadequate.  

However, in 2010 at least 326 241 people were eligible for ARVs and 95 794 people were initiated on ART.

But Emmie Wade, the director of Kunzwana Women’s Trust, an organisation that seeks to empower women at grass-roots level, said government had not been able to support people living with the disease in rural areas.

She argued that the decrease in the prevalence rate could be attributed to the fact that research to ascertain true figures had literally ground to a halt because of funding constraints.

“If you look at the statistics being used, you will find that they are being derived from the time when we still had the funding and were still able to report on developments,” Wade said.

She however, concedes that there could be reduction in prevalence rate because a good number of people now have information on prevention and treatment.

“People now have information which was disseminated during the time when we had funding, you will also find out that there is now a larger use of the condom but the issue of access to ART is still a big issue.

“We can actually see the effects of the dwindling funds on our relatives, we see them losing weight and their skin which was once fair beginning to deteriorate,” Wade said.

Some activists say the decrease in prevalence rates is not an indicator that government programmes have succeed but point to a much deeper problem.

“The facts are that we have many people who are internally displaced here.

“Take for example the 2005 Operation Murambatsvina which saw at least 700 000 people being displaced and if they say one in three people in Zimbabwe is infected, how many of those displaced persons failed to access services,”  HIV/Aids activist Gloria Gumede said.

Gumede added that: “Some of the people who were displaced during Murambatsvina never bothered to continue with their treatment programmes because they had much bigger problems like where to lay down their heads than treatment.”

Several others were also displaced during the runup to the June 2008 election which was marred with violence.

According to the World Health Organisation statistics revealed in 2010, only 59 percent requiring ART were accessing them in Zimbabwe.

Wade, who works closely with women in rural areas, said women and children in rural areas could not access treatment or treatment centres where HIV/Aids programmes where rolled out.

Director of Justice for Aids Trust Albert Chambati told the Voice of America in May this year that dwindling support for HIV/Aids programmes would affect the ordinary people.

He called for immediate action to be taken to avoid disaster.

The fight against HIV/Aids is further intensified by the collapse of the public health institutions across the country owing to lack of funding.

The government has since increased by two percent its budget for health for the year 2013.

But the efforts are a far cry from the Abuja declaration which Zimbabwe is a party to that states that at least 15 percent of the budget be allocated for health.

While presenting the 2013 budget last month, Finance Minister Tendai Biti said the ailing sector would also receive an external loan to purchase equipment amounting to $98 million.

“Using the limited available fiscal space, government will improve funding for dealing with communicable, maternal, perinatal, nutritional conditions to achieve better health outcomes given that the burden of disease come from these conditions,” Biti said while reaffirming government’s commitment to improving health systems.

While the 2013 budget brings a ray of hope of resuscitating the country’s health delivery systems, it is important to note that indications are that HIV/Aids programmes could face a $227 million deficit by 2018.

Minister of Health Henry Madzorera says: “The consequences of global meltdown will be catastrophic to our programmes and will take us back many years.” - Thelma Chikwanha, Features Editor

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