Free ARVs available from next month

Government hospitals in Zimbabwe's two major urban centres, Harare and Bulawayo, will start providing free antiretroviral (ARV) drugs next month, in partnership with UNAIDS, the World Health Organisation (WHO) and the local health ministry. The programme, unveiled last week, is part of WHO's "Three by Five" vision of providing three million people globally with access to ARVs by 2005. "The Three by Five programme is part of our efforts in assisting the Zimbabwean government with the provision of antiretrovirals," WHO country representative to Zimbabwe, Everisto Njelesani, was quoted as saying. He added that health personnel were already being trained in the administration of ARVs, and the drugs would be rolled out to other parts of Zimbabwe as the scheme expanded. However, Zimbabwean AIDS activists said there were significant challenges to implementing the programme. Lynde Francis, founder of The Centre, an organisation providing treatment, care and counselling for people living with HIV/AIDS, said the first requirement, before making ARVs available, was to revive the collapsing health sector - undermined by a lack of funding, low staff morale and the exodus of skilled staff to other countries. "Our health delivery system is in such a shambles that drugs for some opportunistic infections cannot be found," Francis said. "The need to administer ARVs would be reduced drastically if areas like the prevention of mother-to-child transmission were given attention," she pointed out. "The [implementation] committee is full of learned professors and doctors, but there are no women or people living with HIV - how can they be passionate about implementing the Three by Five programme if they are not affected by AIDS?" asked Francis, who has lived with the virus for 18 years. Believe Dhliwayo, coordinator of Zimbabwe Activists on HIV and AIDS, questioned the urban focus of the programme. "Providing treatment to urbanites first, ahead of rural dwellers, raises issues of human rights," charged Dhliwayo. "The people in rural areas, where there are vulnerable orphans being looked after by grandparents, should be given first priority." He noted that there was an urgent need to educate both patients and health care workers about ARVs - which are extremely powerful drugs and require a strict regimen - before they were administered. "The implementation of the Three by Five initiative should be accompanied by an information blitz, because there is a lot of vital information that patients and health providers should have. Treatment literature on issues like adherance and nutrition should be a priority before everything else," said Dhliwayo. An estimated 24.6 percent of Zimbabweans are HIV-positive, but very few are able to afford the ARV medication that could extend their lives.