Scepticism over AIDS drugs roll-out

A government programme to provide anti-AIDS drugs to HIV-positive Zambians had ignored those who needed it most and was simply "a lot of hot air", activists told IRIN. Last year, the government announced that up to 10,000 people living with HIV/AIDS (PWAs) would receive free antiretroviral (ARV) drugs in nine provincial treatment centres. The project would also provide a team consisting of a physician, faith healer, counsellor and social worker in each centre. But the Network of Zambian People Living With HIV/AIDS (NZP+) has expressed concern that PWAs who are poor and powerless, still have no access to treatment. "The NZP+ was completely left out of the process and is still not aware of how their members will benefit," Winston Zulu, NZP+ founding member, told IRIN. Despite the "media hype" surrounding the ARV roll-out, HIV-positive Zambians did not know how to access the drugs. "There is all this talk about ARVs but we don't have them here," Zulu added. The government project had been advertised in newspapers and on local radio, but "clearly the message had not got through" and had to be repeated, admitted Zambian Minister of Health Dr Brian Chituwo. With the limited resources available in the country, it would not be possible to immediately provide ARVs for all HIV-positive Zambians. "But we started with this project because we viewed it a matter of urgency to care for those who are already [HIV] infected," Chituwo told IRIN. The initial funding for the project has been budgeted for and approved by parliament. A portion of the money awarded to the country by the Geneva-based Global AIDS Fund, as well as a US $2 million World Bank loan "will help sustain" it. Inadequate resources, however, were often used as a "red herring" by governments, said Zulu, who is also part of a pan-African activist movement fighting for access to HIV/AIDS treatment. "Given the political will, we can roll out the drugs in Zambia. We have to start where we can and continue expanding. Money should not always be the excuse," he added. Chituwo noted that a programme as "complex" as this one would have its "teething problems". He warned, however, that there had to be "a system" and people living with HIV/AIDS could access the treatment once they had registered and been tested at their nearest ARV centre. Monitoring the therapy would still be difficult, as there were only two centres for CD4 and viral-load testing in the country, Chituwo said. Existing guidelines for managing patients on antiretroviral therapy (ART) use viral-load and CD4 count testing to measure the impact of ART on the patient's health. "We can't line up people living with HIV/AIDS and say 'here we are, here are the drugs'. We have created guidelines which must be adhered to," the minister added.