Unregulated ARVs cause health havoc

After years of resisting the introduction of antiretroviral drugs (ARVs) in Swaziland, the government bowed to pressure from international donor organisations last year and permitted their distribution. However, what followed has been a confusing and dangerous free-for-all which has reached the point where some activists have called for the drugs to be banned. In some cases pharmacies are dispensing ARVS without prescription or instructions informing patients of how to take the medication, and no warning of possible side effects. "There are pharmacies in Mbabane that sell ARVs to anyone coming off the street. They do not dispense instructions, because the queue of people wishing to buy [the drugs] is so long," Siphiwe Hlope, co-director of the AIDS support group Swazis for Positive Living, told IRIN. "We concur with government's policy to permit ARVs, but a law regulating their distribution is needed - anyone can sell ARVs. Taxi drivers going to clinics to pick up ARVs for people get an extra supply, and they sell them to passengers," Hlope said. AIDS activists have expressed concern that the lack of guidance in taking ARVs had led to patients starting a treatment regimen and then stopping, risking treatment resistance and further endangering their lives. "People are not told to expect side effects. When they become nauseous, dizzy and develop flu-like symptoms, which is to be expected with ARVs, they tell us they stop taking the pills because they think they are poisoning them. Once the regime of taking the medicine in proper and regular doses is broken, it cannot be effectively renewed," said one health worker. Widespread claims for AIDS cures published in the local press are also causing alarm among health workers. Advocates of such cures usually insist they are better than the "unsafe" ARVs. Hannie Dlamini, president of the Swaziland AIDS Support Organisation (SASO), has come out against the government's policy in promoting ARVS. "These drugs are not the way to go - the only reliable treatment is the adoption of a healthy diet, which entails eating mostly vegetables such as spinach and sweet potatoes," he said. An international aid worker told IRIN: "People are confusing nutrition with medicine. These should go hand in hand: nutrition to boost bodily strength, and ARVs to counter HIV." But the problem in Swaziland is that some nutritional products are being advertised and sold as "treatments", or even as "AIDS cures". When contacted, the ministry of health said a statement would be prepared to address the improper distribution of ARVs. Dr John Kunene, principal secretary at the health ministry, noted in a recent statement: "There is no known cure for AIDS. People seeking over-the-counter treatments must consult their physicians." UNAIDS estimates that 38.6 percent of adult Swazis are HIV positive. The National Emergency Response Committee on HIV/AIDS, set up by government to dispense United Nations Global Fund grants to local programmes dealing with the disease, said half of people in their twenties were HIV positive.