HIV-positive patients in drought-hit eastern Uganda are abandoning their anti-retroviral regimens in droves, and leaders fear that unless more food becomes available, they will soon be dealing with drug resistance and death.
"In our assessment in Teso [a sub-region in eastern Uganda], we found that HIV/AIDS patients in the region take their ARV drugs on the understanding of food [being available]; in the absence of food, many stop taking their ARVs and this risks their lives," Musa Ecweru, State Minister for Relief, Disaster Preparedness and Refugees, told IRIN/PlusNews.
A prolonged dry spell has withered the region's traditional crops, leaving hundreds of thousands of people hungry; instead of eating a balanced diet from their farms, they are surviving on a diet of bought maize meal.
"I have never seen a famine like this - people can't afford a meal for several days," said Omax Hebron Omeda, Resident Commissioner of eastern Uganda's Amuria District. "The most affected people are those on ARVs. Very soon, if government doesn't intervene by scaling up the food supply, people are going to die."
Julius Ochen, a resident of Amuria, told IRIN/PlusNews that he had stopped taking his HIV medication. "When you take these drugs without eating, they make you weak and reduce your strength - you feel like vomiting," he said.
"If the government doesn't address the food crisis, many of us who are on ARVs are going to die," said Rose Anyiat, another resident.
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Keeping patients on drugs
"It's true that TB drugs and ARVs are very strong; if taken without food, they make someone doze and feel weak, but we encourage our clients to take them," said Beatrice Okware, branch manager for the AIDS Support Organization in Soroti district.
"We are carrying out sensitization and encouraging our clients on ARVs to continue taking the drugs because if they default, there are side effects," she added.
Poor nutrition weakens the body's defences against the virus, hastens progress from HIV to AIDS, and makes it difficult to take ARVs, which can sometimes increase a patient's appetite. Sufficient food can help reduce some side-effects of ARVs and promote adherence to drug regimens.
Zainabu Akol, director of HIV/AIDS programmes in the Ministry of Health, said health workers in government medical centres were warning patients of the dangers of interrupting their ARV regimens.
"We frankly told them that it's a choice of life or death," she said, adding that some patients had heeded the advice and gone back on their drugs.
The government has spent an estimated US$10 million on food for the Teso sub-region, with some specially designated for people living with HIV, but local leaders say much more is needed; local media have reported that more than 40 people in the region have died of hunger since May.
"The food being given to our people is just a drop in the ocean," said Patrick Amuriat, chairman of Teso Parliamentary Group. "What can one cup of beans and two of posho [maize flour] do? It's just for one meal."
"We are now giving special attention to people on ARVs; we are discussing with the Ministry of Health to package a special arrangement to help these vulnerable people," said Minister Ecweru. "They need to be supported with supplementary food to balance their diet."
A total of 17 districts in northwestern, northeastern and eastern Uganda have been listed as worst-hit by a nationwide drought; another 31 districts are experiencing “acute food shortages” and four districts have been evaluated as “moderately affected”.
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions