More free antiretroviral drugs to become available

The Djiboutian government is to expand the provision of free antiretroviral drugs (ARVs) to people infected with the HIV virus using an allocation of US $12 million from the Global Fund Global Fund to fight HIV/AIDS Malaria and Tuberculosis, officials told PlusNews. Omar Ali Ismael, the head of Djibouti’s inter-sectoral technical committee on HIV/AIDS, said that the government would also improve treatment and care for those suffering from AIDS, target vulnerable groups through prevention and care, promote civil society involvement and improve data gathering and surveillance. Until now, only 200 people were receiving free ARVs, Omar Ali said. With the new funding, the number of those receiving free ARVs would initially be increased to 4,000. "Everybody in Djibouti, including refugees and legal immigrants who need ARVs upto 2007, will be able to receive them free," he told PlusNews on Monday. A March 2002 survey showed that the national HIV-prevalence rate in Djibouti was 2.9 percent - a figure which the country's health authorities say is low by African standards, but represents a generalised epidemic. The country however has one of the highest rates of TB infection in the world. The survey also showed that 90 percent of those infected lived in Djibouti Ville, and that women were more affected than men. But it also showed that less than half the population knew that condom use reduced the risk of infection. Omar Ali said Djibouti's application to the fund for support to control malaria and TB had not been successful. "I don’t know why they refused the TB proposal, and we will be appealing. If the appeal is not successful, then we will apply in the fifth round," he said. Tim Clark, spokesman for the fund told PlusNews that the application was not successful due to technical reasons which needed clarification. A Global Fund mission is expected to visit to Djibouti in September. Omar said the government would clarify the technical questions raised by the fund. According to officials in the capital, Djibouti Ville, the spread of HIV/AIDS could be stabilised because of the low prevalence in the country, and also because most of Djibouti's small population of 600,000 was concentrated in the capital. The Global Fund's technical review panel noted that Djibouti's strengths in combating the spread of HIV included political commitment, a balance between prevention and care and strong donor participation. But it said that the environment in the country was difficult to operate in, citing severe human resource constraints and dependence on foreign experts. Djiboutian officials say the spread of HIV/AIDS has been fuelled by several factors. These include poverty that is linked to prostitution, traditions that encourage "sexual relations with prostitutes", low literacy rates and high urbanisation. In May 2003, the World Bank gave a $12 million grant to support the Djibouti government's response to HIV, sexually transmitted infections, malaria, and TB. Omar Ali said the World Bank grant was mainly for prevention, while the new funding from the Global Fund would be used for care and treatment.