Free ARV drugs for all

Cameroon’s ministry of health has declared that antiretroviral drugs have been made free to anyone eligible as part of a national distribution programme.

The decision, made public by health minister Urbain Olanguena Awono in the capital Yaoundé during a press conference, is part of the 2006-2010 national strategic plan to combat AIDS. The minister stated that the aim is to make ARV’s accessible to 75 percent of adults and 100 percent of children requiring this treatment by 2010.

First-line and second-line ARV’s, which are distributed to all public and private hospitals across the country, will be free, as will treatments for opportunistic infections related to HIV/AIDS. Olanguena Awono stated that, in due course, 43,000 adults and 4,000 children will have access to the ARV’s.

According to official statistics, more than 30,000 people currently take these drugs in Cameroon, at a price of 3,000 and 7,000 CFA francs (US$6 and 14) for first-line and second-line treatments respectively. According to the United Nations, 5.4 percent of Cameroon’s 16 million people are living with the virus, one of the highest prevalence in West and Central Africa.

The minister stated that it had been made possible to distribute drugs for free thanks to subsidies from the Cameroonian government and financial backing from partners including the Global Fund to Fight HIV/AIDS, TB, and Malaria, the Clinton Foundation and Unitaid, the international initiative to finance medicines in poor countries, which Cameroon signed up to at the beginning of 2007.

According to the Cameroonian health ministry, the cost of providing free ARV’s has been estimated at 5.5 billion CFA francs (US$11.5 million) for 2007 alone.

The decision, made by the Cameroonian government, follows an announcement in January that HIV screening tests will be free for vulnerable people, including pregnant women, children under 15, school children and students, patients suffering from tuberculosis (the main opportunistic infection linked to HIV), and people in prison.

Although organisations supporting people living with HIV in Cameroon welcome the move to make ARV’s free, they are cautious about the impact of this measure.

“We are not turning our nose up at the decision, this is very good news for people living with HIV,” Nathalie Machoussi, the Executive Secretary of the Cameroonian network of organisations for people living with HIV (Recap+), was quoted as saying in Mutations, a daily newspaper. She added that organisations fighting to combat AIDS have been pushing for this measure for a long time.

However, Machoussi emphasised the need to “geographically decentralise medicines which are not available everywhere.” Although the treatments have been made available for free, “ill people would have to continue to pay often exorbitant transport costs [to get to the treatment centres],” she said.

Machoussi also raised concerns about the possibility of ARV stocks running out. “When the ARV’s were sold, the problem of stocks running out existed. Now that they are free, everyone will come to claim them and this will be difficult if no measures have been put in place”.

Once patients have started taking the ARV treatment, they must take if for life. If there are any interruptions to the therapeutic protocol, the patient is exposed to the risk of developing resistance to the medicine and will have to resort to more recent and expensive ARV’s.

In response to these concerns, Olanguena Awono confirmed that an inventory of ARV stocks for treating opportunistic infections will be carried out before the 30 of April.