adminwardrobe in Mount Pleasant, Harare, where she works as a housemaid.
Trips to clinics and hospitals where she hoped to restock yielded no positive results as she was told that she could only collect the life-prolonging drugs from the site she had registered.
The news sent shivers down Munhondo’s spine as she was first registered in Gokwe North, about 442km from Harare.
Failure to get the pills from Harare meant that she had to make regular trips to the rural district hospital something she said would be too costly considering her salary of US$70 per month.
“I tried collecting them from Harare Hospital, but they said I would only get medication from the centre I was registered.
“I pleaded with them but told me they could not help me in any way. The only advice I got was for me to go where I had registered before my pills ran out. I had no bus fare as it was during the middle of the month.
“It was also my second month at the new job and I could not ask for an advance salary from my employer,” said Munhondo who is a mother of three minor children.
She said she confided in a gardener who referred her to a neighbour who is also HIV positive and had “plenty” of ARVs.
“I went to see the neighbour who told me that he was registered at three centres in Harare and one in Murehwa. The neighbour said he collected the ARVs from the four centres and had excess to sell. He sold them to me on credit for US$25. I have been buying from him ever since,” she said.
Munhondo is not the only one facing such challenges, many others around the country face the dilemma of collecting ARVs only from the centre they registered.
The problem of double dipping has also been affecting the proper distribution of ARVs.
Double dipping is when a person who is on ART registers and collects medication from more than one site.
But, it seems as if Munhondo’s prayers have been heard as the National Aids Council is this month expected to rollout an anti-retroviral electronic card system to help people living with HIV and Aids access to medication anywhere in the country.
NAC monitoring and evaluation director Mr Amon Mpofu said each patient shall be a holder of a patient electronic card which will have information about patient history regarding access to ARVS and their medical history. Patients will be issued with cards that they present at any clinic or hospital with ARVs.
“We are going to provide equipment in all hospitals so that if a patient is carrying an electronic card and comes for consultation, they are just logged on and their history will be shown in a computer.
“This system will pilot in a few hospitals before being rolled out to other sites countrywide.
“It is a system that will assist in curbing double dipping and it will also ensure that patients are able to access services anywhere without us contacting the site where they were initiated,” he said.
Mr Mpofu said as of now it becomes difficult for patients to access treatment where they are not registered, but with this system they will be able to access services anywhere in the country.
“It also emerged that some unfaithful patients where getting registered on more than one site and we had no way of identifying them.
“But with this system, we will be able to identify that this patient collected drugs on this date and is registered at this institute and will avoid double dipping.
“We believe this will also improve recording in terms of people accessing ARVs and this will improve planning because as NAC we are responsible for procuring drugs.
“We can then make projections and estimates in terms of budgetary issues,” said Mr Mpofu.
“While some rural areas have no electricity and Internet coverage, this is no drawback as information will be transported through CDs to a site where both are available and updates will be made, according to Mr Mpofu.
He added that benefits of using the electronic card include the issue of confidentiality and privacy.
“What it means is we will be having a web based system as there will be minimum information on papers.
“This will preserve confidentially and patient records remain private as only the person carrying a card will have access to the information.
“This gives dignity to the patient. We are able to collect data to know how many patients we have in a district and we can also disaggregate to the point.
“This will also enable us to check how many people defaulted and we can follow them up,” he said.
He said the system is NAC’s strategy to increase the number of people on treatment by 9 percent by 2015 in line with the Millennium Development Goals.
The 2010 MDG status report says Zimbabwe appears to be on course to achieving the target of reducing the prevalence of HIV to 9 percent by 2015 due to efforts being made to increase coverage of HIV counselling and testing services to improvements in the quality of Prevention of Mother to Child Transmission (PMTCT services, and to mobilising communities to support and use these services.
NAC aims to reduce HIV-related deaths from the 2009 figures of 66 000 to 46 200 by 2015
“We also want to increase the number of tuberculosis patients who know their HIV status to 90 percent by 2015,” said Mr Mpofu.
He added that they were working hard to ensure that the current two-percent of health institutions that run out of drugs drops to zero.
Zimbabwe’s HIV prevalence rate stands at 14,26 percent. A decline is expected following increased behaviour change programmes and male circumcision among other initiatives and factors.
Mr Nevson Mutapi (not real name), a reader of The Herald said the idea of an electronic card is just wishful thinking and sweet talk.
“One would ask at what point NAC will introduce these electronic cards when most ARV roll out centres are understaffed and records dating from over 10 years ago are in shambles.
“Some people on ARVs have relocated, others have died, others are now getting the drugs from the private sector such as pharmacies and others have simply defaulted on taking their treatment.
“One would have thought instead of NAC going on this expensive exercise, it must address urgent issues such as the New WHO guideline which now state that people living with HIV with a CD4 count of 350 must be put on treatment immediately.
“We have a huge backlog of people in need of treatment and NAC must channel those resources towards securing much needed treatment and securing CD4 machines in the public sector.
“This just shows that NAC is a poor strategist and not serious with curbing the AIDS epidemic,” he said.
But another reader only identified as Walter applauded NAC for the initiative saying this is a positive move because at least it will ensure that no more double dipping by some unscrupulous people.
Dr Walusaga Rogers (Society of Aids in Africa – Governing Council Member – Uganda) responded by saying: “This is an auspicious move to brandish the so deteriorating ethics in combating HIV/Aids especially in the stigma and Discrimination societies.
“Now the affected ones will move with vigor to get medications at any time of their need. The only worry about this is that there is no proper statistics in the way of administering the dosages of the ignorant communities”.
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