Chronicle Editor
Robin Muchetu, Senior Reporter
STAKEHOLDERS in the HIV treatment and support programmes have expressed concern over an emerging challenge where those taking ARVs are now ageing and in need of treatment for other ailments that come with age.
There are reports that 30 to 40 percent of HIV-positive clients are now above 50 years of age.
Dr Earnest Chikwati the country programme director of Aids Health Care Foundation (AHF) Zimbabwe said despite notable successes that the country had achieved, people with HIV are now faced with more health challenges like diabetes, hypertension, and stroke as a result of ageing while on ARVs.
He said there was a need for adequate planning in that regard.
“As we look at the trend, not many people are dying from HIV today, there is medicine available and people are taking these drugs but new challenges are coming up as people are getting older while on treatment. We need to think of how best we can take care of them. We are creating centres of excellence in HIV treatment and care because people are growing with the disease and they are dying from non-communicable diseases and we need to take care of that,” said Dr Chikwati.
Non-Communicable Diseases are those diseases that are not transmittable directly from one person to another but are typically caused by unhealthy behaviours.
According to UNAIDS, many countries with HIV epidemics are now experiencing growing rates of NCDs with death rates nearly twice as high in low and middle-income countries like Zimbabwe.
In a report, Responding to the Challenge of NCDs by UNIADS it was noted that the four NCDs that account for the greatest number of comorbidities among people living with HIV in low and middle-income countries are cardiovascular disease, cervical cancer, depression, and diabetes.
Hypertension, obesity, and chronic respiratory disease also form part of the top NCSs affecting people with HIV.
“NCDs contribute to ill-health, poverty, and inequalities and slow development of countries. Every year 15 million people die before the age of 70 from NCDs with 86 percent of these premature deaths occurring in developing countries,” read the report.
Dr Chikwati said there is an urgent need to take care of this emerging trend.
“We need to have a holistic approach when treating people to make sure that if they have diabetes or hypertension and other conditions, we treat them so that they live longer. We have realised that they are dying from strokes and other things and not HIV. This is the area where we are in terms of the HIV pandemic, we are winning the battle but we should not relax,” he said.
In a bid to nip NCDs in the bud for people with HIV, the director said the centres of excellence that have been created in the country are serving as one-stop shops where clients walk in with any condition and are treated for that rather than HIV alone.
“We are treating a person and not a specific disease, if they present with other comorbidities we are treating them so we are trying our best to provide medicines for hypertension and other conditions. We also test them for other non-communicable diseases when they come to the centres, we also screen for cancers such as cervical cancer. We are offering the service to our clients to make sure we protect them,” said Dr Chikwati.
He said other service providers whose clients are above 50 years of age and are HIV-positive are now presenting with kidney problems, diabetes, and hypertension.
Mpilo Central Hospital in Bulawayo is a centre of excellence in terms of treatment and care of people with HIV and AFH is operating from the centre.
Last week the organisation celebrated two million lives in care symbolising the growth of its operations in the treatment and care of HIV.
“We are celebrating two million lives in care, we started operating to support people dying from Aids all around the world. In Zimbabwe, we started supporting people in 2016 and we have grown more than three times in terms of patients in care under the support of AHF. We started with 15 000 only at Mpilo Central Hospital and Parirenyatwa Group of Hospitals but now we are talking of about more than 63 000 people in care under our facilities and we are celebrating that,” said Dr Chikwati.
He said it was pleasant to note that Zimbabwe has contributed to the 2 million lives in care.
“In Zimbabwe, we have more than 16 facilities where we are supporting patients, they are getting the best care possible and our mission is to provide cutting-edge medicine irrespective of ability to pay. Our understanding is that there should not be any difference between the public and private sector in terms of accessing medication and services for people with HIV,” he said.
Dr Chikwati said since their inception and also the availability of HIV medicine in Zimbabwe there has been a significant change in mortality.
“There is a big transition in terms of people dying, in 1987 there was no medicine to talk about but from 1989 we started getting some medicines not adequate as people were still dying. Even from around the year 2000 resources were still not adequate and were difficult to access and we lost many people because medicines were too expensive. Around 2004 we noticed a change, organisations started supporting people with HIV. AFH was the first organisation that started offering HIV medicine in South Africa and we are proud of it,” he said.
Dr Narcisius Dzvanga the Chief Medical Officer for Mpilo Central Hospital said HIV interventions in the city and beyond have been assisted greatly by the presence of organisations like AFH.
“As a Government and as a ministry we have done extremely well in terms of provision for HIV care right from the point of testing for the virus at New Start Centres to rapid on-site testing so that if one truly wants to know their status the testing facilities are awash in the country. Even in the outpatient departments of hospitals, testing is readily available and at clinics and laboratories,” said Dr Dzvanga.
He said drugs have also been readily available for the longest time despite the changes in treatment in various programmes and have managed to keep up pace with new recommendations like the World Health Organisation (WHO).
“We are privileged to have AFH as a partner. They run the Mpilo Centre of Excellence at our Opportunistic Infection Clinic, they buy the drugs and have record systems and staff. We have Ministry of Health staff also supporting the clinic and it is one of the best-run clinics in the city. We do not lose sleep about drugs or test kits now,” said Dr Dzvanga. — @NyembeziMu
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