adminLACK of resources continue to hamper efforts by most African countries, Zimbabwe included, to implement latest recommendations on early HIV treatment that are aimed at reducing Aids-related deaths, Government officials and HIV activists have conceded.
Latest data from clinical tests conducted by federal scientists in the USA show that people who get treatment immediately after testing positive for HIV are 53 percent less likely to die or develop Aids or a serious illness than those who delay getting treatment.
According to latest World Health Organisation (WHO) recommendations on Antiretroviral Therapy (ART), adopted in 2013, adults who test for HIV should be initiated on treatment when their CD4 cell count falls to 500 or less.
However, the latest findings announced on Wednesday last week show that initiation of treatment soon after diagnosis when a person’s CD4 count is above 500 would significantly reduce Aids-related deaths.
Zimbabwe has already adopted the latest WHO guidelines on ART.
Researchers have also noted that the latest findings could also act as an incentive to encourage people to get tested early.
“This is another incentive to seek out testing and start therapy early, because you will benefit. The sooner, the better,” said Dr Anthony S Fauci, director of the National Institute for Allergy and Infectious Disease, which sponsored the study.
Director of the Aids and Tuberculosis Unit in the Ministry of Health and Child Care Dr Owen Mugurungi welcomed the latest findings which he said served as reaffirmation of evidence already available on the benefits of early treatment.
He, however, said the latest recommendations may be difficult to implement due to lack of resources in most African countries.
Dr Mugurungi said because of limited resources most Governments, in developing countries were forced to use CD4 count to determine people eligible for treatment as a way of targeting those with lower immunity and were more at risk of death.
“Ideally and resources permitting people should be put on treatment as early as possible. This (findings) is just reaffirming what we already believe in. The rationale behind using CD4 count was to try and achieve equity and reduce deaths.
“If a person’s CD4 cell count is at 500 chances of that person dying in the next five or so years are less than those of a person whose CD4 cell is below 100. Because we want to achieve equity and save lives we prioritise people whose immunity is more compromised.
“Developed countries can afford to initiate their people on treatment even if one’s CD4 count is way above 500 because they have the resources. If we were to do that demand for treatment would increase and our resource base would be constrained. We just don’t have the resources,” he said.
Dr Mugurungi’s assertions were backed by Zimbabwe Network of People Living With HIV advocacy and communications officer Mr Edmore Mutimodyo who added that African countries needed to start moving towards self-sustained HIV intervention programmes.
“The findings are welcome and echo what we have always been calling for.
“The challenge, however, is that we may not have the resources to scale up rolling out of ART and include people whose CD4 count is above 500. We are not ready for that yet.
“As you know we largely rely on donors for our drug supplies and that does not give us enough room to determine how we would want to roll out our treatment programmes.
“We would need to move towards domestic funding of our HIV intervention programmes if we at any time hope to emulate developed countries in terms of early treatment initiation,” he said.
According to UNAids about 14 million of the estimated 35 million people living with HIV around the world are on treatment.
In Zimbabwe about four million people are living with HIV and of that figure 955 000 are receiving treatment, with the remainder still on the waiting list.
At least 156 718 children are living with HIV of which 46 319 are receiving treatment.
The country has witnessed a steady decrease in the number of people dying from Aids-related illnesses in the past 10 years with the figure having gone down by more than 50 percent, to about 60 000 recorded in 2013 from about 170 000 who died in 2003.
In a statement last week, UNAids welcomed the latest evidence on HIV treatment with the organisation’s executive director Mr Michel Sidibe saying delaying access to treatment was a violation of human rights.
“UNAids welcomes additional evidence that starting antiretroviral therapy at a higher CD4 (a measure of immune system health) level has a positive effect on the health and well-being of people living with HIV.
“Every person living with HIV should have immediate access to life-saving antiretroviral therapy. “Delaying access to HIV treatment under any pretext is denying the right to health,” he said.
UNAids also commended Zimbabwe on its efforts to scale up access to treatment, pointing out that the country’s response to Aids was among the most successful in the continent although the epidemic remained a public health threat and more needed to be done.
Online Reporter