What are the future perspectives for ART in Zambia?

What are the future perspectives for ART in Zambia?

Although the country has made strides in providing ART, many people still have no access to treatment, especially outside of Lusaka. There, centres for ART are fewer and facilities and personnel are inadequate. People have to cover long distances to be treated and access to free treatment is limited.

Furthermore, there is a lack of information. Even though people may be aware of the availability of treatment services, few have first hand information on what these drugs actually do and what they do not do. Those who do not understand or ignore the fact that drugs are only part of a whole regime of positive living that encompasses diet and the prevention and treatment of accompanying diseases, gain a false sense of security. Others, on the other hand, feel that these drugs are too toxic and that it is not advisable to take them for the rest of their lives.

The stigma associated with HIV/Aids makes even those people for whom counselling is available unwilling to undergo testing. This is one of the challenges the SOS Medical and Social Centres face within their social outreach programme.

Another issue nobody is ready to tackle adequately right now is sustainability. It is still unclear who will win the trade wars on drugs. Price drops are probably inevitable but how practical is it that someone living on less than a dollar a day will contribute eight dollars monthly? How can governments that have failed to tackle the shortages of drugs to treat common problems like malaria safeguard the provision of medication? How long shall the international good will that has precipitated the establishment of the Global Fund to fight Aids, tuberculosis and malaria last? Will this massive aid, in the long run, have any negative effects on the debt burden of poor countries like Zambia?

Many patients are uncertain about whether and how the WHO and United Nations AIDS programme (UNAIDS) will continue. They ask themselves what will happen when these people (donors) go. With the hope of stocking up drugs for such a case, some register at more than one health centre, without being aware of the repercussions of such actions. At some stage the drugs will have expired, the viruses may have become resistant to the medication. Or the combination of drugs in the patient’s antiretroviral treatment (ART) may have to be adjusted. The accumulated drugs will then lose their value for this particular patient. What will stop him or someone else from selling his worthless stock of drugs out of financial need and thereby possibly causing damage?