Experts afraid of WHO ARV`s directives

Despite the directives from the World Health Organization (WHO) requiring all HIV/AIDS victims whose cluster of differentiation 4, (CD4s) counts rates at 500 to be put on antiretroviral (ARV) drugs, experts have cautioned that such an exercise is costly for the country.

The Tanzania Commission for AIDS (TACAIDS), Director Policy, Planning and Research, Dr Raphael Kalinga warned that the country is not prepared to allow such an increased access of patients to access ARV’s considering that each victim spends at least $60
0 annually for the exercise.

Dr Kalinga was speaking mid this week, during the HIV and AIDS policy review meeting organised by TACAIDS, in collaboration with local and foreign health experts in Dar es Salaam.

He said such a directive from the WHO was good at ensuring that HIV and AIDS victims’ lives are saved at an early stage of their infection.

“It is too early to adopt that in Tanzania because of financial constraints. Victims are required to use ARVs throughout their lives which is costly, he said adding that without other health related projects to be implemented on specific time frame, such an initiative would be possible”

The doubts on WHO’s directives came after the representative from a key donor, the Global Fund’s Dr Michelle Roland confirmed that Tanzania will be unable to acquire the whole fund it requested for HIV/AIDS activities in the coming three years, starting from 2015.

She said the country will only get $286million out of the $485million it requested from the Global Fund causing a deficit of $199million saying the limited access to such a support will be caused by requests from other countries.

She however advised the country to direct such funds on helping special groups such as children, women and disabled.

Commenting on how the government struggles to fill the $199million shortfalls in order to reach more HIV/AIDS victims, the Director of Finance and Administration with TACAIDS, Beng’i Issa said the government was looking forward to introducing AIDS Trust Fund next year.

He urged stakeholders to come forth and help governments’ initiatives in ensuring that such services reach the majority victims because the scheme is not for the government alone.

For his side, the Chairperson of the National Council for People Living with HIV and AIDS (NACOPHA), Vitalis Makayula, said the $199miilion deficit was insignificant to reach patients with 500 CD4s count, because it will involve over 1.6 million Tanzanians living with the virus.

“At no point in time has HIV/AIDS victims been ever smoothly reached. If a certain group experiences shortage of ARVs, the other suffers from ARVs side effects while there is no substitute for their doses” he said.  

He said previously, ARVs were for HIV/AIDS victims whose CD4s counts stood at 200, and at that point the government failed to reach half of the 600,000 patients living with the virus.

“Three year back, we announced that victims with 350 CD4s count should also use ARVs, this worsened the situation in term of service delivery considering that all ARVs services are donor funded. Now, how will the state be once there is an expansion to cover patients with 500 CD4s count?” he queried.

He cautioned that the directive if implemented will likely deteriorate the health status of the majority victims even those previously on ARV’s, thus leading to loss of lives caused by scramble for the few available tablets.

“While administering victims with CD4 200count, patients were told to eat a balanced diet, this principle should be maintained and be promoted to those patients with CD4 350 and 500 instead of rushing them into using ARV’s” he insisted.

The Civil Society Organization National Steering Committee on HIV and AIDS Response (CSONSC), Agnes Junga said the government needs first to improve its internal sources of incomes such as in gas, tourism, ports and others and use such funds in supporting HIV/AIDS victims.

“We need financial stability and not donor dependency if we are to ensure that all the victims are entitled to ARV’s. Experts argue that if the drug is used by the victims for three consecutive years, it is capable of suppressing the virus, stop the disease progress and could also lead to incapability of the infected victims to spread new infections.