Twice as many HIV-positive people in Swaziland are in need of life-prolonging antiretroviral (ARV) drugs than previously thought.
This has highlighted the inadequacy of the Swazi Government in dealing with this health crisis.
According to a report from the news agency IRIN/ PlusNews, the United Nations AIDS organisation UNAIDS says the number of people in Swaziland needing ARVs has almost doubled from 34,000 to 62,000. In a kingdom where 26 percent of sexually active adults are HIV positive, the new numbers will require the health ministry and non-governmental organisations (NGOs) working in the AIDS sector to devise new strategies to rapidly scale up treatment, IRIN/PlusNews reports..
Dr Velephi Okello, the ARV therapy coordinator at Swaziland's National AIDS Programme (SNAP), said that the new figure presented a significant challenge to a resource-limited nation like Swaziland.
Hannie Dlamini, founder of the Swaziland AIDS Support Organisation (SASO), the country's first group for people living with HIV AIDS, said even at the current level of about 30,000 people on ARVs, the government's treatment programme appeared to be under strain.
‘There is a shortage of ARVs from time to time, from bottlenecks in the distribution system. People's schedules for taking the drugs are thrown off, and this can make the drugs ineffective for them.’
According to Dlamini and local press reports, the government hospital in Mbabane, the capital city's main ARV distribution point, periodically runs out of the drugs.
Last year, 8,000 people – almost a quarter of all patients on ARVs - dropped out of the treatment programme. A health ministry survey found that occasional drug shortages were not the only reason; a lack of health facilities distributing the drugs and inadequate adherence counselling were also obstacles to staying on treatment.
‘Distance to hospitals was given as the main reason people became defaulters [stopped taking their drugs]. They either couldn't get to the ARV distribution centres at hospitals in the towns, or they didn't have money for transport,’ said Okello.
Health officials estimate that by 2009 more than 200,000 people, almost a quarter of the Swaziland population, will be HIV positive and require monitoring; of the 16,700 new HIV infections anticipated in 2009, around 3,000 will be children.
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