OF late, I have noted with concern the rising number of people so wasted away, bringing back the memories of the late 1990s where HIV knowledge gap was wide and medication was not available for the poor in developing countries. We only heard that anti-HIV medication was available in the developed world and was costly. This made anti-retroviral medication a pipe-dream only achieved by the rich. Then only brand medication was available for HIV treatment and the monthly cost was only afforded by the rich in these countries, leaving the majority of people in needy to wallow and die.
However, the advent of generic medicine by Indian pharmacies changed the outlook as prices came down dramatically leading to the availability of medication even to developing countries.
Thus India became known as the Third World Pharmacy.
For Zimbabwe, National Aids Council was set up by an Act of Parliament in 1999. This was to ease the plight that had gripped the nation. President Mugabe declared it a national emergency. It still remains one. A first of its kind was a domestic fund called The National Aids Trust Fund (NATF) which is a taxable portion of three percent of an employed person’s taxable amount.
This fund, although not able to cater for all in needy, was and remains a great initiative. Neighbouring countries have visited the country to learn more of the fund. NATF has over the years, opened up to cover more than HIV issues alone taking up cancer treatment in 2016. TB and HIV infection have a relationship where tuberculosis finds a nest in a weakened immune system.
So people living with HIV are prone to get TB infection more as compared to people with full immunity system. Thus TB-HIV co-infection becomes a challenge which needs everyone to get tested for HIV as a means to overcome the co-infection.
Somehow, that seems not to be the case as many people who test positive to TB only get to know of their HIV status being positive after falling ill and having tests run. So this brings me back to the period when information and knowledge was not grasped by many lay people like me, when we relied on clinic staff to disseminate the health aspect. Today, HIV prevention messages have been replayed over and over again. Children even in pre-school talk of HIV as the topic is taught on all fora.
Radios, television and even songs talk of HIV as an issue that I would doubt if there are sections where the message has not reached. However, I feel we ought to up the tempo if what I am seeing is to be halted and get the message as a priority again.
Talking to three people who were receiving treatment at a local clinic this month, I asked them why they had to be wheeled into the clinic when they could have known their TB and HIV status before both had gotten the better of them. They all said they thought it could not happen to them. Mind you, no one lives in a vacuum and infection of the two must never be viewed with stigma. The first patient said she was a married woman, was faithful and never ‘saw’ this happening to her.
“I am happily married for the past 15 years and never imagined that I could be HIV positive. I thought it happened to people who had multiple partners,” said the woman. True, multiple partners are a leading cause to the spread of HIV and if one is in multiple relationships, they are advised to use protection always.
I told her that it was not an issue that she needs to blame on her spouse now, she needed to accept the status, take medication religiously complete her anti-TB medications and also not default on the ant-HIV medications which are currently taken for life. At the end of the chat, she smiled and asked for my contact details, in case she needed someone to talk to. The second was a woman again who said she was too scared to get tested for HIV after she had had multiple partners.
“I could not stomach taking an HIV test. I had lived on the fast lane, so I was scared of the results. However, I got ill when I was across the border on business and had to be hospitalised in South Africa where I got the wake up call,” she said.
She added that she was now feeling much better and should have taken the test before falling ill. The last one I talked to was a man in his 30s. He said that he was not surprised at all that he had HIV-TB co-infection. “I am not surprised at all. I only blame myself for not having used protection. I should have kept getting tested. I last got tested two years ago and tested HIV negative. I said to myself, if I am negative after such a spate of wild-living, I will remain negative. It is at that moment that I should have taken to the use of protection mother,” he said.
The chats showed me that all three people had heard the message, but somehow wished reality away one way or the other. As we approach World Aids Day which is globally commemorated on December 1, may we not lose focus of prevention. May we always remain safe. May we all get tested for HIV for a better tomorrow. According to CDC- Zimbabwe, TB is a public health problem which causes significant morbidity and mortality.
Zimbabwe is one of the eight countries in Africa designated by the World Health Organisation (WHO) as being ‘high burden’ for TB, TB/HIV co-infection and multi-drug resistant TB.