HIV-positive patients to get ARV therapy for first time

Forty of the 504 people diagnosed with HIV/AIDS in Afghanistan will be provided with standard antiretroviral therapy for the first time, as efforts are made to boost control of the killer disease, the Ministry of Public Health (MoPH) has said.

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“We expect WHO [the World Health Organization] to have imported ARVs [antiretrovirals] by the end of January. We will give them to 40 already identified patients,” Saif ur-Rehman, head of the national HIV/AIDS programme at the MoPH, told IRIN.

“We have earmarked US$50,000 for the initial procurement and will allocate more in future,” Rehman said. The country is introducing the ARVs thanks to financial assistance from various donors. In addition to the 504 HIV-positive cases, a further 2,000-2,500 are suspected of carrying the virus nationwide.

The MoPH said the 40, who were selected on the basis of their HIV/AIDS status, needs and other criteria, will also receive guidance on how to use the drugs.

Three antiretroviral drugs will be used to suppress the virus and stop the progression of AIDS, according to WHO. “Huge reductions have been seen in death rates and suffering when use is made of a potent ARV regimen,” it said.

The drugs will be freely distributed - initially in Kabul and Herat provinces - and more patients could be entitled to them in future.

Dispensation will be determined in consultation with WHO and international NGOs. Health workers will be trained to supervise treatment.

ARVs are unaffordable for the vast majority of those with HIV/AIDS, health officials say. ARVs are not generally available, and it is difficult to determine - because of stigma surrounding the disease - whether people living with HIV/AIDS have access to ARVs via the private sector.

Afghanistan launched its national HIV/AIDS control programme in 2003 and has received pledges of over US$30 million from donors up to 2013.

Potential for HIV spread

Afghanistan is a relative latecomer in terms of introducing ARVs to fight HIV/AIDS. The number of formally registered cases is among the lowest in the world, but the potential for further HIV infections is there: armed conflict, lack of awareness of HIV/AIDS, lack of access to basic social services such as education and health, rising intravenous drug addiction, and the poor social status of women, experts say.

“We want to tackle the existing gap between real and suspected HIV cases by 2010 so as to draw up appropriate plans and implement relevant projects,” Rehman said.

Health workers said there was no room for complacency as the disease could spread quickly, as it has in some other poorly developed countries.

MoPH officials and aid workers note donor efforts but say limited technical capacity to make best use of the funds is “a major challenge”. Many are hoping the Joint UN Programme on HIV/AIDS (UNAIDS) will fill the national capacity building gap. UNAIDS plans to open an office in the country in 2009.