Missing the Target #5: Improving AIDS Drug Access ... - CD8 T cells

Linking nutrition and treatmentBy Wendi Losha Bernadette and Dr. Oliver Birnso VerbeCurrent situationBetween March and June 2007, the number of adults on ART in Cameroonincreased by nearly 25 percent, from 29,198 to 37,081 1 . That surge followed thegovernment’s declaration that ARVs would be dispensed free of charge to all inclinical need. The subsequent sharp rise in ART access indicates that provision offree ARVs plays an important role in scaling up ART uptake.However, despite recent improvements, more than half of those who need ARTin Cameroon have yet to start treatment. The situation was particularly dire forchildren. Just 1,360 children were on ART at the end of June 2007, a number thatrepresented about 13.7 percent of the 9,953 children considered eligible for ART.Cross-section by age of PLWHA on ARTAge 0-15 16-19 20-24 25-29 30-34 35-39 40-45 45 +% 3.7% 2.4% 7.9% 15.1% 20.2% 19.7% 15.3% 15.7%Source: National AIDS Control Committee’s Central Technical Group Report (June 2007)The main barriers to treatment access and uptake are the high cost of diagnostictests (about $42 per person on average for a CD4 count test, and $68 perperson for viral load analysis, for example); the lack of affordable and convenienttransportation to treatment centers; and lack of awareness about the availability offree ART or where to obtain it.Another persistent problem is that many patients start ART only after they becomeextremely ill. In such cases, ART should be accompanied by treatment for OIs orthe acute illness, and supplemented with adequate nutrition and treatment fordrug side effects, if necessary. Yet OI medications are costly and some patients gountreated if they cannot afford them. Nutritional support rarely exists, especiallyfor the poorest patients, and many health providers are not trained to manageor mitigate drug side effects and toxicity. As a result, the average survival rate ofindividuals on ART in Cameroon is just 12 months.1 National AIDS Control Committee Progress Report No. 7. August 2007.37