AIDS patients deprived of proper care

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The number of people living with HIV/AIDS is increasing in the country but they are not getting proper treatment as the lone Infectious Diseases Hospital (IDH) is yet to provide antiretroviral (ARV) therapy for these patients since it is very expensive.

The IDH is providing treatment guidelines for HIV/AIDS patients since 1989. But the government-owned Essential Drugs Company does not produce ARV, and it is not supplied to the IDH due to its high price, hospital sources said.

“A person living with HIV/AIDS needs antiretroviral worth Tk 6,000 to Tk 10,000 every month. But the hospital does not have any special funds for HIV/AIDS patients, and it is not possible for the hospital with its limited funds to spend the huge amount of money needed for them,” said infectious diseases specialist Dr Selimuzzaman of the IDH.

“We just provide them treatment for opportunistic infections that occur due to collapse of the immune system of HIV/AIDS patients although they need psychological and nutritional support, opportunistic infection management and antiretroviral therapy at a time,” he said. The IDH can provide around 50 percent of drugs required for AIDS patients, he added.

Non-government organisations (NGOs) working with people having HIV/AIDS however reported that patients get only 20-30 percent drugs for opportunistic infections, and no ARV, at the IDH.

“Worldwide there are 20 types of ARV for treatment of HIV/AIDS patients. But we can provide only four types of ARV to our patients with interrupted supply. And there are at least 100 registered patients who need ARV badly but we cannot provide it,” said Asma Parvin, programme manager of Ashar Alo Society (AAS).

“Antiretroviral drugs should be included in the essential drugs list,” said Lazeena Muna, social mobilisation and partnerships adviser of UNAIDS. An ARV drug policy is needed immediately for uninterrupted flow of these drugs, she stressed.

She pointed out that a draft ARV drug policy was crafted a few months ago with no further progress in this regard .

The IDH does not have even the machine for counting CD 4 cells that determine immune status of a HIV/AIDS patient.

Patients now have to go to the ICDDR,B for counting CD4 cells, spending Tk 2,500 each. The counting is essential to assess whether ARV is needed or not. If CD4 cells decrease to 200, it becomes urgent to treat such patients with ARV, experts said.

Sources noted that HIV/AIDS patients also find it difficult to have treatment at the public hospitals due to stigma.

Meanwhile, the National HIV and AIDS Communication Strategy 2005–2010 emphasised that all public hospitals should provide treatment to HIV/AIDS patients.

The National Strategic Plan has set the goal of ensuring that any one infected with HIV /AIDS has access to comprehensive systems of care, support and treatment by the year 2010.

Talking to The Daily Star, AAS authorities said that in December last year, an AIDS patient referred to the IDH was asked to go for surgery as he had developed gangrene due to arsenicosis. But it took three months for the patient to under surgery as no private clinics wanted to admit the patient.

When contacted, Professor of Virology at Bangabandhu Sheikh Mujib Medical University (BSMMU) Mohammad Nazrul Islam said the government should launch an anti-stigma programme concerning HIV/AIDS at health care centres. And it should start from the centres near voluntary counselling and testing centres as the diagnosis process begins there (testing centres).

Unless there are treatment support facilities near the counselling and testing centres, HIV/AIDS patients would be left in a more vulnerable position.

There are around 1,200 reported HIV/AIDS cases in the country and about 7,500, unreported cases, official sources said.

The Commission on AIDS in Asia in a report said, nearly five million people are living with HIV in Asia with 440, 000 people dying each year. An additional eight million people will be infected by 2020.

The death toll can be kept to less than 300,000 in 2020, saving the lives of more than 200,000 people each year.

Governments must establish and maintain systems that provide continuous and sustainable access to antiretroviral therapy for all who need it, by ensuring affordability, availability, accessibility and adherence, the commission said.

AIDS begins with HIV infection. People infected with HIV may have no symptoms for 10 years or longer, but they can still transmit the infection to others during this symptom-free period. But, if the infection is not detected and treated, the immune system gradually weakens, and AIDS develops.

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