Dar es Salaam. The demand for antiretroviral therapy (ART) in the country will now more than double after the World Health Organisation reckoned Tanzania and other countries to urgently scale up the number of people eligible for the life-long medications, ARVs.
With its new “treat-all” recommendations announced on Wednesday, the World Health Agency has now removed all the limitations in accessing ARVs for anyone found with the virus.
‘’All HIV positive patients should be put on an antiretroviral therapy of three drugs immediately after diagnosis,’’ the agency said.
This means that all the 1.4 million people currently living with HIV/Aids in Tanzania—and those who will be diagnosed with the virus today and in the days to come—must be put on ARVs immediately--contrary to the current government’s plans.
According to the current HIV/Malaria Indicator Survey, some 432, 542 people are receiving ARVs in Tanzania. The WHO now wants the number of people on the ARVs globally to increase from 28 to 37 million.
The move is likely to put Tanzania into another ARV crisis if the health ministry adopts the guidelines because the supply of the medications is largely donor-dependent--with the government investing less in raising domestic resources for health.
However, in July this year, a report by the health advocacy NGO Sikika blamed the recent shortage of ARVs in the country on the contradictory perceptions between policy makers in government and the donors.
While donors blamed weak government systems, the government blamed the funding model employed by the donors, noted the report.
Efforts by The Citizen to reach the Ministry of Health officials yesterday to comment on the matter did not bear any fruit but recently, the government has been looking into ways of mobilising domestic resources for funding HIV programmes after donor agencies began walking out.
Most African countries that highly depend on donors for the medications, have been using the CD4 count of 500 as the cut-off point for starting HIV patients on ARVs, and this is WHO’s old recommendation.
However, Tanzania has been relying on even an older version of WHO guidelines—whereby people are being put on Antiretroviral Treatment when their health has somehow deteriorated, with CD4 count of 350, as the cut-off point. Even though the government has substantially raised the number of people on ARVs over the years, experts warn that the new target is ambitious and the government will struggle to rise to the occasion.
An independent researcher on HIV/Aids policy and planning in Tanzania, Dr Raphael Kalinga, told The Citizen yesterday that if Tanzania adopted the new recommendations, it means that the country now needed to invest hugely to ensure that the drugs are available.
‘’If Tanzania adopts the guidelines it means the coverage for people with ARVs will be great,’’ said Dr Kalinga. But, he queried, ‘’Will it make sense economically? ‘’And, is it feasible in such countries like Tanzania, where access to ARVs is caused by financial hurdles?’’ remarked the researcher.
Almost USD 22 billion is currently spent on AIDS in poor and middle-income countries, according to UNAIDS. Half of it is contributed by donors, says the agency. Even before these new guidelines, the cost was predicted to rise to UDS32 billion by 2020.