ARV funding crisis threatens lives

Global health NGO Médecins Sans Frontières (MSF) has warned that a “dangerous shortfall” in donor support for ARV treatment in Zimbabwe will result in the loss of lives as well as undermine progress made in curbing the spread of HIV.

Thousands of people living with HIV in Zimbabwe will likely lose their lifesaving anti-retroviral treatments after donors cut back on support for the programme.

“In Zimbabwe, ARVs are not currently covered by the Health Transition Fund (HTF), which creates serious problems. Until end 2011, a pool of funds financed by the UK, Sweden, Norway, Ireland and Canada paid for ARVs,” MSF said in a statement.

“This year, the HTF, absorbed this pool, but purchasing ARVs was no longer part of its mandate. This means that some 66,000 patients already on treatment do not know where their ARVs will come from, to say nothing about people waiting to begin treatment.”

To deal with the funding crisis, health workers have proposed that patients try and finance their own treatments but MSF said this would lead to the loss of lives as well as undermine progress made in fighting HIV in the country.

“Passing the burden on to the patients themselves is not the answer. That would mean expecting people who are already vulnerable to pay for treatment that should be free; it also jeopardises the gains and results treatment programmes have made,” the statement added.

“Most people accessing ARVs in high-burden countries through government health care, as in Zimbabwe, are already impoverished because they have lost income due to the disease and are shouldering ancillary health care costs.

“The majority of patients in Zimbabwe and similar low-income countries often live below the poverty line and already struggle to pay costs related to care, be it for drugs to treat opportunistic infections.

“We know from experience that patients with unpredictable incomes may start rationing their ARV intake, taking less than the recommended dosages of pills in order to make drug supplies last longer.

“This leads to added complications, drug resistance and interrupted virus suppression—all of which would further increase the cost of care, wiping out any savings generated by the imposition of fees.”

MSF said Zimbabwe’s AIDS Levy was “an effective model that shows the country’s increasing commitment to generating domestic financing for HIV”, but added that international funding “is and will remain critical”.

“MSF urges donors to make sufficient funding available for free and effective HIV treatment to all who need it. Domestic resources must be augmented with consistent and continued international involvement,” the organization said.

“Only then can we curb the HIV epidemic in Zimbabwe and similar high-burden, low-income contexts.”