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Winning the fight against HIV/AIDS

 The Big Issue Malawi 11 July 2019

Malawi has over 1 million people living with HIV. But the country’s efforts to curb increasing HIV and AIDS infection seems to be working. (1185 Words) - By Constance Msosa

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BI malawi_The fight against HIV

An AIDS patient shows her anti-retroviral (ARV) medication at the Tapologo hospice in Rustenburg, South Africa. Photo: REUTERS/Siphiwe Sibeko

Recent statistics show that infection rates which were over 14 per cent have slowed to about 12 per cent. This progress is attributed to multisectoral approach where all people engaged in the HIV and AIDS fight are working together to provide education and treatment.

The government has shown commitment to bringing life prolonging drugs closer to the people. It is currently discussing with a drug manufacturer over the establishment of a factory to produce anti-retroviral drugs (ARVs) in the country.

President Bingu Wa Mutharika first made the announcement at the height of the campaign, two years ago. Such a time span is a long one in politics, and this announcement could simply have been dismissed as campaign rhetoric.

However, the Vice President, Joyce Banda, garantees the plans are still on. "Government is committed to setting up the factory [to] manufacture the important drugs," she said.

Banda told a gathering of people living with the virus that the planned factory will make it possible to get these life prolonging anti-retroviral drugs to the people who need them.

The country has over 300,000 people who are on anti-retroviral drugs. The Health Ministry has set targets to reach about 500,000 within the next few years.

National Association of people Living with HIV and Aids in Malawi (NAPHAM), which last year celebrated 17 years of its existence, is at the forefront of lobbying government to do more to help people living with the virus.

NAPHAM believes government can do more by increasing budgetary allocation to health institutions so that drugs can be available to those who require them.

"Stigmatization and lack of access to drugs are the major problems facing people living with the virus," says Adam Phiri, a member of NAPHAM in Zomba.

He says many people, especially in the rural areas like in his home district of Zomba, die without getting the crucial drugs. Some health institutions do not stock the drugs.

People who are already weak are forced to walk long distances to access them. "A sick person, often with no access to food, has to travel long distances to get the drugs every month," he says.

"Most do not recover, and death is still common, just as it was before 2003 when they began to be prescribed." Government acknowledges that access to the drugs has been a problem due to logistical problems, a lack of CD4 count machines and the cost of the

drugs.

Dr Mary Shawa, the Principal Secretary for the Department of HIV,AIDS and Nutrition, says that alongside government efforts, health stakeholders and donors are working to reach as many people as possible.

However, Don Mbewe, 39, who lives near Lake Chilwa in Zomba, the former capital of Malawi, does not seem to see any improvement.

"I travel to the town about 30km every month to collect my drugs. I used to receive some food supplements every time I went there but this has stopped."

Mbewe, who operates a small business, admits that his health has improved, but he is concerned about some people who live with the virus and have problems finding food.

"The problem is that some of the people begin the programme when their health has deteriorated. Often they do not go to the hospital in time and are only diagnosed when they are in bad shape." he says.

The major obstacle to getting people tested is the stigma that is still attached to the disease in the rural areas of the country.

An official from the Ministry of Health agrees that such food supplements are not readily available to all the people who are on an ARV programme because of the increased number of people now accessing the drugs. He notes that the awareness campaign on proper eating habits has also improved the lives of people living with the virus and most of them are able to source good food on their own.

"Most of the people on the drugs have their lives improved. They can work and earn a living. We don't want to create dependency in the people," says the official.

Village headman Edward, in Chief Chikowi`s area in the same district of Zomba, says: "People view those living with the virus with suspicion. People can refuse a hand shake from a known carrier of HIV and AIDS."

The local leader says people are still reluctant to come out and accept that

HIV and AIDS is just like any other disease.

"There is change of course. A few years ago, few people would attend a funeral of a person known to have died of AIDS. That has changed as people now know the causes of the disease.

It is the sexual aspect of transmission that is causing problems. People living with the virus are regarded as immoral. People are quick to view HIV and AIDS as a punishment for immorality," he adds.

NAPHAM, which was formed in 1993 by one of the first women to declare their status, late Winnie Chikafumbwa, has helped to change public altitude about HIV and AIDS.

She declared her status at the time when anyone with the problem was condemned.

NAPHAM slowly grew and now has over 28,000 members - about 70 per cent of whom are women.

Annie Kalinda, a Blantyre-based business lady and mother of four, was divorced by her husband when she was diagnosed with the virus.

"It's terrible to be told that you are HIV positive," she says. "You need someone to be near you and convince you there is life after a test. The genuine counseling comes from peers. Members of NAPHAM act like a big brother. There is genuine love and fellowship. You know you are not alone, and besides, you know you can live naturally."

After her diagnosis, Annie briefly lived with relatives, but it was when she joined NAPHAM that she started a new life. She got trained in basic skills and started a business from a small loan. Today she is able to feed her children and live a normal life.

"I get scared of what will happen if the drugs run out. It`s like removing the life support machine from a patient. I believe the drugs have changed lives, and without them our country will suffer," she says.

Annie views the government's determination to open a factory as a critical move. "We have too many people out there who need the drugs," she says. "A factory will increase access and that's brilliant."

She believes that NAPHAM and other related organisations have helped to reduce the stigma of the disease, but admits there is a long way to go.

"After many years only 28,000 people are members of the organisation and two-thirds of them are women. Where are the men? These are the challenges we face in changing attitudes towards the scourge," she says.

Annie believes that if many people get to know their status, stigmatization will reduce and eventually disappear.

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