Africa-Press – Botswana. The Ministry of Health and its strategic partners are exploring varied means of improving delivery and accessibility of Anti Retro Viral (ARV) drugs.
Recently, President Dr Mokgweetsi Masisi received a certificate of appreciation from US President’s Emergency Plan for AIDS Relief (PEPFAR) in recognition of efforts in the HIV fight and surpassing the 95-95-95 global target set by UNAIDS to be achieved by 2025.
Currently, the number of people who have tested HIV positive stands at 95 per cent, 98 per cent are said to be adhering to the treatment and 98 per cent have their HIV viral load suppressed.
Elaborating Ministry of Health (MoH) strategies of availing and distributing ARVs, the ministry’s Public Relations Officer, Dr Christopher Nyanga said government was providing ARVs in almost all health facilities across the country.
He said the MoH together with its partners and civil society organisations, were currently exploring other service delivery models with the focus on patient-centred care.
He said the measures would among others include facilitating patients to receive the ARV medication wherever they wanted be it at home, workplace or opting for the current disposal point being at the health facility.
By so doing, Dr Nyanga said, patients could easily access ARVs within their localities.
“For stable patients, the Ministry of Health provides multi-month dispensing of two to three months. This means that patients do not have to be frequenting facilities in search of medicines,” he said.
Dr Nyanga said since December 2019 ARVs were provided free of charge to both citizens and non-citizens residing in Botswana.
He said about 655 clinics and health posts and 34 hospitals, including mine hospitals, across the country were dispensing ARVs.
“Almost all the private hospitals in the country provide ARVs especially for admitted patients. Some private clinics also do provide ARVs. The majority of private pharmacies also dispense ARVs across the country,” said Dr Nyanga.
He said the private sector was actively engaged in the provision of ARVs.
“As already indicated, some medical aids, mine hospitals, private hospitals, private clinics and private pharmacies dispense ARVs or facilitate patients to receive ARVs through prescriptions,” said Dr Nyanga.
To address cases of defaulting on medication, he said, there was continuous counseling for patients on ARVs at clinics by doctors and nurses, at pharmacies by pharmacy officers and also by social workers who work with Infectious Diseases Control Centres (IDCCs).
“Counseling is also conducted with every visit for consultation and medication dispensing. The treatment buddy system where a patient discloses to a family member or friend who will support them during treatment has also been useful.”
Dr Nyanga said this system reduced stigma and discrimination, thereby enhancing adherence. He said with PEPFAR support, the programme had engaged expert clients. He said these were people who were HIV positive and treatment experienced.
“They support other patients on treatment and help improve adherence. They also help bring back those who would have defaulted treatment. There is also ongoing health education to patients, the community and people living with HIV. Support groups are also involved in the education of patients about HIV and the importance of taking their medication,” said Dr Nyanga.
He said efforts were being made to improve ARV uptake. As such, he said two products used as injectable HIV medication had already been registered with the Botswana Medicines Regulatory Authority (BoMRA).
“The two products are CAB LA and Rilpivirine. Both CAB LA and Rilpivirine are used together for treatment while CAB LA is also used alone as an HIV prevention medication or Pre-Exposure Prophylaxis (PrEP),” he said.
However, Dr Nyanga said the logistics of bringing the injectable HIV drugs was currently delayed due to their shortage in the market.
Dr Nyanga also said the annual budget for ARVs and laboratory monitoring had been very high, going up to P700 million.
“It is important to note that laboratory monitoring is an essential part of the ARV treatment,” he said.
Fighting stigma was an important remedy in combating HIV, he added.
Therefore, Dr Nyanga said it was important to educate the public on facts and myths about HIV.
“The ministry has been active in this component. The ministry has also partnered with HIV support groups and the community which helps complement its public education activities,” he added.
Dr Nyanga said networks of people living with HIV were in existence across the country implementing the strategy of positive health dignity and prevention.
He said the strategy centered on HIV positive people to ensure that their dignity was maintained.
Additionally, Dr Nyanga said HIV champions were also engaged to eliminate stigma associated with HIV.
“These are people who have come out in public to speak about their HIV status. This helps allay the doubt and fear of others. Religious groups and traditional healers have also been engaged to support this cause”.
Currently, Dr Nyanga said there were 337 635 patients on ARVs.
“Of these numbers, 214 022 are females while 123 613 are males. So, there are more females living with HIV on ARVs than males,” he said.
In terms of age groupings, he said there were more people living with HIV and on ARV treatment who were 44 years old and above.
“In terms of the geography, there are some high-volume districts in the eastern corridor such as Gaborone, Francistown, Mahalapye, Kweneng East, Palapye and Kgatleng,” he said.
As it was the case with any other ailments, Dr Nyanga said an HIV positive person must adhere to a balanced health diet with lots of fruits and vegetables and avoid excess alcohol.
“They are also advised to stop smoking. Regular exercise is also recommended, depending on the condition of the patient. Some activities should be prescribed by health care workers in order to avoid patients causing harm to themselves with strenuous exercises,” he said.
He said it was important to note that a person infected with should be on ARVs and adhere to their treatment and get virally suppressed, to minimise the chance of passing the virus to others.
“By so doing, they will live healthier and more productive lives. This will help boost the economic performance of the country,” added Dr Nyanga.
For those who were negative, he said the aim was for them to stay negative, urging them to adhere to the ABCs of HIV prevention being abstinence, being faithful to one negative partner and using condoms correctly and consistently.
“There are now other biomedical interventions such as Pre-Exposure Prophylaxis and Post Exposure Prophylaxis, which can be provided at the health facilities. Furthermore, men are encouraged to get circumcised,” said Dr Nyanga.
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