Bukavu-Goma - The medical relief organization Médecins Sans Frontières (MSF) has begun providing free treatment with antiretroviral drugs (ARVs) to HIV/AIDS patients in Bukavu. In the war-afflicted east of the Democratic Republic of Congo, where people are more used to people dying of HIV/AIDS than living with it and local health structures have no capacity to provide ARVs, this initiative marks an important step in the fight against HIV/AIDS.
Today, seven patients in the MSF HIV/AIDS project started treatment with the life-prolonging anti-retroviral drugs which offer patients the possibility to regain their health, to live as normally as possible, to work, and take care of their families again.
"In African settings, it has been unthinkable that someone with HIV could survive, let alone live a normal life," explains Corry Kik, MSF project coordinator in Bukavu. "With ARVs this becomes a possibility. We hope ARV treatment will firstly have a huge effect on the lives of individuals, but also on the way people with HIV/AIDS are treated in the community." Taking ARVs does present significant challenges to the patients in this environment.
Besides taking daily medication, patients also need to have regular blood tests, regular medical checks and learn to cope with the side effects of ARVs. "Patients also need to understand that they have to take pills for the rest of their lives, even when they don't feel ill - a concept that is not always easy to absorb in a setting where most diseases are either cured or (they) kill," said Kik.
Adherence is, however, crucial if resistance is to be prevented and patient education is almost as important a component in the new programme as the drugs themselves. No accurate seroprevalence studies have yet been done in the region, but the HIV positive rate based on attendance at the MSF Voluntary Counselling and Testing Centre for the year 2003 is 17%.
The individuals starting today have been selected from over 180 patients. Selection criteria include the need for each patient to have the support of one other individual to whom they have revealed their status, residence in Bukavu, and a demonstrated ability to adhere to the clinic appointments and prophylactic medications. With an enrolment of 10 patients per month, the MSF team aims to have 150 patients on ARV treatment by January 2005.
ARV treatment is the most recent step in the MSF project which also includes voluntary testing and counselling, treatment for opportunistic infections and sexually transmitted diseases, home-based care and nutritional and psycho-social support. In DRC, the second MSF ARV treatment programme will be open in the HIV/AIDS project in Kinshasa before the end of this month. By the end of 2005, the objective is to be treating 800.
MSF is already providing ARV treatment in several other African countries.