More people get ARVs, but distance can be a big challenge

I’ve already posted on the theme of drug or treatment access (here and here), but so far we’ve only looked at part of the story.  Two recent articles provide a good intro to another issue: people who can afford the HIV/AIDS medicine they need may still they have to travel a long, long way to get it.  Needless to say, this is hardly a helpful situation, especially for people who are caring for sick loved ones, are sick themselves, or both.

1.  This article from IRIN/PlusNews tells the story of Khuda Mutchato, a Zimbabwean woman who “has to regularly cross a chain of mountains into Mozambique to improve her chances of survival.” 

2.  This article from the Rwanda News Agency reports that many Rwandan HIV/AIDS patients have to travel long distances within the country to reach ARV distribution sites.  One of these people is a very ill 45-year-old woman named Daphroza, who has to walk for one whole day to get a 15-day supply of ARVs.

Click the links above to access the articles, or keep reading this post for more summary.

(1.)  According to IRIN/PlusNews, in Zimbabwe “only about 100,000 of the estimated 321,000 people in need of ARVs are receiving them through the public health sector.”  It is estimated that over 100 Zimbabweans in need of AIDS medication are surreptitiously picking up their ARVs in Mozambique, where “about 100,000 HIV-positive patients are currently getting free ARV treatment.”  (In a bit of unqualified good news, this number is up from only 7,000 in 2005.)

Health officials in Manica – the region of Mozambique that Mutchato and others are travelling to – say that although the influx of patients is a strain on already limited resources, they are committed to providing treatment to the Zimbabweans who come to them for help.

(2.)  Daphroza is one of “up to 73 HIV positive patients” in “varying conditions” who have to walk a distance that would take two hours by car “to have their bi-monthly dose of ARVs.”  According to Dr. Jules Mugabo, the leader of a “government and donor funded agency” in charge of ARV distribution, health officials are well aware of the problems rural Rwandans have in getting their medicine, but they are already doing all they can to extend accessibility with the resources they have.

According to the article, over 53,000 Rwandans – including 5,000 children – currently on ARV treatment.  This is up from a mere 800 or so who were on ARVs between 1999 and 2003.  According to Dr. Mugabo, medical infrastructure has expanded rapidly to facilitate this massive growth (“from just four main provincial hospitals in 1999 to about 143 health centers currently”), but “limited resources […] do not permit the expansion of the program to the ‘door steps of all the patients’. ”  He is optimistic that within “the next two to three years […]  patients should be having their doses from meters away.”  But as the author of the article points out, that may be too late for people like Daphroza.


In looking at these stories, I’m struck by the irony of the situations.  In a sense, these are problems created by successes.  The number of people able to take ARVs has exploded in both Mozambique and Rwanda.  Now health workers are facing the logistical difficulties of actually getting the medicine to all these people.  If you think about it, it makes perfect sense.  Nonetheless, it’s clearly a very serious problem.  I suppose it illustrates the need for cooperation among people working on various aspects of AIDS work, and even various aspects of providing treatment.  I’m thinking that people like Dr. Mugabo could use our prayers as they try to keep up with these sorts of rapid developments.


~ by h.e.g. on July 3, 2008.

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