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With only three days left to commemorate this year’s World Aids Day, experts in HIV treatment say the provision of ARVs to all HIV-positive individuals can greatly reduce new HIV infections and accelerate the country’s efforts in achieving the 90-90-90 global targets in HIV/Aids control.
Tanzania’s current vision is part of the UNAids 90-90-90 targets that entails diagnosing 90 per cent of people, who are HIV infected putting 90 per cent of them on ARVs so that the virus is suppressed in 90 per cent of all the HIV-positive individuals by the year 2020.
In the wake of a decision by Tanzania Commission for Aids (TACAIDS) to unveil atestand treat projectwith the aim of providing ARVs to all People Living with HIV (PLWH), regardless of their CD4 count, experts who spoke to The Citizen were generally upbeat about the new approach, but were skeptical about the country’s financial capacity in the reaching the targets. Of concern, were also people’s readiness to accept testing and the being immediately put on the ARVs upon testing. Dr Pendael Paul, a medical doctor, who participated in the formulation of the guidelines on the test and treat, believes that the new approach is a game changer but it requires sustainable funding.
« The decision (to adopt the test and treat) was reached after the country failed (in some of the indicators) for the 90-90-90 targets, » he said.
« This approach can help in reducing the new infections but I am worried about sustainable funding because the ARVs are funded by donor agencies. What happens when they pull out? » he queried.
In this year’s study: Opportunities and Challenges for ‘Test-and-Treat’: Insights from eastern and southern Africa, researchers from Europe and Africaincluding Tanzania, noted that country programmes implementing the ‘test-and-treat’ must also consider shaping people’s readiness and motivation to test for HIV and accepting treatment.
Findings published in the Alpha Network, a site for analysing Longitudinal Population-based HIV/Aids data on Africa, warned of potential new challenges emerging from the success of the test and treat approach.
The HIV/Aids Care and Treatment Centre (CTC) manager at Amana Regional Hospital in Dar es Salaam, Dr Shanny Mwaluko, said that efforts to put everyone on ARVs may have to surmount barriers, especially when individuals have their personal biases and attitudes towards HIV treatment.
« When a person is found HIV-positive, he/she is supposed to be put on ARVs within 14 days, but, many people usually ask to be given more time to think about it, citing preparedness, » said Dr Mwaluko in an interview with The Citizen.
Currently, there are estimated 36.7 million HIV-positive people across the globe. If the universal testing and treating goal is achieved, recent UNAids reports show that over 33.2 million of these people would be diagnosed, 29.5 million would be on antiretroviral and 26.9 million of them would have viral suppression.
According to TACAIDS, the rate of new HIV infections in Tanzania is 0.36 percent, meaning that out of every 1000 people around 32 become newly infected each. The commission’s target is to reach zero new infections with the adoption of various new approaches for intervention.