HEALTH-ZIMBABWE: Shady Dealings With Antiretrovirals

Ephraim Nsingo

HARARE, Dec 12 2008 (IPS) – The current political and economic crisis in Zimbabwe is dealing a blow to the provision of free treatment and care to people living with HIV/AIDS (PLWHAs).
While there has been a significant decline in the country s HIV prevalence rate from 18.1 percent in 2005 to 15.6 percent in 2007, activists believe this has been the most difficult year for HIV-positive persons.

It has become increasingly difficult for PLWHAs to access antiretroviral (ARV) drugs and treatment for opportunistic infections because a number of health institutions, including two of the main referral hospitals in Harare, have closed some of their units due to lack of resources. In addition, the mass exodus of health care workers, who have sought better working conditions and higher salaries overseas, has led to long queues in hospitals and clinics.

Otto Saki, acting director of the Zimbabwe Lawyers for Human Rights (ZLHR), said the plight of PLWHAs had been worsened by the deterioration of the political and economic situation in Zimbabwe.

We have recorded an increase in the cases of individuals failing to access ARV treatment. This is linked to the current collapse of the health delivery system and broader issues of governance, he said.

AIDS activists agree. We are facing a lot of challenges. The current situation has made it very difficult for most of our members, especially those in rural areas, to access treatment, said Sikhumbuzo Mvinjelwa, chairperson of the Zimbabwe National Network for People Living with HIV/AIDS (ZNNP+). [Apart from access to health care], the transport costs are so prohibitive that it is not possible for patients to travel to the nearest health centre to collect drugs. Most of them end up defaulting [from their treatment plan].
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Mvinjelwa told IPS that while international donors are still supplying ARVs to Zimbabwe, most of the drugs and other forms of financial support do not reach the intended beneficiaries those who are living with HIV. Much of the aid is diverted by health workers to PLWHAs who are not open about their status, he said.

Aid diverted

In Zimbabwe, free treatment is given only to PLWHAs who are registered with an Aids Service Organisation (ASO), through which ARVs are distributed. In times of economic crisis and financial hardships in the country, however, some health care workers have started to sell the drugs which are supposed to be free of charge to HIV-positive Zimbabweans who are still financially well off and not willing to disclose their status and register with an ASO. Other health carers pass on the drugs to unregistered, HIV-positive relatives and friends.

It is not all PLWHA who are open about their status. There are those who connive with health workers to divert drugs, Mvinjelwa told IPS.

One such case where money meant for free ARV treatment has been diverted has been documented in a current court case where Esther Mutero and 77 other PLWHAs accuse a military official, Tanaka Mutava, of embezzling aid of the Mashambanzou Care Unit in Harare, an ASO with which they tried to register to receive access to free treatment.

Mutero and the other complainants are all members of Takashinga, a support group at St. John s farm on the outskirts of Harare. In their affidavit, they say they have not received assistance for the last few months because Mutava hindered them from registering with Mashambanzou Care Unit.

They accuse Mutava of unilaterally and illegally hindering them from continuing to access the treatment in September by advising ASOs that the applicants belong to him . He allegedly told them they were covered under his Miriro Orphanage, another NGO based at St. John s farm, which is also run by Mutava. The complainants further claim he threatened officials from ASOs attempting to offer assistance.

Mutava, however, denies the charges, while officials were not able to comment on the matter until it has been dealt with in court.

Mutava s actions threaten the very lives of all the applicants who are living with HIV/AIDS and urgently require medication for opportunistic infections and food to complement the medication, states the affidavit. If applicants continue being prevented from obtaining food aid and medication, they will succumb to opportunistic infections and they will die.

Mutero and the other complainants also claim that Mutava, a soldier employed by the Zimbabwe National Army, was sourcing financial aid from local and international donors to assist PLWHAs, but that the money never reached the intended recipients.

Lives threatened

Justice Aids Trust (JAT) a Harare-based NGO that advocates for the rights of those infected and affected by HIV says Mutero s complaint is one of many. The organisation is dealing with a number of cases where persons have used community-based organisations as a front to source and then abuse donor money.

JAT provides free legal support services to HIV-positive persons and advocates for the formulation of policies, legal frameworks and legislation that facilitate HIV prevention efforts as well as care, treatment and support for PLWHA.

There are a lot of organisations [aimed at supporting PLWHAs in Zimbabwe], but the intended beneficiaries are not getting much services, said JAT projects lawyer, Portia Mabasa. Some have come to us to complain, but we have had problems with quite a number who are less privileged and cannot commute to the office or call. In such cases, we only get the details when we visit the areas or attend their support groups meetings.