Maputo, 28 Nov (AIM) – The Italian NGO, the Sant’Egidio Community, has argued that Mozambique must pay attention to the quality of anti-retroviral therapy (ARVT) in order to ensure effectiveness in the fight against HIV/AIDS.

ARVT was introduced into Mozambique in 2002, and currently rather more than 200,000 HIV-positive Mozambicans are taking the life-prolonging anti-retroviral drugs

According to Paola Germano, Coordinator of the Santo’Egidio Community’s DREAM (Drug Resource Enhancement against AIDS and Malnutrition Project) programme, it is not enough simply to expand treatment – there must also be follow-up to see whether it is working or not.

Speaking to reporters in Maputo, she stressed that, while there are many people currently benefiting from the treatment, there are also others who have abandoned it for various reasons.

Among the causes for people dropping out of the treatment are the side effects of the anti-retroviral drugs, and the lack of an adequate diet to sustain the therapy.

“The great challenge in fighting HIV/AIDS in Mozambique is quality”, said Germano. “Many people start the treatment and then give up. A system must be organised that not only expands ARVT, but also includes accompanying patients to reduce the losses. We have to see whether the treatment given is having effects or not, so that we can act at once”.

The Mozambican health authorities recognise that the quality of the treatment is indispensable. To reduce the number of people abandoning treatment, last year the government introduced a food and nutrition kit for people taking ARVT.

A further challenge, Germano said, is to prevent vertical transmission – that is the transmission of the virus from mother to unborn baby during pregnancy. If Mozambique wants a generation free of HIV/AIDS, then it must invest in treating HIV-positive pregnant women, with the cocktail of three anti-retroviral drugs, and not just with nevirapine.

The three dugs are taken in a single pill, and this has proved effective and makes it possible to simplify treatment. It is being used to treat adults throughout the world.

By using the triple drug treatment (“tritherapy”) it is much more likely that a child born of an HIV-positive mother will be healthy and will not be carrying the virus.

However, in Mozambique the prevention of vertical transmission is done only through the use of nevirapine. This is the bare minimum, Germano said, adding that when nevirapine is taken just once, during childbirth, it does not produce the desired effects.

”Mozambique should be more ambitious in its efforts against HIV/AIDS, if it wants to have a generation free from this pandemic”, she stressed.

Also fundamental are sophisticated laboratories. Adequate use of ARVT depends on measuring the number of CD4 cells in the bloodstream, (these are the parts of the human immune system that HIV attacks) and measuring the viral load, to assess the progress, or retreat, of the virus.

But Mozambican health units have great difficulties in carrying out these tests – although now, thanks to the DREAM project, there are advanced molecular biology laboratories available which can carry out the sensitive tests required.

It is currently estimated that 11.2 per cent of the Mozambican population aged between 15 and 49 is HIV-positive. In absolute terms, about 1.6 million Mozambicans are infected.
(AIM)