THE secretary general of the SADC Parliamentary Forum Dr Esau Chiviya has hailed the decision by Zimbabwe to adopt the single-tablet HIV dose, saying the country had shown leadership in the fight against the epidemic. New Zimbabwe.com recently reported on a decision by Zimbabwe to introduce the three-in-one ART tablet as the country fights to contain the HIV-AIDS scourge. According to the online publication, the new single-tablet dose is a combination of three drugs (Tenofovir/Lamivudine/Efavirenz TLE) and is a departure from the previous complicated treatment of three different tablets Tenofovir, Lovovidine and Nevirapine (TLN).
In a statement Chiviya lauded the initiative and said it also marked the beginning of more work for Zimbabwe, where approximately 1,5 million people - about 188 000 of these being children below the age of 15 - are reported to be living with HIV. "Despite well-documented challenges, Zimbabwe seems to be taking leadership in the war against HIV and AIDS in Southern Africa. The reported decision to introduce the three-in-one ART tablet can be viewed as a giant step towards removing barriers to effective treatment of HIV and AIDS," Chiviya said.
CHALLENGES GALORE
Chiviya said for Zimbabwe and many other countries working towards halting and reversing the HIV-AIDS epidemic, the challenge has been on how to keep patients on treatment for life and, specifically, on how to ensure that the patients can afford the treatment; that they can access medication and services and that they can religiously take the medication as prescribed to ensure efficacy under optimal conditions.
"The designers of these medicines require that they are taken at regular intervals, consistently and in the correct doses. Additionally, they require that the outcome of the medication or treatment be monitored continuously to ensure that parameters - either in the patient or the drugs - do not change."
He said this final requirement remained a major challenge on the African continent because even the physical realities under which the medications are taken vary tremendously from country to country.
"For much of Africa, these conditions are typically low resource settings in which affordability is an issue. On some parts of the continent, national health systems are weak and delivering drugs on a regular basis, sometimes for up to 50 years for any particular patient while ensuring that such an individual can remain on treatment and take it at the appropriate doses is not easy."
Experts say storage in the homes across the continent in which these drugs are administered should be done carefully if the drugs are to retain their potency and efficacy. This implies that parameters that include heat and moisture become important given that many of the drugs used to fight HIV and AIDS are designed outside the continent. Unless they are stored properly, they might not produce anticipated results. They may even lead to drug resistance.
Said Chiviya: "The patient must be committed, the health system must be able to deliver the medicines, the country must be able to afford it, and the doctors and other health practitioners must understand the conditions under which these medicines are administered. Yet these conditions can change, even when dealing with the same patient. For instance, the patient's standard of living may fluctuate and with it nutrition, necessitating certain changes to be introduced." He explained that adherence was a major factor in Africa because patients were prone to suffer from conditions for which they may require to take additional drugs.
"Often this is the reality for HIV patients in Africa. More than half of them would also succumb to TB and so they would have to deal with more tablets. The patient may also fall prey to a myriad of other so-called opportunistic infections. Understandably, but erroneously, in the fight against HIV-AIDS many people think of just the administration of drugs for HIV-AIDS when the reality is that often there are more drugs required in treating the patient."
SOURCE - allAfrica.com
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