5,000 more HIV-infected Jamaicans now need life-saving drug

XVIII International AIDS Conference in Vienna Austria

with Ingrid Brown

THE recently revised World Health Organisation (WHO) guidelines requiring HIV-infected persons to be placed on medication at an earlier stage of the disease will require an additional 5,000 more Jamaicans to be placed on the life-saving drug.

Dr Kevin Harvey, head of Jamaica's National HIV programme, told the Observer here in Vienna that the revised guidelines mean that instead of 10,000 there are 15,000 Jamaicans who will now be required to be placed on ARV.
Of this number only 7,000 persons are currently receiving treatment.

"This (new guidelines) means our coverage would drop from 75 per cent to 50 per cent, hence we have moved from nearly achieving universal access to being half-way there," he explained.

Prior to the revised guidelines persons were only placed on the drug when their CD cell count was 200 and below, but they are now required to take the drug when their CD cell count is at 350.

But with the need for persons to be placed on ARVs earlier, there is great disquiet among infected persons that inability to afford good nutrition will render the drug less effective and result in a shorter life span.

Once placed on ARVs, infected persons must take the drug for the rest of their lives.

According to Dr Harvey, the HIV programme provides small grants for income generation as well as small stipend for bus fares and lunch to those most in need and ready-to-use foods for children.

HIV-positive children need between 50 to 100 per cent more calories, compared to HIV-negative children, while adults need up to 30 per cent more calories as the disease progresses.

In light of this, head of the United Nations World Food Programme Martin Bloem is urging Governments, health care providers and other partners to include a good nutrition programme in the treatment of people living with HIV/AIDS in their respective countries.

"There is a growing body of evidence that food, and nutritional support are essential for keeping people living with HIV for longer and for improving the effectiveness of treatment," said Bloem.

"If people don't have access to food it is hard to take antiretroviral drugs and the risk of going off the treatment rises," he told the Observer.

He pointed out that among malnourished patients who start on ARVs the risk of death is two to six times higher, compared to those who are receiving proper nourishment.

Meanwhile, Dr Anthony Fauci of the United States Institute of Allergy and Infectious Disease said HIV needs to be addressed directly but also in the context of various other issues surrounding the disease such as lack of proper nutrition for infected persons.

"But we cannot say we will not address AIDS until we address these other problems and vice versa, so we have to address them both," he said.

Asked about placing persons on ARVs earlier than normal given the nutritional challenges, Fauci said malnourished infected persons do badly regardless of what stage they are placed on the life-saving drug.

Meanwhile, he insisted that countries need to also assign large budgets to purchasing ARVs and to ensure that they source cheaper and better drugs.