ARVs make women lives safer

ARVs make women lives safer


Date: November 30, 2011
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Seven years ago when Mary Alividza’s doctor diagnosed her with HIV/AIDS, her living became a nightmare. One morning after an animated discussion with her husband about conceiving their second child, she left to see a doctor to attend to her recurring cough.

The doctor, among other things, requested an HIV test to help determine what was causing this cough. That is when she learnt about her HIV positive status. Immediately, her life and plans changed. She decided she was not going to conceive for fear of transmitting the virus to her unborn baby. This decision invited violent reaction from husband and relatives.

They demanded that she either give birth to more children or allow him marry another woman who was going to do so.

“I was subjected to verbal violence by relatives. Some even roughed me up, but I stood my ground,” recalls Alividza. “What they did not know were the reasons why I was refusing to conceive. My husband never defended me, hence the continuous violence.”

Alividza is just one of the many women living with HIV in Southern and Eastern Africa who have experienced gender based violence at the hands of their husbands, partners, and relatives for refusing to get pregnant. However, in the past couple of years, things have changed with the advent of new treatment options.

Statistics from various hospitals where an effective prevention of mother to child transmission programme is being run indicate that over 70% of children born by women living with are HIV negative.

“With the current technology and knowledge and good facilities, there is no need to deny a woman who wants to have a baby. Those times when doctors couldn’t give women living with HIV options are long-gone,” says Surendra Patel, an adjunct Professor at the Kenya’s University of Nairobi College of Biological and Physical Sciences.

While these outcomes are highly celebrated, another positive dimension of the improved access to ARVs and other technologies that has not received much attention is the reduction of violence against women.

Agnes* says that with the aid of antiretroviral drugs, she has managed to give birth to two HIV negative babies. “I feel I am normal like any other woman and my husband, relatives, and friends treat me the same. The most reassuring thing is giving birth to a negative child when you are HIV positive.”

She adds that before she could access these drugs, the violence she underwent at the hands of relatives was acute, though in her case her husband was very supportive.

“The support I got from my husband helped me go through it well. Only the two of us knew why we were delaying having babies, to gather enough resources to enable has use all interventions to protect the transmission to the baby.”

Surveys from around the world suggest that between 10 and 50% of women are victims of physical abuse by their intimate partners at some point in time during their lifetimes. HIV experts say included in this category are women living with HIV, with HIV being both a cause and consequence of their suffering.

What is however worrying is access to ARVs and other technologies that give women happiness and contribute to reduction of this gender based violence, is not assured. Major funders of Prevention of Mother to child Transmission, ARVs, and other HIV care programmes are either reducing or stopping funding. For example, the United Sates President’s Emergency Plan for AIDS Relief (PEPFAR), which supports many patients, the majority of them being women such as those attending PMTCT, has warned that in many of African countries, it is not going to increase current HIV/AIDS funding.

Take Kenya, a country that caters for women across Eastern Africa, PEPFAR has indicated that it is not going to increase funding for the next four years. There are concerns that even if PEPFAR agrees to continue funding HIV/AIDS programmes after 2014, when the current funding ends, the amount is likely to remain the same or be less.

The Clinton Health Access Initiative, the main funder for HIV treatment programmes for children, had indicated that it will stop any further procurement of paediatric ARVs by end of September 2011, according to Nascop’s Kenya Anti-Retroviral Drugs Stock Situation-December 2010. Official communication on the final closure of the funding is yet to be made public.

Global Fund on the other hand has been unable to realise its desired funding which might have adverse future implications on the funding extended to countries in Southern and Eastern Africa.

In October 2010 at the Fund’s Third Voluntary Replenishment meeting in New York, donor governments pledged US$11.7 billion for the years 2011-2013, but this was less than the US$13 billion ‘lowest funding level’ identified by the Fund as necessary to continue to expand its work and far less than the ‘ideal’ US$20 billion objective.

“As a result, expanding access to prevention, care and treatment programmes will be more difficult, and efficiency savings (such as providing money only to those countries that are seen as ‘the worst affected’) may have to be considered,” says AVERT, an HIV/AIDS Charity Organization based in the UK in its recent newsletter.

Countries in Southern and Eastern Africa with high HIV prevalence such as South Africa, Botswana, Lesotho, Malawi, Zambia, Kenya, and Tanzania, are likely to be hard hit by any reduction in donor funding.

The problem in many of these countries is the heavy reliance on external funding. “Using external funding to run HIV/AIDS programme may not be sustainable in the long-run. We need to start thinking more of how to use resources generated locally to finance these programmes,” Dr Ibrahim Mohamed, the Head of Kenya’s National Aids and STD Control Programme (Nascop).

Countries are now exploring several proposals, supported by UN agencies such as UNAIDS, on how to ensure sustainable HIV financing using locally generated resources. Establishment of an HIV and AIDS Trust Fund to which the government, donors, the private sector, and individuals will contribute, is one such proposal. Others include putting HIV solidarity levies on the air travel, mobile calls, internet usage, and remittances from the diaspora.

Studies have shown that if done well, levies such as this can raise huge sums of money. In Kenya, for instance, it was estimated that a modest levy of US$2.5for each air passenger ticket (international and domestic) along with US$0.05 levy on each ton of air freight would yield US$160 million without affecting the demand for such airline services.

If this sustainable financing mechanism are effected, the biggest gainers will be the women such as Alividza who have borne the brunt of the disease

Arthur Okwemba is a writer with the African Woman and Child Feature Service (AWCFS). This article is part of the GL Opinion and Commentary Service and AWCFS special series for the Sixteen Days of Activism on Gender Violence and COP 17 Conference.

 

 


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