Alliance Zambia welcomes the Zambian government's commitment to provide free anti-retroviral treatment
31 August 2005
The Government of Zambia announced in July that all Zambian health facilities will begin to provide free anti-retroviral treatment, a move welcomed by Alliance Zambia but which it also called long overdue. "People in Zambia understand the value of treatment, and more hospitals are able to provide treatment," Dr Tito Fachi, Alliance Zambia’s Country Office Director explained, "but to date many have been unable to raise the 40,000 Zambian Kwacha needed to pay for treatment."
Alliance Zambia has identified a number of immediate opportunities and challenges for both the government and the Alliance in light of the Zambian government’s announcement:
Sustainability
The Zambian government’s policy demonstrates the government’s political will and Alliance Zambia hopes that it also will prove sustainable. To be sustainable, the government must put in place measures to ensure a continuous supply of medicines throughout the country. (There is already a wide shortage of CD4 reagents, testing kits and storage facilities.) Input is required from all relevant ministries on supply, logistics, information dissemination and administration to ensure that the drugs are procured and transported, and that people have the correct information.
The cost of providing anti-retroviral medicines (ARVs) should be shared equally among all stakeholders and must be included in their budgets next year. The incremental per capita expenditure on health makes good economic sense as it concerns national development. The government must also take full advantage of Zambia’s debt relief to direct resources towards the procurement and administration of ARVs.
Equal access
The government needs to ensure that ARVs are accessed by people in both rural and urban areas. Vulnerable groups should be targeted in particular. Support for orphans and vulnerable children must be scaled-up, as they represent Zambia’s future, and are most in need of health, shelter, education and nutrition.
Nutrition
The government needs to recognise that nutrition is a key component of anti-retroviral treatment; the government should consider nutritional support for people on treatment who cannot afford it. Dr Cynthia Bowa, Anti-retroviral Community Education and Referral Project Manager, confirms that the ACER project has lobbied the government to provide nutritional support and income-generation information to people on treatment and to their carers. A partner’s meeting was held earlier this year, attended by the government’s Director of Health Policy, where the issues of treatment and nutrition were advocated.
Human resources
“Investment into humanity cannot be a lost cause!” said Dr Tito Fachi, Alliance Zambia’s Country Office Director.
The Alliance welcomes President Mwanawasa’s announcement that the government is exploring ways of retaining health personnel. This is a considerable challenge, and Alliance Zambia hopes that the government can confirm that health institutes can absorb the new demands for treatment, care and support that will follow the government's announcement.
The challenge for the Alliance
Willys Simfukwe, Alliance Zambia’s Programmes Director, says that the Alliance must now be clear about how its programmes will adapt to this new context; “We need to analyse the Alliance’s role in monitoring access, resources, nutrition and other aspects related to treatment,” he said. The Alliance needs to work strategically with local non-governmental and community-based organisations to ensure that provision of free ARVs will be sustainable at community level and to explore new ways of monitoring and programme delivery.
