Strengthening capacity for HIV/AIDS care

Consolath Muhaji discovered she was HIV positive fifteen years ago. She was infected by her husband Peter, who died from the disease in 1992 when he was 35 years old.

While studying at nursing college, one of their three daughters, Yustina, accidentally found out about her mother's illness.

"I didn't know what to do when I learned that my mother was infected. I was so upset and thought I would lose her at any moment. I don't know why, but I couldn't tell her that I knew. I always cried when I thought about how tough it would be to talk to her about it."

For five years Ms Muhaji, from Dar es Salam in the United Republic of Tanzania, kept the secret to herself. However, in 2005 she gained the courage to confront her mother, who had contracted tuberculosis twice due to her weakened condition and was relying solely on traditional medicines.

"There is a stigmatism surrounding the illness and that is why my mother didn't want to talk to anyone about it. She was ashamed of the disease and refused to take the drugs." 

Since then Ms Muhaji has convinced her mother that the treatment available is worthwhile and consequently her health has improved. Ms Muhaji believes that countries like Tanzania need increased medical presence and improved methods of HIV/AIDS treatment because many people are too scared to locate drugs and speak with doctors about their situation.

"It is important for medical personnel to get on the streets in towns and rural areas and make it easier for those suffering to approach them and get treatment. People also need to be educated about the drugs so that they can come forward and understand their benefits."

Ms Muhaji, 27, attended a workshop which was organised by the Commonwealth Medical Association in collaboration with the Commonwealth Secretariat on 'Strengthening Capacity for HIV/AIDS Treatment and Care in West and East Africa' as part of the Eighth Commonwealth Women's Affairs Ministers Meeting (8WAMM) in Kampala, Uganda in June 2007.

At the workshop, which addressed some of her concerns, Ms Muhaji was one of many who were shown the potential treatments available and the efforts being made to improve the delivery of drugs for patients like her mother.  

Dr Oheneba Owusu-Danso, Vice-President of the Commonwealth Medical Association for West Africa and co-ordinator of the workshop, believes that individuals like Consolath Muhaji "will come forward when they know that there is hope in terms of getting drugs and other supplies that will improve their health."

National Medical Associations (NMAs) from West and East Africa all met for the first time at the workshop and participated in talks on how to improve their ability to address HIV/AIDS care. The feedback, collated by Dr Owusu-Danso, suggests that the individual participants, who are health professionals working with HIV/AIDS patients, successfully revised their knowledge of treatment and care following the workshop. 

"The major challenge of delivering treatment is cost," says Dr Owusu-Danso. "For many countries, treatments are only supplied to between ten and thirty per cent of those people who need the drugs." 

This led to the National Medical Associations endorsement of the Commonwealth Medical Association Executive Committee agenda for the establishment of an Anti Retro-Viral Drugs Revolving Fund within the Commonwealth.

"We want to mirror what was done by Pan American Health Organisation (PAHO) in the Americas on the procurement of vaccines over twenty years ago for tuberculosis, measles and polio. This can be achieved. More supplies will be attained by pooling resources, which leads to better availability for patients that need the drugs most."

Dr Lydia Mungherera was responsible for discussing treatment from the perspective of civil society at the workshop. She is Chairman of the HIV/AIDS Committee of the Ugandan Medical Association and acts as a training and advocacy officer for The Aids Support Organisation (TASO). Dr Mungherera has been involved in HIV activism work since 1998, a year after discovering she was HIV positive. 

"One good thing to come out of me contracting the disease is that it has spurred me on to make as many people as possible understand HIV/AIDS."

A lack of access to treatment and ignorance regarding the correct information about HIV/AIDS are challenges that can be overcome, argues Dr Mungherera.

"We need to empower people with information on treatment and prevention. We must fight for universal access to treatment for all those in need. It is crucial to find a solution to gender inequalities and fight stigma and discrimination, which is still rampant in our communities."

A further concern relating to treatment, highlighted by Dr Melville George, the World Health Organisation representative in Uganda, is that there is a lack of trained staff in charge of the often complex treatment in some areas.

"Access to treatment is directly related to the number of doctors and other medical and nursing staff available. If you don't have a good staff mix, it is difficult to initiate the treatment," says Dr George, who believes that the solution lies in establishing trained teams who have the ability to manage the treatment.

Increased knowledge of treatment, competent medical staff and improved access to drugs all helped Consolath Muhaji, according to her daughter. However, Yustina is determined that ideas and initiatives such as those raised at the workshop continue in order to "make sure that drugs are available to every person with HIV/AIDS."

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