Zambia Must Fulfill Promises to Children Living With AIDS

• by Brian Moonga (lusaka)
• Monday, November 29, 2010
• Inter Press Service

There are an estimated 85,000 HIV-positive children in Zambia who need these drugs to stay healthy; AIDS campaigners say the current treatment scheme through public health institutions is a fraction of what's needed.

Simon Mwewa, coordinator of paediatric treatment programmes at the Network of Zambian People Living with HIV, says much more needs be done to provide treatment to children under the age of 16. 'I think we still have a long way to go in terms of access to treatment for paediatric ARVs. There are about 2,000 children on ARV treatment [in Lusaka]; more than 5,000 children are infected. There is little information being given to the parents and the guardians of children living with HIV/AIDS on issues of treatment in relation to adults.'

One of the lucky few on anti-retroviral therapy is four-year-old Michael Mulenga. Diagnosed as HIV-positive within a few months of being born, his mother Karen Mwale, is grateful that he started treatment so early.

'The child takes a combination of three drugs, lamivudine, zidovudine and stavdine,' she says. 'He has been taking the drugs for the past three years. He is doing fine. Very active so far. He is growing like the other children.'

Mwale, a single mother, is fortunate to live just a stone's throw away from Lusaka's Kabwata Health Centre, which hosts a a specialist HIV treatment unit for children. But even at Kabwata, the drugs provided are adult tablets, which must be broken into pieces to get the appropriate dose for her son.

'It is not easy because when it’s time for the child to take the medicine, there are all those drugs they are supposed to be given. And for a child it's not something easy to swallow. If am not there to give the child the medicine, it’s not an easy thing for me to [be certain] that the people who are looking after the child will definitely give him the medicine.'

The lack of child-specific medicine is just one indicator of the unfulfilled need in the area of paediatric AIDS in Zambia.

'Most of the centres don’t have that facility to detect CD4 count for children,' says Mwewa. 'There are a lot of challenges looking at pediatric HIV treatment. Now imagine someone has got HIV and is not on treatment; obviously that person will eventually die, so there will be high mortality amongst children who are not on treatment. There is no proper adherence to treatment. Instead of a child getting a three month dosage, he is given one month - there is a danger of developing drug resistance.' Despite international commitments to achieve universal access to prevention of mother-to-child transmission by 2010, Felix Mwanza, the National Coordinator of the Lusaka-based Treatment Advocacy and Literacy Campaign, says progress towards this goal has been slow.

'The country now has reached a mark of 50 percent [coverage] yet the global rate agreed upon is 80 percent. The question is are we in that particular position to reach the target of 80 percent by the end of the campaign. That's a very big question mark, as far as we are concerned, because of a lot of bottlenecks: the lack of human resources, the lack of infrastructure and also the limited investment in the health sector.'

The National AIDS Council is hopeful that new programmes to reduce child AIDS cases will be successful.

'As a way of improving paediatric response in the area of HIV, government has strengthened the capacity of early infant diagnosis,' says the Council Chairperson, Bishop Joshua Banda.

Providing anti-retroviral therapy means that HIV-positive status is no longer a death sentence.

'The future of my child, it’s bright, because I see my child growing like any other normal child,' she says. 'He doesn’t have to miss school like the children I used to see. He is just like any other child who is suffering from asthma.'

But Mwale and her son will wrestle with a new set of challenges as Michael grows up.

'How am I going to tell the child that he is HIV positive? Because somehow I feel the child may start blaming me as a parent, that I gave him the virus... Why didn’t I give it to the other ones, only him?

'So that’s my main worry as the child is growing up: how is he going to accept his status and fuse it in with his daily activities, with the friends plus the peer pressure that is there? Because there are special precautions that he has to take as he grows up as an adolescent. All those are things that worry me as a parent.'

Of the estimated two million children under the age of 15 living with HIV and AIDS globally, 1.8 million of them are in sub-Saharan Africa. The Zambian Government intends to place all children in need of antiretroviral therapy on treatment by the end of 2010 in line with its National HIV/AIDS Strategic Framework on the road to meeting its millennium development goal number of halving child mortality by 2015.

© Inter Press Service (2010) — All Rights ReservedOriginal source: Inter Press Service

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