By Petronella Sibeene
WINDHOEK
In Namibia, a person living with HIV cannot start anti-retroviral treatment unless he/she has satisfied public hospitals’ entry criteria, one of which requires the patient to find a treatment supporter.
This requirement has, however, raised eyebrows among some observers who feel that it is tantamount to infringing on the patient’s right to confidentiality and access to treatment.
Minister of Health and Social Services, Dr Richard Kamwi, confirms that hospitals will always ask patients intending to go on anti-retroviral treatment to have a treatment supporter.
He defined a treatment supporter as someone who helps an HIV/AIDS patient to make their treatment a success. A treatment supporter is usually a family member, partner or friend above 18 and is enlightened about HIV/AIDS issues.
The role of a treatment supporter is to encourage abstinence or condom use, help the patient keep doctor’s appointments, remind the patient to take medication as required, tell the health worker about the problems that may affect treatment, ensure patient does not abuse alcohol or drugs, and contact home-based care givers when necessary.
Kamwi explained that the medication must be taken everyday for the rest of the patient’s life and this is easier to do with support at all levels.
The Minister was adamant that this requirement will always be needed to meet the entry criteria, otherwise the Government’s objective of prolonging life becomes futile.
“The objective is to prolong life and we are looking at a viable way of doing this. We encourage, by all means, that the client has a supporter because if they start the medication and then stop, their life is shortened,” he justified.
However, the HIV/Aids Law Unit at the Legal Assistance Centre feels it will be wrong to compel the person to first seek support from another, before receiving treatment. There could be reasons why a person does not have support, such as fear of stigmatisation, discrimination, exclusion and confidentiality.
Each and every case should be considered on the circumstances of the particular person. A blanket rule will violate people’s human rights to decide or determine for themselves on matters affecting their lives.
This in itself will hamper increased access to treatment, which will be disastrous for the entire national programme whose aim is to encourage treatment.
The Minister said considering that ARVs are a cocktail of drugs given to HIV infected persons to reduce the rate of replication of the virus in the body and thus prolong their lives, some patients stop taking their medication for various reasons.
Local media reports once highlighted that some of those infected and are on treatment stop taking their medication due to hunger.
“You must eat first, but what can you eat if there is no food? Sometimes, they are forced to skip their hospital appointment for medication – what is the use on an empty stomach?” asked a community-based counsellor who declined to be identified.
Kamwi said all member states of the World Health Organisation (WHO) apply this criterion.
The Minister further argues that the exercise is not a violation of human rights and is not discriminatory.
He reiterated that the Government aims to prolong lives. He said experience has shown that some patients fail to comply with the requirements or the need for taking their medication as some might consider it monotonous.
The UNAIDS Country Coordinator, Salvator Niyonzima, supported the Minister’s argument saying different countries have different strategies to ensure that patients adhere to treatment. This was introduced because many patients found it difficult to stick to the demanding treatment course, he added.
While Namibia demands for a treatment supporter, Niyonzima says other countries counsel patients and educate them on the importance of taking their medication.
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