Rising threat of NCDs could derail HIV response in Zimbabwe
By Vivian Mugarisi
While access to antiretroviral treatment for people living with HIV in Zimbabwe has seen many living longer and healthier lives, prolonged use of the medication has triggered a rise in non-communicable diseases (NCDs), experts have said.
More people living with HIV remain at risk of developing diabetes, cancer, hypertension among other common NCDs in the southern African country.
The World Health Organization reports that NCDs account for 74 percent of all deaths globally, with 15 million people dying prematurely are between the ages of 30-69.
About 85% of these premature deaths occur in low- and middle-income countries, and most countries in Sub-Saharan Africa where the most affected by HIV.
Zimbabwe’s health system remains ill-equipped to deal with the burden of communicable and NCDs.
“ART treatment is free, the other medicines are not, save for those who get resupplies from centres of comprehensive health care under sponsors. So someone may not afford the diabetes treatment if one is on insulin which costs US$36 or more a month,” Catherine Murombedzi, a journalist and Vice Chairperson for the Health Communicators Forum who is living with HIV since 2008 said.
Murombedzi added that drug interaction had become a challenge in the absence of necessary diagnostic equipment to monitor the long term effectiveness of all the drugs.
“I fear that one day I may get drug interactions resulting in treatment failure. I take ART, medication for hypertension and diabetes mellitus. So for me, every day is a blessing,” she added.
During a media tour of Glenview Clinic, Sally Mugabe Central Hospital and Parirenyatwa Group of Hospitals Opportunistic Infection (OI) Clinics, the notable increase in NCDs amongst people living with HIV in Zimbabwe were under spotlight as major challenges.
“The HIV response has matured and we have clients who are now getting old. They now need adult care, especially where NCDs are concerned looking at diseases such as diabetes, hypertension and some cancers,” Dr Stead Matokwe, OI Clinic Medical Officer at Sally Mugabe Hospital said.
At Parirenyatwa Group of Hospitals, Dr Pascal Shambira said the high costs associated with management of NCDs has led to low treatment outcomes despite ARVs being available for free.
“While antiretroviral treatment is for free, the treatment of these NCDS is not for free hence this is a challenge to most patients. The issue of access and affordability of treatment of these diseases now becomes a challenge and so you will see that some end up dying because they cannot access treatment,” Shambira said.
Parirenyatwa and Sally Mugabe Opportunistic Infection clinics had 5 620 and 4 700 patients by June 2022.
The two centres, supported by AHF, had reached 95 percent HIV viral load suppression, a major feat towards attainment of the UNAIDS global goals.
AHF is also supporting Glenview Clinic with comprehensive HIV care as part of efforts to reach global goal of ending AIDS by 2030.
Murombedzi said: “NCDs require funding. We could have domestic funding, nearly every family has a member or relative living with an NCD and that relief fund will go a long way to have those who don’t afford,” she notes.
Health and Child Care Deputy Minister John Mangwiro added that including NCDs in HIV programming would help the country’s fight against HIV in Zimbabwe.
“We know some antiretroviral drugs are linked to diabetes and diabetes is linked to cervical and breast cancer. While we incorporate NCDs in our HIV response, we also need our local scientists to research more on the links between HIV and some ailments such as diabetes, hypertension among others,” said Mangwiro.
Viviam Mugarisi is a communication specialist working with WHO