Scale up free and easy mass testing
Dec 05, 2008
TODAY is World AIDS Day but rather than celebrate achievements registered over the years, the Government and other stakeholders in the fight against the disease are dealing with yet another problem-complacency.
By Irene Nabusoba
TODAY is World AIDS Day but rather than celebrate achievements registered over the years, the Government and other stakeholders in the fight against the disease are dealing with yet another problem-complacency.
“People no longer look at HIV/AIDS as an immediate threat. The era of antiretroviral drugs and therapy has made people complacent. That is why recent findings are showing doubling infection rates, a shift in trends and negative behavioural patterns,†says James Kigozi, the communications officer of Uganda AIDS Commission.
He says, consequently, as the world marks the 20th anniversary of the annual World AIDS Day, policy makers are in an energised drive to get one million people tested in a campaign that started on November 26 and ends today.
Kigozi says they have signed up with the World AIDS Day 2008 Global Testing Campaign, in coalition with hundreds of global partners notably; non-governmental organisations, local and national governments, international relief agencies, faith-based organisations, civil society and the media.
It is organised by AIDS Healthcare Foundation (AHF), a US-based global organisation providing cutting-edge medicine and advocacy since 1987.
The organisation has embarked on a mass testing initiative to identify and treat the 25 million people who do not know they are infected. It is calling for one billion global tests annually, while advocating new mass testing models in the hope of eliminating older and more time-consuming methods.
In 1988, the World Health Organisation (WHO) declared the first World AIDS Day in an effort to raise awareness about HIV/AIDS, including the need for support and understanding of people living with it. The day also highlights the need for continued development of education and prevention initiatives.
Counselling and testing is the core of HIV treatment. We have committed ourselves to take it from here and test at least 1.2 million people annually,†Kigozi says.
The organisers urge global players in the fight against HIV/AIDS to embrace a variety of rapid testing modalities, group pre-test counselling models, and easy anti-retroviral treatment (ART) referrals because ART saves lives and prevents further transmission of HIV.
“The campaign will include data reporting as well as people sharing their success stories. This will be published on the website throughout the campaign.
The growing list of participating partners establishes a new testing coalition with a united voice to advocate accessible testing and treatment worldwide,†AHF says.
“With 33 million people living with HIV/AIDS and only three million on treatment, we have a global crisis that we cannot ignore. We have fought for universal access to treatment and made it a potential reality.
However, it is not possible until we take a step back and create universal access to free and easy HIV testing,†AHF argues.
It notes that with the vast majority of HIV-positive people unaware of their status, governments and stakeholders must unite to create innovative ways to quickly scale-up access to quality testing and treatment referral.
WHO estimates that 33 million people live with HIV/AIDS globally; 9.7 million of them in urgent need of lifesaving ART, yet less than three million are on ART and the majority of people living with HIV are unaware of their status.
In its 2008 Progress Report, the global health body says with the availability of treatment, however, the need to scale-up HIV testing and counselling is increasingly recognised both as a gateway to treatment and prevention and as a way to “normalise†and destigmatise HIV.â€
It urges member states to set higher daily/weekly/ monthly testing goals, seek new rapid test kit modalities and break out of the clinic as well as put up tents in communities to provide fast and easy testing.
“There is no one “right way†but we do know that we have to step up the pace. We have to think smarter, act faster and unite to scale-up free, safe and easy HIV testing,†the report reveals.
In Uganda, statistics show that an estimated 1.1 million people live with HIV/AIDS; 350,000 are in need of antiretroviral treatment to keep the virus under control; but only 150,000 are receiving the medicine, while the disease kills about 80,000 people annually.
However, while an estimated 135,000 Ugandans get infected every year, less than 20% of the population are aware of their sero status. Rakai district, the epicentre of HIV in the late 1990s, is now reportedly battling unabated rates of new infections.
This is a reflection of the national findings where prevalence, which had dropped to 6.2%, ranges between a worrying 6.4% to 6.7%.
Recent findings reveal increasing numbers of discordant couples and new infections among the married. “People have become complacent, especially marrieds who are increasingly engaging in adultery, yet they do not use condoms. Married men do not want to test once their wives test during antenatal care.
They assume that the results are the same. We did a study in seven districts and it showed that 64% of people who tested did not disclose their status to their partners,†Kigozi says. “Many test but they do not want to pick their results.â€
Dr. Zainabu Akol, the director of the AIDS Control Programme in the Ministry of Health regrets that 70% (about 15 million people) of Ugandans would like to know their HIV status but cannot access the services.
“The biggest challenges are lack of funds to enhance testing logistics and human resource. Close to $29m (sh52b) is needed to buy testing materials. We don’t have resources to meet the demand,†she says.
The policy says a counsellor should see six to 10 people a day, but about 300 people see only three counsellors. Consequently, competence is compromised with counsellors rushing the process in order to maximise coverage.
Akol also argues that the training facilities are inadequate. “Counselling, as a profession, requires one to study for a maximum of three years, yet here, some people are trained for five days or three weeks.
We are focusing on counselling for ART and positive living. We have no counselling for behaviour change,†she explains.
The ministry has embraced HIV testing for post-exposure prophylaxis and routine testing in clinical settings like family planning.
These approaches are designed to remove barriers to testing, imposed by the VCT approach.
She says the policy also provides improved guidance on testing for children and people with disabilities.
Need to change approach to HIV
“The traditional voluntary counselling and testing (VCT) model is ineffective to provide the volume of tests required to reach one billion people globally per year.
New testing models need to be embraced by NGOs and government health systems,†the AIDS Healthcare Foundation (AHF) says, recommending group pre-test counselling; routine and provider-initiated testing; one-minute testing with same day results; community-based and on-site testing as well as treatment referrals.
“We can no longer wait for people to take themselves to inaccessible VCT centres. We have to find ways to bring testing to the people,†AHF advises.
AHF says service providers should ensure that confidentiality is maintained, quality testing modalities utilised, safer sex and prevention information provided and support as well as treatment referrals immediately offered to positive clients.
“However, we must scale-up testing and knock down the barriers that are allowing preventable virus transmissions and deaths.â€
Facts on HIV/AIDS in Uganda since 1982
In 1982, the first AIDS case in Uganda was diagnosed. Prevalence was about 30%. Today, it is about 6.4%, up from 2002’s 6.2%
In 1987, the AIDS Control Programme was set up
In 1990, voluntary counselling and testing was started
In 2004, free antiretroviral drugs were availed
Sexual transmission is the commonest mode of infection followed by mother-to-child transmission
About 135,000 Ugandans are infected every year
1.1 million people are living with HIV/AIDS; 140,000 are children, accounting for 14% of new infections and 18% of the deaths
350,000 people are in need of antiretroviral treatment
150,000 are receiving ART
HIV/AIDS kills about 80,000 people annually
About half of Uganda’s 1.8 million orphans have lost one or both parents to AIDS
About 70,000 people were accessing ART by January 2006
In 2002, the Ministry of Health developed the first voluntary counselling and testing policy
Up to 38% of adults (seven million people) have accessed health-centred testing. A total of 70% of Ugandans voluntarily want to know their HIV status, but cannot access the services
Nearly 6% of Ugandans in sexual affairs are living in discordant relationships but they do not know their status
Male participation in prevention of mother-to-child-transmission is 5%
Mother-to-child-transmission accounts for 15% of infections and 95% of infections in children below two years
There are about 1.4 million pregnancies every year with 91,000 infected women. Many women get pregnant when they do not know their HIV status. Less than 20% of the population are aware of their sero status. Only 12% know their HIV status
A study done by the Uganda AIDS Commission in seven districts indicates that 64% of people who tested did not disclose their status to their partners
The 2007 budget for HIV programmes was sh60b
TODAY is World AIDS Day but rather than celebrate achievements registered over the years, the Government and other stakeholders in the fight against the disease are dealing with yet another problem-complacency.
“People no longer look at HIV/AIDS as an immediate threat. The era of antiretroviral drugs and therapy has made people complacent. That is why recent findings are showing doubling infection rates, a shift in trends and negative behavioural patterns,†says James Kigozi, the communications officer of Uganda AIDS Commission.
He says, consequently, as the world marks the 20th anniversary of the annual World AIDS Day, policy makers are in an energised drive to get one million people tested in a campaign that started on November 26 and ends today.
Kigozi says they have signed up with the World AIDS Day 2008 Global Testing Campaign, in coalition with hundreds of global partners notably; non-governmental organisations, local and national governments, international relief agencies, faith-based organisations, civil society and the media.
It is organised by AIDS Healthcare Foundation (AHF), a US-based global organisation providing cutting-edge medicine and advocacy since 1987.
The organisation has embarked on a mass testing initiative to identify and treat the 25 million people who do not know they are infected. It is calling for one billion global tests annually, while advocating new mass testing models in the hope of eliminating older and more time-consuming methods.
In 1988, the World Health Organisation (WHO) declared the first World AIDS Day in an effort to raise awareness about HIV/AIDS, including the need for support and understanding of people living with it. The day also highlights the need for continued development of education and prevention initiatives.
Counselling and testing is the core of HIV treatment. We have committed ourselves to take it from here and test at least 1.2 million people annually,†Kigozi says.
The organisers urge global players in the fight against HIV/AIDS to embrace a variety of rapid testing modalities, group pre-test counselling models, and easy anti-retroviral treatment (ART) referrals because ART saves lives and prevents further transmission of HIV.
“The campaign will include data reporting as well as people sharing their success stories. This will be published on the website throughout the campaign.
The growing list of participating partners establishes a new testing coalition with a united voice to advocate accessible testing and treatment worldwide,†AHF says.
“With 33 million people living with HIV/AIDS and only three million on treatment, we have a global crisis that we cannot ignore. We have fought for universal access to treatment and made it a potential reality.
However, it is not possible until we take a step back and create universal access to free and easy HIV testing,†AHF argues.
It notes that with the vast majority of HIV-positive people unaware of their status, governments and stakeholders must unite to create innovative ways to quickly scale-up access to quality testing and treatment referral.
WHO estimates that 33 million people live with HIV/AIDS globally; 9.7 million of them in urgent need of lifesaving ART, yet less than three million are on ART and the majority of people living with HIV are unaware of their status.
In its 2008 Progress Report, the global health body says with the availability of treatment, however, the need to scale-up HIV testing and counselling is increasingly recognised both as a gateway to treatment and prevention and as a way to “normalise†and destigmatise HIV.â€
It urges member states to set higher daily/weekly/ monthly testing goals, seek new rapid test kit modalities and break out of the clinic as well as put up tents in communities to provide fast and easy testing.
“There is no one “right way†but we do know that we have to step up the pace. We have to think smarter, act faster and unite to scale-up free, safe and easy HIV testing,†the report reveals.
In Uganda, statistics show that an estimated 1.1 million people live with HIV/AIDS; 350,000 are in need of antiretroviral treatment to keep the virus under control; but only 150,000 are receiving the medicine, while the disease kills about 80,000 people annually.
However, while an estimated 135,000 Ugandans get infected every year, less than 20% of the population are aware of their sero status. Rakai district, the epicentre of HIV in the late 1990s, is now reportedly battling unabated rates of new infections.
This is a reflection of the national findings where prevalence, which had dropped to 6.2%, ranges between a worrying 6.4% to 6.7%.
Recent findings reveal increasing numbers of discordant couples and new infections among the married. “People have become complacent, especially marrieds who are increasingly engaging in adultery, yet they do not use condoms. Married men do not want to test once their wives test during antenatal care.
They assume that the results are the same. We did a study in seven districts and it showed that 64% of people who tested did not disclose their status to their partners,†Kigozi says. “Many test but they do not want to pick their results.â€
Dr. Zainabu Akol, the director of the AIDS Control Programme in the Ministry of Health regrets that 70% (about 15 million people) of Ugandans would like to know their HIV status but cannot access the services.
“The biggest challenges are lack of funds to enhance testing logistics and human resource. Close to $29m (sh52b) is needed to buy testing materials. We don’t have resources to meet the demand,†she says.
The policy says a counsellor should see six to 10 people a day, but about 300 people see only three counsellors. Consequently, competence is compromised with counsellors rushing the process in order to maximise coverage.
Akol also argues that the training facilities are inadequate. “Counselling, as a profession, requires one to study for a maximum of three years, yet here, some people are trained for five days or three weeks.
We are focusing on counselling for ART and positive living. We have no counselling for behaviour change,†she explains.
The ministry has embraced HIV testing for post-exposure prophylaxis and routine testing in clinical settings like family planning.
These approaches are designed to remove barriers to testing, imposed by the VCT approach.
She says the policy also provides improved guidance on testing for children and people with disabilities.
Need to change approach to HIV
“The traditional voluntary counselling and testing (VCT) model is ineffective to provide the volume of tests required to reach one billion people globally per year.
New testing models need to be embraced by NGOs and government health systems,†the AIDS Healthcare Foundation (AHF) says, recommending group pre-test counselling; routine and provider-initiated testing; one-minute testing with same day results; community-based and on-site testing as well as treatment referrals.
“We can no longer wait for people to take themselves to inaccessible VCT centres. We have to find ways to bring testing to the people,†AHF advises.
AHF says service providers should ensure that confidentiality is maintained, quality testing modalities utilised, safer sex and prevention information provided and support as well as treatment referrals immediately offered to positive clients.
“However, we must scale-up testing and knock down the barriers that are allowing preventable virus transmissions and deaths.â€
Facts on HIV/AIDS in Uganda since 1982
In 1982, the first AIDS case in Uganda was diagnosed. Prevalence was about 30%. Today, it is about 6.4%, up from 2002’s 6.2%
In 1987, the AIDS Control Programme was set up
In 1990, voluntary counselling and testing was started
In 2004, free antiretroviral drugs were availed
Sexual transmission is the commonest mode of infection followed by mother-to-child transmission
About 135,000 Ugandans are infected every year
1.1 million people are living with HIV/AIDS; 140,000 are children, accounting for 14% of new infections and 18% of the deaths
350,000 people are in need of antiretroviral treatment
150,000 are receiving ART
HIV/AIDS kills about 80,000 people annually
About half of Uganda’s 1.8 million orphans have lost one or both parents to AIDS
About 70,000 people were accessing ART by January 2006
In 2002, the Ministry of Health developed the first voluntary counselling and testing policy
Up to 38% of adults (seven million people) have accessed health-centred testing. A total of 70% of Ugandans voluntarily want to know their HIV status, but cannot access the services
Nearly 6% of Ugandans in sexual affairs are living in discordant relationships but they do not know their status
Male participation in prevention of mother-to-child-transmission is 5%
Mother-to-child-transmission accounts for 15% of infections and 95% of infections in children below two years
There are about 1.4 million pregnancies every year with 91,000 infected women. Many women get pregnant when they do not know their HIV status. Less than 20% of the population are aware of their sero status. Only 12% know their HIV status
A study done by the Uganda AIDS Commission in seven districts indicates that 64% of people who tested did not disclose their status to their partners
The 2007 budget for HIV programmes was sh60b