How access to ARVs became a right in Rwanda

Assoumpta (second name withheld on request) tested HIV positive in 2002, when she was still single. She thought her life would end soon despite assurances given by medics who were her caregivers. When she was infected, there was no treatment for AIDs or therapy; people would wait to die in agony and stigma. At the time, it was not easy to even get an HIV test. It required waking up early and they would serve a maximum 20 people who arrived first, she said. “When society knew that you are HIV positive, no one would approach you again, even family members would abandon you. Anti-Retro Viral (ARV) drugs were like a dream to us, we didn’t think that one day we would have access to them,’ she narrated. The ARV programme began in 2003 but it didn’t immediately get to everyone. Luckily, she was among the first to access it, she said. “It was difficult to the extent that some people died and had no family member to bury them. We (the HIV positive) would organize ourselves to arrange funerals,” she said. After taking ARVs for a while, Assoumpta became healthy again and she has since gotten married to an HIV negative husband, and now they have healthy children, she said. “I feel sad when I see HIV positive people who don’t take their drugs seriously. The government spends a lot of money on them just to help us live longer. It is not like that before, many of us died because they didn’t find the chance we have today,” she said. In Rwanda, 94 per cent of infected people between the ages 15 and 49 years old take ARVs. Charles Ngendahimana, in charge of ARVs service in Nyamata Hospital in Bugesera District said once people test positive, they immediately start to follow up on their lives to monitor the viral load in order to put them on treatment and ARVs immediately. He said that others are necessitated to undergo counselling immediately they test positive before they start on ARVs. “We have people taking drugs once in three months and others who are given drugs for the whole month. It depends on their viral load during two consecutive years. If a person gets results of 20 viruses in a drop of blood they are put under the three-month programme,” Ngendahimana said. It also depends on their discipline to respect hospital appointments. If they behave well, they are put on a three-month program. But rebellious characters such as some adolescents and those who consume a lot of alcohol among others; they have to be present at the health centres every month or even earlier, he said. 62% in Nyamata hospital are on the three-month programme. Statistics from Rwanda Biomedical Centre show that at least 10,000 people get new infections in Rwanda, while 5,000 of the HIV positive die every year. In 2005, HIV and AIDS was the cause of most deaths but according to latest statistics from the Institute for Health Metrics and Evaluation, it is now in fourth position with morbidity reducing by a significant 77.9 per cent in 2016. Ernest Aimée Nyirinkindi in charge of Behaviour Change and Communication at RBC said Rwanda wants to achieve a target of zero new infections, zero stigma and reduce the percentage of HIV infected persons. “Strategies set to fight against new infections have been successful but we are making all efforts to reduce it to even lower percentage,” he said. Meeting the cost Nyirinkindi said Rwanda has to pay a big price to save its people from HIV and AIDS. Since the beginning, there is set of tests conducted to see the health status of an HIV and AIDS patients taking ARVs, regular tests and consultation to monitor the health status and viral load which are free of charge for them but costly for the country, he said. There are also other tests to see how various organs including the liver are functioning. In last years, they used to send some tests in Europe because Rwanda had no capacity to do them. “Now in Rwanda, we have the best pill available in the world which is a concoction of three drugs taken once a day. Just one pill costs around rfw180,000. The government of Rwanda has a role to play in paying for that pill, and the funders also have their part. We are working toward fully paying for these drugs, and allow people to get ARVs from the hospitals using insurance cards like they pay other drugs,” he said. However, when patients don’t take their ARVs adequately, the viruses become resistant to the drug and they fail to cure. Such people, he said, have to be put on the second line which is more powerful and more expensive than the first. editorial@newtimes.co.rw

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How access to ARVs became a right in Rwanda