Up-Country Insight: Children need access to ARVs

SOUTHERN PROVINCE Government’s effort in combating HIV/Aids is commendable. Through various organisations like Global Fund, people living with the virus, especially the adults have access to free antiretroviral drugs. However, there is a group of innocent victims of the disease, children born with HIV, whose plight has not been given enough attention. Children with HIV/Aids are dying prematurely because of lack of access to ARVs. The problems arise mainly from lack of cheap feasible diagnostic tests for children under 18 months, lack of trained health personnel and the affordable child-friendly ARV drugs. Recently in Nyamagabe district, the Mayor Alphonse Munyantwali revealed that out of 1000 infected children eligible to start treatment, only 350 were doing so. This means the 650 are left to die early because no one has taken care of them. Unlike adults, the treatment of children living with HIV/AIDS poses serious challenges to developing Countries like Rwanda. The Global market for Children’s Aids drug formulations is not attractive for pharmaceutical Companies; mainly because in developed countries very few children are born with the virus. And in developing countries where we find many cases of children infected with HIV, their treatment is not considered a priority. Treatment for children is often beyond the reach of many families, the cost of treating one child is said to be six times more than the recommended dose for an adult. Experts say there has been a break-through in developing fixed dose combinations of ARVs that require only one or two pills twice a day to simplify the treatment in adults, but development of simplified drugs for children lags behind. For Countries like Rwanda, the only way to combat this problem is through prevention. Efforts should be put in the prevention of mother to child transmission (PMTCT). For this to succeed, expectant mothers should be encouraged to go for antenatal check ups and produce from health centers in order to give birth to HIV free children. Going by statistics from districts’ performance contracts, there is still a along way to go. For example in all 8 districts of the Southern Province, more than 70 percent of live birth was outside health centers, according to last years’ evaluation. This increases the risk of infected mothers passing on the virus to their children at birth because of the lack of medical expertise. There is also the need to increase the number of qualified medical personnel in district hospitals and offer more training to all birth attendants to expertly handle such cases. Another problem highlighted at a public debate on children’s rights held in Nyamagabe district recently was that of stigma. Children living with the virus are discriminated in families. The fact that many of them are orphans living with relatives aggravates the problem. They are denied education because doing so is considered useless since they will die soon or later. This is a sad revelation in that it is a denial of ones right to life. Children should be helped to live full lives. HIV/Aids should be seen as any other disease other than a death sentence where death is certain. Communities should be mobilised to handle such children as their own by providing the much needed care that children in such conditions crave for. Children’s access to ARVs should be made a priority by districts in their performance contracts. However, much effort should be put in preventive measures like PMTCT, encouraging mothers to deliver under medical attention and securing trained personnel for all district hospitals and health centres. Ends