Two Pills a Day – Treat HIV/AIDS Now!

Two years of anti-retroviral treatment in Arua, Uganda commemorated amid calls for urgent expansion of free treatment.

The Arua Hospital AIDS Program last Friday 30 July, commemorated two years of providing free access to anti-retroviral (ARV) treatment for nearly 1,100 people living with HIV/AIDS in Arua, a rural region in northwestern Uganda. The community celebration included dramatic performances as well as visits by Jim Muhwezi, Minister of Health of Uganda, Stephen Lewis, UN Special Envoy on HIV/AIDS in Africa, and others.

A partnership between the Arua Regional Referral Hospital and the international medical humanitarian organisation Médecins Sans Frontières, the Arua Hospital AIDS Program also marked the occasion by releasing a clinical monitoring report showing how well patients are responding to ARV therapy and pointing to the urgent need for expansion of access to free ARV treatment in Uganda.

"After two years of providing ARV therapy, we want to share our experience with others who are undertaking efforts to increase access to HIV/AIDS treatment and care in Arua and beyond," said Dr. Olaro, Medical Superintendent of Arua Regional Referral Hospital and the Arua Hospital AIDS Program. "Although our program has improved the lives of more than a thousand patients and their families, we must be modest regarding our achievements, be aware of the important challenges that we face, and remind ourselves that over one million people have died in Uganda since the epidemic first appeared."

Providing treatment free of charge; adopting simplified treatment protocols and regimens, particularly the use of an inexpensive generic three-in-one fixed-dose combination (FDC) pill taken twice a day; and working in close partnership with the local ministry of health, the community, and people living with HIV/AIDS; are all factors that have made the expansion of the Arua AIDS Program possible.

The experience in Arua has also revealed challenges similar to those found in other ARV programs conducted by Médecins Sans Frontières, including the need for decentralised health services, increased human resources, and improved and cheaper diagnostic tools and medicines, especially for second-line and paediatric treatment.

"At first I was losing weight, down to 45 kilos, but now I'm 52 kilos. I couldn't come from home into town and I couldn't do my work at home. Now I can and my family is happy," said Diana, who has been on ARVs in the Arua Program for 9 months. "I want to tell the people of Arua that those who have this disease should come out and see the example of me - I am okay."

An estimated 46,200 (5.5%) of Arua's 840,000 residents are living with HIV/AIDS, yet ARV treatment is only available through the Arua Regional Referral Hospital AIDS Program supported by Médecins Sans Frontières. Throughout Uganda, UNAIDS estimates that 150,000 people clinically require ARV treatment, while only 23,000 actually receive it and nearly 80% must pay something for their care.

"Treating people living with HIV/AIDS in poor, rural areas like Arua is possible and transforms lives and communities," said Australian Janthi Price, Médecins Sans Frontières’ field coordinator. "But expanding HIV/AIDS treatment and care to all people who urgently need it in Uganda is a challenge that only the government, with strong international support, can take up. It's crucial that there is an immediate shift from verbal commitment and planning to actual implementation of services."

MSF Australia