The State Minister for Health in charge of General Duties Sarah Achieng Opendi, on November 29, 2016 launched the consolidated guidelines for the prevention and treatment of HIV in Uganda. They endorse the “HIV test and start program”.
She said, the ministry is releasing a new circular to all health facilities to ensure a smooth roll out of the new guidelines. The new guidelines replace those released in 2013, where only those infected with HIV with advanced opportunistic diseases like TB and with CD4 cell count below 350 were eligible for antiretroviral treatment.
Having a new set of guidelines means facility staff will need to acquire training in the new guidelines and also ensure that they are supported with requisition of adequate stock of antiretroviral drugs to meet the added demand for ARVs.
Speaking at the same function, the UNAIDS regional director for eastern and southern Africa professor Sheila Tlou said, “Short of an HIV vaccine or cure, test and treat is one of the critical tools we need to create an Aids-free generation,” Dr Tlou said, adding that expanding access to treatment is at the heart of the UNAIDS ‘Fast-Track’ approach to achieve the 90-90-90 targets set with the aim of ending the AIDS Epidemic by 2030.
Previously, test and treat has only been applicable when it comes to Elimination of Mother to Child Transmission (eMTCT). However, some of our membership have reported that, when women disclosed their status to partners, they too wanted to start treatment immediately. However, this was not possible in some health centers as the treatment was limited to eMTCT mothers and their spouses would always be referred to go try at other health centres. The male spouses then resorted to taking some of the women’s treatment, affecting the women adherence and hence effectiveness to reduce HIV infection risk to the unborn child.
Therefore, endorsing test and treat is an important step in the right direction for us women living with HIV. The International Community of Women Living with HIV (ICWEA) has since the time of our establishment been advocating for universal access to treatment for all women living with HIV.
Our efforts doubled, when scientists recently published findings that starting people on ARVs immediately, is another way in HIV prevention as the ARVs treatment if adhered to well reduce the person’s viral load and thus further reduce their chances of transmitting HIV to another person. The person also lives a better quality life.
Apart from advocacy for treatment and all, ICWEA meaningfully participated in meetings that were organized by Ministry of Health –Uganda aimed at drafting and developing consolidated HIV guidelines.
At the meeting ICWEA, made tremendous input and comments regarding the language used in documents. ICWEA called for non-discriminative language, removal of any sections that would fuel criminalization of HIV and inclusion of all key population specifically the LGBTI that the draft guidelines were silent about and advocated for PreP. ICWEA also advocated for civil society organizations involvement in the final drafting processed as key stakeholders.
As we wait to read the entire guidelines, we ask government to ensure that roll out is national and to share work plan with Civil Society Organizations on how test and treat is going to be implemented in the entire country. We also continue to demand for a PrEP guidelines.
