- Zimbabwe's health minister, HIV/AIDS activists and health experts have all warned that a recent increase in the cost of CD4 tests, which measure the strength of the immune system, will negatively affect the already ailing national AIDS treatment programme.
The tests are essential to assess the degree to which an immune system has been compromised by the virus, and one of the most important tools for deciding when someone should begin antiretroviral (ARV) treatment. CD4 cell testing is also used to determine the efficacy of ARV therapy.
According to health minister David Parirenyatwa, the scarcity of testing centres in Zimbabwe has allowed the few available ones to charge astronomical fees. "Testing costs, especially at private health institutions, have soared of late. Many people cannot afford them, and this is a setback that has to be addressed as a matter of urgency," he said. "We have a situation whereby patients end up dying prematurely, just because they have taken antiretroviral (ARV) drugs without going through proper CD4 count tests first to ascertain their condition."
There are only two health facilities conducting CD4 count tests, both privately owned, in Bulawayo, Zimbabwe's second city, which has a population of almost 2 million. Both doubled their testing fees two weeks ago, from Z$25,000 (US$100) to Z$50,000 (US$200), sparking an outcry by AIDS activists.
"Patients normally start treatment when their CD4 count is below 200," said Ambivalence Dube, a Bulawayo-based AIDS activist and health expert. "However, with the recent increases, we are likely to see many people shying away from [CD4 count] testing, and this will negate the whole concept of fighting HIV/AIDS." Dube said many people who started taking ARVs without first ascertaining their CD4 count suffered complications.
The lack of testing centres in public health facilities has been blamed on government funding shortfalls. Privately owned testing centres have taken advantage of the gap in provision.
According to the National AIDS Council, set up by the government to combat the HIV/AIDS pandemic, at least 14,000 Zimbabweans die each month of AIDS-related illnesses. Experts attribute the high death rate to low nutritional levels and limited access to life-prolonging ARVs. As of July 2006, only 46,000 of the estimated 600,000 people in need of ARVs were receiving them in the national treatment programme.
UNAIDS estimates that Zimbabwe has the fourth highest level of HIV/AIDS prevalence in the world: in a population of 11.5 million, an estimated 20.1 percent of sexually active adults are HIV-infected.
Despite recent evidence of a decline in the infection rate, analysts have warned that with a crumbling health sector and an economy in the doldrums, Zimbabwe still has a long way to go before the fight against the epidemic is won.
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