29,000 targeted for HIV anti-retroviral therapy

ACCRA, - The World Health Organisation (WHO) has said it wants to place 29,000 Ghanaians living with AIDS on anti-retroviral therapy by 2005 under its global "three by five" initiative.

At present, only about 1,000 people receive anti-retroviral therapy at four major hospitals, where the drugs administered are heavily subsidised by government

?In the short term, the project looks very challenging. But the idea is to ensure that there is universal access to these drugs,? Napoleon Graham of WHO-Ghana, told IRIN.

?In Ghana, placing 29,000 people on anti-retrovirals under the three by five initiative amounts to 50% coverage of people currently living with HIV/AIDS,? he added.

WHO?s "three by five" initiative aims to scale up the response of individual countries to AIDS so that three million people can be put on life-sustaining but expensive anti-retroviral drugs by 2005.

Ghana?s 2003 Sentinel survey, which used the results of voluntary testing carried out at selected ante-natal clinics to come up with an estimation of the HIV prevalence rate, suggested that the number of people living with full-blown AIDS could be much higher than the 58,000 estimated by WHO.

According to the Sentinel survey, 3.6 percent of Ghana's 19 million people were HIV positive last year, up from 3.4 percent in 2002. That implies there are 684,000 Ghanaian living with the virus, although not all of them will have developed AIDS-related illnesses yet.

Under the government's current ARV programme, patients pay 50,000 Ghanaian Cedis (US $6) a month for treatment. They also have to pay the full 250,000 Cedis (US $25) cost of a CD4 cell count - the main test used by doctors to monitor immune system performance - to establish how advanced their condition has become prior to commencing treatment.

Ghana received a US$15 million grant from the Global Fund to Fight AIDS, Malaria and Tuberculosis in 2003 to finance the country's AIDS treatment programme over the next two years.

However, WHO's preliminary research suggests that the Ghanaian health authorities will have to overcome key constraints in order to reach the target of 29,000 people on ARV therapy by the end of next year.

These include limited human resources, an inadequate healthcare infrastructure and poor laboratory facilities. Other constraints include the high cost of the equipment necessary for performing the CD4 blood cell count, the continuing stigma attached to people living with AIDS and limited financial resources to complement the grant money provided by the Global Fund.

?That is being worked on," Graham said. "We know the Ghanaian authorities are scaling up efforts to equip all 10 regional hospitals and selected district hospitals and clinics in hotspots, where prevalence rates are high or there is a known aggregation of people living with HIV/AIDS, with the right equipment.?

?Ghana has already presented a two-year US $90 million budget tailored to cater for its 'three by five' programme under the Global Fund fourth call,? Graham said.

WHO has suggested that Ghana?s Ministry of Health should undertake a three-pronged strategy. This would involve:

1. The initiation of discussions with collaborating institutions on the training of health workers by July 2004. 2. The organisation of a stakeholder meeting on additional funding by the end of May 2004 3. The immediate strengthening of the capabilities of the National AIDS Control Programme.

?If Ghana is able to raise more money, it may exceed its target and place more people on retroviral treatment. On the other hand, if there is a deficit, then we will have to step up our efforts. The initiative does not end after 2005. It will be a continuous process,? Graham said.

Health experts say the 'three by five' initiative should bring a window of hope to AIDS sufferers in Africa if it is successfully implemented.

Africa is thought to account for 30 million of the 40 million people affected by HIV/AIDS worldwide. There were about 3.2 million new infections and 2.3 million deaths in Sub-Saharan Africa in 2003.

About 4.2 million people living with AIDS currently need anti-retrovirals in Sub-Saharan Africa, but only 50,000 are thought to receive the life prolonging drugs at present since they are too expensive for most Africans to afford.