Access to Anti-Retroviral Treatment in Ghana

(A research proposal by Mr. Joshua J.K. Baku - Principal Researcher, Head of the Research Department of the West African Examinations Council and the General Secretary of the Educational Research Network for West and Central Africa [ERNWACA]

Background

The HIV/AIDS pandemic continues to threaten mankind. Globally, more than 60 million people have been infected with HIV since it was first detected in the early 1980s. It has claimed the lives of more than 20 million people to date. In year 2002 alone, 3.1 million died of AIDS. At the end of 2002, there were approximately 42 million people living with HIV/AIDS. Each day, approximately 14,000 new infections occur. Young people, especially girls and young women, aged 15 - 24 are particularly vulnerable to infection. AIDS is reversing many hard fought development gains. Life expectancy in some countries is declining. The numbers of orphans is rising rapidly.

Though Sub-Saharan Africa accounts for only 11% of the world's population, it accounts for about 70% of people living with AIDS. Indeed, UNAIDS, in July 2002, reported that 70% of the over 40 million HIV carriers in the world live in Sub-Saharan Africa and that, without massive prevention and treatment, 55 million Africans could die prematurely by 2020 as a result of HIV/AIDS.

Ghana, like most African countries, has a youthful population with 52.2% aged less than 20 years and about 42% under 15 years, (GSS, 2000). This youthful population is at a great risk.

Reports estimated the national prevalence rate in 2004 to be 3.6%. This national figure, however, masks variations in HIV infection among various sub populations and sites. Moreover, this statistic represents only the reported and known cases.

The disease has assumed a feminine and youthful face in Ghana. Among those infected, about 60% are females. The peak age group of 25-29 for females and 30-34 for males, means that the epidemic has both economic and social implications for each individual and for the country as a whole.

Worst of all, HIV infection is still perceived in many communities as a taboo and a humiliation to the family. No family ever or easily admits that a family member is suffering from AIDS even if the symptoms are so obvious. This culture of silence over the epidemic is the direct result of stigmatization and discrimination against people living with HIV/AIDS (PLWHA).

Stigmatization of PLWHA, according to Baku (2004) is a natural sequence from misconception held about the epidemic. This concealment syndrome thus essentially closes all doors of anti-retroviral treatment to many who could have been kept alive in a productive venture. He also found that many people feared and perhaps even hated people living with HIV or AIDS because of the misconception that they could get infected merely through proximity. Such people simply chose to keep their distance from the PLWHA. In such circumstances one could hardly expect any compassion or reaching out to the PLWHA or the dependents they left behind.

There is some level of widespread ignorance about mitigating possibilities for PLWHA. The rural communities are, for instance, generally unaware that the life of an infected person could be prolonged to some extent by early detection and an early application of mitigating measures. The existence of anti-retroviral drugs that can delay the maturation of the HIV into AIDS if it is detected before the situation degenerates into an AIDS situation may remain unknown to many, including even some of those who know they are living with the virus.

Access to anti-retroviral treatment prolongs the lives of PLWHA and reduces the seriousness of the adverse effect of the epidemic on individual and national productivity and the resultant poverty levels. The country is then better positioned to meet the MDG 6. Even more importantly, access to anti-retroviral treatment addresses the right of PLWHA to health and to life. If people living with HIV/AIDS are not supported to prolong their lives and encouraged to live productive and meaningful lives, the development and growth of the economy of the country would be adversely affected.

Problem Statement

In spite of the fact that every Ghanaian has a right to the provision of good health, access to anti-retroviral treatment for PLWHA in Ghana appears to be extremely limited, largely due to cost constraints, inadequate information, geographic inaccessibility, among others. Out of the estimated 400,000 adults believed to be living with HIV/AIDS in the country in 2004, only about 2,000 are estimated to be on anti-retroviral therapy ( National Strategic Framework 11). Treatment can be accessed (officially) in only four hospitals, all of which are located in the southern half of the country.

Yet, the epidemic has penetrated every region of the country as can be seen from the graph below:

Justification for the study

Ghana's national legal and development framework documents, namely the 1992 National Constitution and the Ghana Poverty Reduction Strategy (GPRS) reflect a commitment to key global agreements and development agendas aimed at securing promotion and protection of human rights of all its citizens, as well as ensuring sustainable development. It becomes necessary to see whether these commitments are put into practice.

Aim of Study

To generate information to establish facts (gaps between policy and practice, scope, geographical/regional equity etc) about the care situation of PLWHA in the country to inform the ISODEC ART campaign.