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No Time to Waste!!! Every HIV+ Cameroonian to Be Place on ART Immediately

 

  • Up To 700,000 HIV+ Cameroonians Could Be Receiving Treatment For HIV/AIDS According To New Directives From The Ministry Of Public Health
  • “Every Cameroonian Who Tests Positive For HIV Should Be Immediately Put On Treatment (No more time wasting)!!!”Minister of Public Health.

This is good news to health personnel and the public, and aligns with scientific evidence that treating HIV+ clients as soon as possible offers enormous gains to the patients, their families, and the society as a whole. This is a bold step that merits applause for meaningful action in the face of overwhelming evidence that early treatment is the best way forward. Though our action lags behind by several years, we are slowly but surely making progress in the right direction in the fight against HIV/AIDS in Cameroon.

Starting HIV+ clients early on HIV drugs significantly reduces mortality, improves survival and decrease onward transmission of the virus by breaking the transmission chain. Gone are those days’physicians waited until persons infected with the virus were almost irrecoverable before they could be granted access to treatment. Following the new directives, if you test positive for HIV, without any further investigations or questioning about the severity of the disease, you are eligible to receive, free of charge, antiretroviral drugs for treatment.

 

 

 

Why is this good news?

  1. It simply makes sense to know that you are being treated for an infection right away rather than waiting to be declared sufficiently sick before benefiting from drugs. Treatment should be focused on preventing persons from becoming sicker and not only to rescue them from their dying beds. There are several Cameroonians who lost their lives because they had to wait to start treatment at a stage when the health facilities couldn’t do anything more but accompany them to their graves. We are now better than that and rightfully so.
  2. Treating all affected persons offers the advantage of treatment as prevention. Evidences has shown that persons who take drugs as directed are more likely to have low viral particles in their bodies and be a lot healthier. This means that the probability of contracting the virus from an infected person in case of exposure is very low. In fact, the risk would be reduced by more than 700% when treatment is correctly taken. This will serve as a major tool in the fight against HIV/AIDS by breaking the transmission chain and protecting the general public from new infections.
  3. Pregnant mothers will also be less likely to pass on this infection to their children. All these would go a long way to prevent the number of new cases in the society. Therefore, no matter from what direction we look at this, we are a lot better than when this drug was administered only to a few persons and only when they were sick.
  4. Only a healthy person can contribute effectively to the development of a nation. By treating early, we would be preserving the health of Cameroonians and by so doing offering them a chance to contribute in the vision 2035. Of course, no nation would make any meaningful development with more than 700,000 persons in their productive years being full time consumers than contributors to the national resources because of very poor health status.
  5. Starting treatment earlier would prevent the onset of opportunistic infections including tuberculosis that remains a nightmare in Cameroon……….

 

What are the potential consequences of early and massive treatment in Cameroon?

 

Puttingall diagnosed HIV+ clients on antiretroviral wouldn’t come without challenges. Some may be concerned about the side effects of these medications when used early and hopefully for a very long time by the clients. While it is true that the side effects are real, the advantage of treating early clearly out matches any potential side effects. Also, the experience with these medications is no longer in its infancy as it was in the early days of HIV/AIDS pandemic and allows for prevention, early detection and effective management of side effects. 

Another downside to this is the fact that putting several persons on antiretroviral may increase the probability of creating resistant strains of the virus. This will be more so if a significant number of persons on antiretroviral fail to stick to treatment guidelines. However, we believe that with proper pretreatment counseling and treatment follow up, most persons would stick to their drugs and avoid plunging the nation into a resistant strain-manufacturing machine.

Putting every HIV positive person (projected at about 700,000 in Cameroon) on treatment will more than double the number of persons on treatment. Treatment requires huge resources including, but not limited to, increasing the number of counselors needed for pretreatment counseling and guidance, increasing the number of treatment centers, increasing the number of prescribing physicians, etc. While we currently have an alarming number of defaulters and lost to follow up HIV+ patients on treatment, I project that with increased treatment access, this might become a bigger pool, creating the perfect environment for resistance to drugs that may rather complicate the fight against this disease condition.

We have witnessed several periods of shortages of antiretroviral drugs supply across the country even when we had a limited number of HIV+ patients on treatment. I would like to be assured and reassured that the officials have fully assessed this potentially threatening condition and have made adequate provisions to provide a constant and adequate supply of medications to the huge number of Cameroonians who would be on treatment.  Should there be a nationwide shortage of drug supply as has always been the case in the past, a good policy might have rather jeopardized all the efforts and turn its nasty side on our nation.

There would be an acute increase in the number of persons on treatment making the existing treatment centers and personnel largely insufficient to address the patients’ needs. These will lead to the provision of poor services to seeking clients and others passively denied care. Also, this might give room to corruption as persons might now be required to personally motivate staff to get the treatment they rightfully deserve.

Is the communiqué sufficient for effective action?

Though I welcome this decision, I very much hope this is not all about a signature onpaper, but accompanied by all the measures for effective implementation and evaluation. This requires that projections of the additional burden on the health sector and the society as a whole should be anticipated and adequate measures put in place to address them.

These are but a few of the possible challenges. However, I believe we have a well-seasoned team of Public Health geniuses that is able to go beyond the papers and translate every single signature into a real day-to-day experience for all Cameroonians. Once more, congrats for taking the bold step, nowlet’s get to work and make this a reality for Cameroonians by adequately anticipating potential areas of weaknesses and addressing them timely.  I now challenge my fellow colleagues to systematically test all clients at regular intervals so as to identify and treat every positive HIV+ client!

 

Chobufo Ditah, MD MPH

Public Health Specialist,

Chief Medical Officer,

CMA-Njinikom.

 

 

Dr. Chobufo Ditah, is a seasoned Public Health Specialist with degrees from the prestigious Faculties of Medicine, University of Yaoundé I-Cameroon (MD), and the Hebrew University of Jerusalem, Israel (MPH). He is currently the Chief Medical Officer at CMA-Njinikom. Despite the challenges faced by the health sector in Cameroon, Dr. Chobufo is committed to providing the highest quality of care to Cameroonians with the limited resources, placing special emphasis on mass prevention. He has gained extensive experience working in several African Countries (South Sudan, Central African Republic, Chad) executing missions with Doctors Without Borders (Médecins Sans Frontières (MSF). He has a huge exposure to and mastery of health systems around the globe including several African Countries, China, USA and Israel. He looks forward to designing a health system that works in Cameroon by piecing together the best concepts from these different systems.  He is also passionate about universal health coverage and having seen his clients suffer the direct consequences of out of pocket payment for health services, he’s committed to the fight for universal healthcare coverage for all Cameroonians. He strongly holds that the major barrier to attaining universal health care coverage in Cameroon is the lack of political will and strong government policies as and not the lack of finances as many Cameroonians have been erroneously led to believe.

 

 

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