Southern African countries have been urged to ensure HIV and AIDS interventions incorporate access to treatment, nutrition and gender issues, beyond home-based care and prevention.

The discourse and strategies to deal with HIV and AIDS has shifted from prevention through condom distribution, general awareness, information, education and communication strategies to include issues of access to treatment through antiretroviral (ARV) therapy and access to proper nutrition. Focus now includes treatment of opportunistic infections and dealing with symptoms of severe illness while providing good nutrition.

A Pan African Treatment Access Movement (PATAM) conference held in Harare, Zimababwe in March explored regional strategies for scaling up access to ARV therapy treatment and other essential medicines for the treatment of opportunistic infections.

The conference noted that in any given country between 10 and 20 percent of People Living With HIV and AIDS (PLWAs) need to be on an ARV programme. However, delays in rolling out ARV therapy programme have been cited as a major impediment to the treatment of those infected.

SADC countries reaffirmed their commitment to fight the pandemic when they signed the Maseru declaration on HIV and AIDS which proposes a multi-sectoral approach that involves partnership with all stakeholders to deal with the situation.

Infrastructure such as laboratories and counselling services for the roll out programmes pose a major challenge to many countries. Rene Loewenson of Zimbabwe, whose organisation is a member of the regional Network for Equity in Health in Southern Africa (EQUINET), notes the need for the region to improve its health services and ensure that there is health activism to support the roll out programmes.

“Along with the need to scale up access to treatment, are systems for making treatment accessible and reinforcing wider health systems, through the consideration of how treatment accessibility can be made sustainable,” says Loewenson.

For countries that have commenced roll out plans such as Botswana there has been improvement in the lives of many, though challenges still exist.

Out of a population of 1.7 million, Botswana has 16, 000 adults and 1, 500 children on antiretroviral treatment. Eighty-five percent of the patients have improved health and productivity while 90 percent of those on treatment for at least 18 months have adhered to the treatment.

ARV rollout programmes have also been started in Malawi, South Africa and Zimbabwe.

Absence of treatment literacy and inadequate dissemination of available literature is a stumbling block for PLWA to enrol and adhere to the regimes of available treatment. People need to know where to access treatment, requirements for use and side effects.

A recently launched book Positive Living: Food and Us has a more practical approach to the HIV and AIDS pandemic given that most African countries cannot afford the ARV drugs and distribution is limited.

The book recommends wholesome nutrition that strengthens the body and the immune system and is intended to help people to avoid the diseases and conditions that have become common. Top on the list is HIV and AIDS followed by diabetes, high blood pressure, heart problems, tooth decay and increasing types of cancer.

The book says that utilising poor soils and bad agricultural practices such as monocropping, and using artificial fertilisers and pesticides, has resulted in food having less nutrients.

Traditional African foods, according to the book, are nutritious but Africans have adopted most harmful foods in the past 50 years copying a “Western” diet. The book proposes that the nutritional balance should be backed by spiritual, physical and mental support.

Suggestions are made that a herbal immune–booster be taken daily especially for people living with HIV; and argues that herbal preparations are much cheaper than anti-retroviral (ARV) drugs and have no negative side effects. These, taken with proper diet and vitamin supplements will help maintain or improve health.

However, people are cautioned that despite efforts to maintain health, they will fall sick sometimes, and will require medical treatment, which has become unaffordable and is sometimes unavailable. Alternatively, traditional healers can provide effective herbs that can help to control symptoms of AIDS and other illnesses.

The author, Lynde Francis, of The Centre in Zimbabwe, says, “I have seen people living with HIV recover from the symptoms of HIV and AIDS. They have become productive in their communities and are able to carry on raising and nurturing their children.” Francis has been living with HIV since diagnosis in 1986 and shares her approach to guide people living with HIV to stay strong and healthy.