The New Times (Kigali)

30 November 2012

Rwanda: Nation Steps Up Efforts to Fight HIV/Aids

RWANDA has stepped up efforts to prevent new HIV infections to achieve the 2015 global target of zero new infections. The efforts come as the country joins the rest of the World to mark World AIDS Day, marked on December1.

The challenge now is to ensure that global progress is mirrored at all levels and in all places so that people, whoever they are and wherever they live, can obtain antiretroviral therapy when they need it

According to Dr Sabin Nsanzimana, the Coordinator of HIV and Sexually Transmitted Infections (STIs) Care and Treatment Department, at Rwanda Biomedical Centre, government has put in place several initiatives to ensure a 0% record of new infections by 2015.

Rwanda will officially commemorate the world AIDS Day today in Gicumbi District under the theme, the role of Intore in stopping new infections within the Rwanda community. Rwanda's HIV/AIDS prevalence is 3% an equivalent of about 400,000 people.

"We are starting the zero percent new infection campaign with the help of Community Champions, the Intore, to lead the process of ensuring no new infections. We want to engage them in coming up with a home grown solution to this new initiative," said Nsanzimana.

In 2011, 2.5 million people worldwide were newly infected with HIV, according to UNAIDS. An estimated 1.7 million people died. That is 700 000 fewer new infections worldwide than ten years ago, and 600,000 fewer deaths than in 2005.

Much of the progress is attributed to antiretrovirals, to treat those infected with HIV.

ARVs prolong life and the chances for an infected person to stay healthy. They also decrease the risk of infected people passing on the virus to someone else.

In 2011, at the UN General Assembly, governments agreed to set the goal of getting 15 million HIV-infected people worldwide on the life-saving antiretroviral medicines by 2015.

One of the other strategies that the country is pushing is stepping up the circumcision campaign. In this context Rwanda projects that about two million men would have undergone circumcision by 2015.

"Our calculations indicate that with this form of circumcision campaign, we would reduce new infections by 50% by 2015," added Nsanzimana.

He pointed out that the Ministry of Health is also planning to contain the HIV incidents that lead to new infections mainly in some target groups like the commercial sex workers of whom the HIV/AIDS prevalence is 51%.

Another area of focus to ensure reduction of new infections is through the ongoing campaign to ensure a reasonable reduction in the transmission of Mother to Child Infections.

Rwanda's gains in AIDS fight are due to several initiatives in place, including adequate supply of anti-retroviral therapy (ARVs).

"The government spends about Rwf1 billion on purchasing ARVs but also another Rwf 1 billion is spent on other logistical requirements like laboratory requirements and personnel. To date about 110,000 Rwandans are on ARVs and they acquire them for free," said Nsanzimana.

Meanwhile, the latest global statistics suggest that, provided countries are able to sustain current efforts, the target of zero new infections is within reach.

"Many countries are facing economic difficulties, yet most are managing to continue expansion of access to antiretroviral medicines," said Dr Gottfried Hirnschall, Director of the World Health Organisation's HIV Department. "The 2015 target looks more achievable now than ever before."

Currently, 8 million people in low- and middle-income countries are accessing the treatment they need, up from only 0.4 million in 2003.

"The challenge now is to ensure that global progress is mirrored at all levels and in all places so that people, whoever they are and wherever they live, can obtain antiretroviral therapy when they need it," adds Dr Hirnschall.

In all regions of the world, some groups of people are still not able to access HIV prevention and treatment. Children, for example, are lagging behind: only 28% of children who need antiretrovirals can obtain them.

Experts estimate the average cost of therapy at Rwf12,000 per patient but with the help of donors, Rwanda supplies the therapies for free to patients with less than 350 CD4.

Also, Rwanda currently has only 450 accredited health centres that provide antiretroviral therapy treatment.

As the country put up plans to control new infections, supply of condoms has been marked as one of the major strategies of prevention.

Available figures indicate that in 2011, over 30 million condoms were distributed in Rwanda and the trend indicates that the condom supply has been increasing each year.

Statistics indicate that 23 million condoms were distributed in 2010 while 16 million were distributed in 2009.

History of HIV/AIDS in Rwanda

The first case of HIV/AIDS was discovered in US in 1981, but the world didn't know what kind of a disease it was. In that same year, a familiar case was reported at Kigali Central Hospital (CHK) of a person who had similar symptoms like those reported in the US, weight loss, diarrhoea, and a pealing skin.

According to Dr Nsanzimana, some people called it a slimming disease.

"..But later, people got to know that it was, actually a sexually transmitted disease and that is when stigmatisation started. Some people called it witchcraft at some point while others called it a punishment from God and hence resulting in extreme stigmatisation," he added.

However, since then there were no figures of the infected people until 2002 when measures were put in place for treatment and several campaigns were fast tracked to ensure reduction of the prevalence which was slightly about 7% by then.

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