LILONGWE, 1 September 2008 (PlusNews) - AIDS-related deaths in Malawi have dropped by 75 percent over the last four years, thanks to the availability of free antiretroviral (ARV) drugs, but better nutrition for people living with HIV would further lower the figure, officials have said.
Mc Anthony Ajabu is seven years old and one of 159,111 Malawians the government has put on ARV treatment since 2004. After his mother died from an AIDS-related disease in 2005, he was taken in by his grandfather, Roben Nangwandu, 53, a widower who works as a security guard in the capital, Lilongwe.
"We have been in and out of hospital so many times. Then one day doctors told me he was HIV-positive and immediately put him on ART [antiretroviral therapy]. Since then he has improved very much," Nangwandu said, adding that a combination of ART and nutritious food had saved his grandson's life. "Those who saw him three years ago do not believe their eyes when they see him going to school. They say it's a miracle that Mc Anthony is walking."
Every two weeks Nangwandu cycles 25km from Chinsapo Township on the outskirts of Lilongwe to the hospital. "Doctors advised me that no matter how far I live, it is important that I get medication for my grandchild in time or I would be putting his life at risk," he said.
According to Mary Shawa, principal secretary for Nutrition and HIV/AIDS, 67 percent of people who started on ARVs since 2004 are still alive. Those who did not survive may not have had access to proper nutrition and information about ART.
"We want people to appreciate that the success in reducing the high death rate that we experienced does not hinge on ARVs alone," she said. A 2001 study found that 25 percent of adults in Malawi were malnourished, of which 75 percent were HIV-positive.
The goal of the National Nutrition and HIV and AIDS Treatment Literacy Initiative, launched recently by the government, is to help Malawians better understand the links between living a long life with HIV and good nutrition.
According to UNAIDS, lack of food security and poor nutrition can hasten the progress of AIDS-related illnesses and make it difficult for patients to adhere to ARVs or benefit from treatment.
Shawa said the initiative would make information on ART and nutrition widely available to help HIV-positive people deal with some of the myths and challenges they had to face.
"We discovered that some people who are on antiretroviral drugs, or were about to start taking them, did not understand how the drugs work. They were wrongly told that the drugs cause serious side effects such as burns and painful sores," she explained.
"In one instance, a patient refused to take ARVs because he was told that they whet one's appetite and, being poor, he could not afford to buy additional food."
McBride Nkhalamba, an HIV/AIDS coordinator for Action Aid International in Malawi, said the country was on the right path to addressing some of the core issues affecting those living with HIV. "There is a need to make information on ART and nutrition widely available, particularly among women and girls," he said.
Dr Felix Salaniponi, director of the Malawi National TB Control Programme, told IRIN/PlusNews that besides the rollout of ARVs, improved strategies for detecting and treating TB patients co-infected with HIV had also helped lower AIDS-related deaths: 77 percent of TB patients in Malawi are HIV-positive.
"In the past we just concentrated on TB and did not look for other conditions such as HIV," he said.
In collaboration with the Ministry of Health, the TB Control Programme has trained clinical officers to treat patients for both TB and HIV/AIDS.
"It has become a guiding principle that every TB patient be counselled on HIV. Once we discover that a patient is HIV-positive we combine treatment and we are saving many lives," Dr Salaniponi said, noting that the death rate of TB patients had gone down from 22 percent in 2004 to 8 percent in 2008.
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