Southern African states accused of ‘AIDS hypocrisy’

INTERNATIONAL organisation Doctors Without Borders yesterday accused donor organisations and southern African states of hypocrisy in combating HIV/AIDS, saying they were unwilling to change policies to expand antiretrovial treatment.

The organisation said more than 70% of people needing antiretrovirals in sub-Saharan Africa were not getting them. The shortage of health-care workers was largely to blame.

None of the emergency measures put in place by governments or donor organisations to deal with the AIDS pandemic addressed the attrition of health-care workers.

The group called on governments to develop and implement emergency plans to retain and recruit health-care workers, and improve their pay and working conditions. It also appealed to donors to review their policies and fund the salaries of health-care workers.

Doctors Without Borders member Sharonann Lynch said: “We do not need more pretty clinics from donors because these are standing empty. We need staff to run them.”

The report, dealing with the roll-out of antiretroviral treatment in SA, Malawi, Mozambique and Lesotho, said that 8000 people a day were dying of AIDS, and more than a million people who needed treatment in these countries were not getting it.

SA had 718000 people with HIV/AIDS and not getting treatment, followed by Mozambique with 192900, Malawi with 109100 and Lesotho with 40300.

SA was, however, also treating the largest number of people of the four countries — about 265000 people.

Eric Goemaere, head of the Doctors Without Borders mission in SA, said: “There is wide acknowledgement of the human resource crisis but little action on the ground. Even in SA, which has more health-care workers who are better paid compared with other southern African countries, unequal distribution and inadequate numbers of staff are causing delays to expanding treatment.

“Clinics are absolutely saturated, waiting lists are growing, and it feels like we are losing the battle,” he said.

To expand access to HIV care in rural settings, Doctors Without Borders relied on “task shifting” from doctors to nurses and from nurses to community workers, said Goemaere. But most governments refused to let nurses dispense antiretrovirals. Governments had to be more flexible.