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Anti-retroviral Drugs Keep People Alive
16 Percent of Adults Are Infected
FrontLines - November 2009
MAPUTO, Mozambique—In
the dusty yard in front of their
cinderblock house in the Polana
Canico neighborhood, Adelina*
and her daughter Cecilia, 12,
nervously show a visitor the
anti-retroviral (anti-AIDS) medicine
they must take each day to
remain healthy—in fact, to
remain alive.
“I don’t want the neighbors
to know we have AIDS,” said
the mother, covering the white
plastic medicine bottle with
her hand.
“But who cares? What is
important is that I am still alive.”
Twice a day they take the
anti-retroviral pills that combine
three medicines: nevirapine,
stavudine, and lamivudine. The
pills enabled Cecilia to resume
school, which she failed two
years ago due to illness. She
now has dreams of a future:
“I want to be a doctor,” she said.
“Maybe a nurse. But doctor is
better. I want to help people.”
She bathes quickly inside a
corrugated metal bathing shelter,
puts on her school uniform,
and walks off to class. To save
25 cents, she walks for an hour
instead of taking the bus.
About 16 percent of
Mozambicans are HIV positive,
of whom about 30 percent are
receiving treatment. The need
for medicine and ways to prevent
the spread of the disease
have become the major task of
many aid agencies, including
USAID.
A large poster with a USAID
logo in downtown Maputo
shows a popular singer advising
people to get tested and prevent
the spread of AIDS. But still the
spread goes on.
The United Nations reported
Sept. 30 that the number of people
worldwide taking anti-retroviral
medicine increased by 1
million last year, to 4 million.
But 2.7 million new infections
were reported in 2007.
So USAID is funding programs—
some of it with $250
million from the President’s
Emergency Plan for AIDS Relief
(PEPFAR)—to encourage people
to avoid multiple sex partners,
delay the onset of adolescent sex,
get tested, and use condoms.
A tent has been set up in a
Maputo street near a clothing
market. Inside, a woman has
decided to get tested. First, the
health worker, funded by
USAID, counsels the woman on
what the test means and how
she can cope with either a negative
or a positive result. It
reaches 10,000 people each
month with these tent programs,
implemented by U.S.-based
Population Services International
and Johns Hopkins University.
USAID also supports nationwide
condom distribution.
The worker closes the tent
flap for privacy, draws some
blood, and in 15 minutes
Preciosa*, 36, is beaming with
delight. She is not HIV positive.
“I came because I wanted
to know my status,” said the
mother of three, who sells
clothes in the market. “Now
I know. This is fine. I will do
everything in my power to keep
myself safe. I will keep to my
husband and will take him to
be tested.
“My cousin died of HIV. It
was very sad. She was 19 years
old and sick and never said anything
to anyone.”
The battle against AIDS is
part of a wider battle to improve
public health in this country
where the average lifespan is
only about 40 years. Malaria,
tuberculosis, diarrhea, and
pneumonia are also deadly.
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In a village about two hours drive from the capital Maputo, a community health worker trained by
USAID teaches her neighbors how to protect their health: build a covered latrine, use mosquito nets
to prevent malaria, use condoms and pills to prevent AIDS or regulate family size, be tested for diseases,
get vaccinations, put aside money for transport to a hospital to deliver babies, watch for signs
such as bleeding or convulsions, and feed themselves and their children three times a day.
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“The minister of health said
he needed to build up the public
health system,” said USAID’s
director in Mozambique, Todd
Amani. “So we moved money to
improve the pharmaceutical
logistics system, and to build
medical supply warehouses,
health centers, and a clinical
training center for future nurses
and other health workers.”
Because AIDS continues to
spread, “we are shifting gears
and increasing money for prevention,
training health care
workers, training doctors, and
for the health infrastructure;
and we are putting less money
into treatment,” said Amani.
The Global Fund to Fight
AIDS, Tuberculosis and Malaria
is distributing more of the antiretroviral
medicines now while
“we do more prevention,” said
Chargé d’Affaires Todd
Chapman from the U.S.
Embassy. “The supply chain for
the medicine is more expensive
than the drugs.”
Meanwhile, U.S. funding to
fight malaria through mosquito
nets, indoor spraying, and medicines
is scheduled to increase
from $20 million a year to almost
$40 million in 2010.
“We save as many lives through
fighting malaria as HIV,” said
Chapman.
★
FrontLines is published
by the Bureau for Legislative and Public Affairs
U.S. Agency for International Development
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Material should be submitted
by mail to Editor, FrontLines, USAID,
RRB, Suite 6.10, Washington, DC 20523-6100;
by FAX to 202-216-3035; or by e-mail to frontlines@usaid.gov
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