Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
Mail & Guardian (Johannesburg) - October 22, 2006
Netsai Mlilo
Muzanenhamo (not her real name), a primary school teacher in Harare, says her situation is "desperate". She takes home $24 000 (R240) with which she needs to buy a month's supply of ARVs for herself and her husband. Last month this cost $39 000.
"I'm going through a tough time. My husband was retired from the police on medical grounds. So, effectively, I am the breadwinner and I am failing to cope. My salary is not enough to buy ARVs for the two of us, let alone food and pay rent," said Muzanenhamo. In addition, she has to find money for the treatment of opportunistic infections that those infected with HIV are susceptible to.
She is forced to rely on her extended family, particularly her brother, who is working abroad, to make up the shortfalls. In the past she would have gone to South Africa or Botswana to buy goods for resale in order to supplement her income. Now she can no longer do so as she has to take care of her bed-ridden husband.
Thousands of Zimbabwean workers infected with HIV are in a similar predicament. The dire situation prompted the Zimbabwe Congress of Trade Unions to take to the streets last month demanding affordable ARVs for workers.
Ironically, unemployed Zimbabweans are better able to access ARVs, thanks to international donors.
Nora Mambunganye is an HIV-infected widow living in Bulawayo. She gets her ARVs from Mpilo Central Hospital where Medecins sans Frontieres (MSF) and the government provide the drugs at heavily subsidised prices.
"The tablets are not a problem. When I went to collect my last prescription I was told we would be paying $700, which is still affordable. My problem is food, because it's expensive. So my worry is about taking the pills on an empty stomach," said Mambunganye. Unemployed patients receive food packs from aid organisations -- World Vision and the like -- containing staples such as a 10kg bag of mealie meal, a 750ml bottle of cooking oil and 1kg of beans.
In the past three months the price of ARVs in Zimbabwe has increased by almost 65%, according to a survey by the National Aids Council. As the prices continue to skyrocket, some patients who were on private schemes are crossing over to the public programme.
Dr Fernando Parreno works for MSF in Bulawayo, which is coordinating several city hospitals and clinics where public programmes are run for people with HIV. At present the organisation is treating about 6 000 patients in Bulawayo.
Parreno says that, although MSF has enough drugs to treat 20 000 patients, it cannot do so because of a shortage of personnel. "Unfortunately, we don't have the capacity to manage that many patients."
The staff shortage has created a bottleneck at Mpilo, the main referral centre. Patients have to wait for up to four months before they can be seen by a doctor and commence treatment. As a result middle-income earners drop out and opt to visit private doctors. Low-income earners either decide to ignore the illness or seek the help of traditional healers.
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