Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.
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New Vision (Kampala) - August 27, 2009
Solome Mukwaya
Despite the fact that few Ugandans seek counselling and testing services, assurance of the availability of care and treatment services is one way of ensuring that the services are sought.
It is a prerequisite that the systems to support HIV care are in place or are strengthened.
HIV testing and counselling should be interlinked with care and support services to ensure comprehensive quality counselling.
In Uganda today, of the 21% Ugandans who know their status, 400,000 are eligible for antiretroviral treatment. However, only 170,000 can access the medication.
As the counselling and testing services increase, the health systems should be supported to provide sustainable treatment and monitor those on ARVs.
ARVs have managed to prolong the lives of HIV-positive individuals but have further created a challenge of non-adherence. Is Uganda able to provide treatment and monitor the steadily increasing numbers of patients in need of ARVs?
This is a vital question as the AIDS Information Centre prepares to implement the five-year counselling and testing programme for all.
For a scale-up of counselling and testing services to be useful, it should be in line with improvement of the capacity of the health systems to manage the load in terms of treatment, human resources and physical facilities.
With limited resources, sustainability of any intervention is important. UgandaÆs ARV programme is 95% donor funded.
The sustainability of this programme has been tested by the credit crunch which has led many service providers to turn away new patients in need of treatment.
HIV service organisations and the Government in the short-run should focus on HIV prevention measures to ensure that the infection rates go down.
In the long-run, systems should be strengthened to cater for the increased testing and counselling services and the subsequent need for care and treatment services.
The writer is a fellow at the Makerere University School of Public Health - CDC HIV/ AIDS Fellow
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