Everton Wokoma (not real name) of Thyolo stands in a queue to receive his monthly supply of ARVs, oblivious of the fact that Medecins Sans Frontiers (MSF) Belgium, who pioneered provision of the free life-prolonging drug, is winding up its programme in the district.
A father of seven, he has been on ART for the past seven years. His wife and last two children have recently joined him in getting free ARVs from Thyolo District Hospital.
In an interview on Wednesday, Wokoma said his health and that of his family have not been compromised in any way because their daily dosage of ARVs has never been interrupted even with government running out of the drugs from time to time.
Said Wokoma: â€œSince I started, this hospital has never disappointed me. The drugs are readily available and it is beneficial because we understand that defaulting leads to resistance. We have safely depended on this hospital and we are grateful.â€
Asked about MSF, Wokoma said he has seen its personnel, vehicles and offices, but never cared to find out what exactly they do. He said he had no idea when MSFâ€™s programme in the area will wind up, let alone when it came to the district.
District health officer (DHO) for Thyolo Dr. Andrew Likaka told Nation on Sunday during the week that MSF was indeed winding up its 16-year service provision to the district in the areas of HIV and Tuberculosis (TB).
Likaka admitted that the development was worrisome and a cause for concern because the impact will be felt, particularly among the over 40 000 people living with HIV and on ART in the district.
Said Likaka: â€œMSF has been in Thyolo the longest in the world. They are usually in a place for shorter periods or as an emergency and Thyolo District has been an exception. They have rescued the hospital time and again with drug supplies, including general non-HIV medications when government coffers have run dry for whatever reason.
â€œHanding over of their projects started in 2009, but they continued to come in to assist from that period and we are trying to maintain the standards. Challenges are there and will be there when MSF finally packs and goes, but it is something we have to live with. It is a big problem and will require strong management, especially looking at the fact that MSF did not initially integrate their programme. They are only doing so they are winding upâ€.
But MSF coordinator Daniel von Rege who returning home in Germany, painted a positive picture to their winding up.
He said: â€œWe do not want to create panic or incite fear and despair among the population. People need the confidence that services will continue and should have confidence in their government.
â€œThere is a general feeling that main drivers of quality are donors and non-government organisations, but there is a lot the government is doing which needs to be appreciated. We have one more year until 2013 and we will continue offering our technical assistance.â€
Likaka said MSF Belgium started work in Thyolo in 1997 and pioneered provision of free ARVs in 2003. He said government rolled out provision of free ARVs in 2004.
â€œWe have had patients come to Thyolo from other districts such as Blantyre and Lilongwe thanks to MSFâ€™s in partnership with Ministry of Health and other stakeholders. Our hospital has a reputable HIV care and management,â€ he said.
Likaka said patients have been assured of a six-month supply of ARVs even when government delays to procure the drug. He said apart from the district hospital, which has a cohort of 18 000 people on ARVs, Thyolo has 11 health centres currently providing the drug.
According to the DHO, MSF has been giving the hospital the most advanced antibiotics (third generation) in the treatment of TB and caposis (skin cancer) and also came in to assist during outbreaks such as cholera.