With confidence that his body is HIV-free, a virus that causes Aids, Ibrahim Bokosi (52) of Nkhonya Village, Traditional Authority (T/A) Mabuka in Mulanje on July 16, 1999 set off for Mulanje Mission Hospital for an HIV test. This was after months of battling with various infections.
He recalls feeling restless while waiting for the results and what he feared for is what he got. He was HIV-positive.
“Immediately the nurse said I had tested HIV positive” he begins the story. “I sweated profusely, felt dejected and useless. I could not believe it. Several questions went over my mind. I felt sorry for my six children. Who would raise them if I die?”
Before the test, Bokosi says his body had started to shut down. Besides losing weight and being too weak, the body had become a hive for various diseases. His skin too had started to send signals of a serious infection.
“I suspected that something big was wrong in my body. My skin turned pale and the hair started to curl. However, I did not suspect that it could be HIV,” he explains.
Immediately he got home, Bokosi says he assembled his family members and informed them about his serostatus.
“My wife and children accepted the situation, but some members did not. Even my parents and some relatives started to avoid me. They could hardly give me a handshake. They never even wanted to share a plate with me. I felt like an alien in my homeland,” recounts Bokosi.
Worse still, Bokosi was diagnosed HIV-positive at a time most people did not understand the virus and the disease it causes. He says such misconceptions bred discrimination and he suffered a lot. There was no relief such as free life-prolonging drugs. Thus, once the body immunity capitulates, the next step was death. For five years, between 1999 and 2004, Bokosi says his relief was in painkillers such as Aspirin.
“My health continued to detoriate. My CD4 count reached the lowest point and I was admitted to Mulanje Hospital,” he recalls.
While in the hospital, Bokosi was greeted by good news one morning. He was among the first 400 people to start taking antiretroviral (ARVs) drugs, which government had just made free. Days later, Bokosi was back on his feet and since then, he boasts that he has never fallen ill. He says he sometimes mocks his family members when they are down with illness saying they used to think they were healthier than him.
In 2007, Bokosi went back to school and sat for Malawi School Certificate of Education (MSCE) examinations. He scored 21 points. His journey to taking the examinations was not easy. He says some people mocked him, asking why he was wasting time when he knows he would die anytime.
After the results, Bokosi says he was selected to undergo training as an expert client (EC) on HIV by AfriCare, a non-governmental organisation working on development and policies to build sustainable, healthy and productive communities
Currently, Bokosi works as an EC at Mulanje Mission Hospital. He supports patients living with the virus in accessing care and adhering to treatment as well as following up on antiretroviral therapy (ARTs) defaulters.
From victimisation to a relief, Bokosi’s story is a testimony of the miracle that is ARVs. His story was a marvel to listen to when he testified before hundreds of people who gathered at Chisitu ground in Mulanje on December 1 to commemorate this year’s World Aids Day. The day was celebrated under theme Getting to Zero.After 16 years of living positively, Bokosi believes the dream in the theme is possible. Even the figures confirm this. Several efforts being undertaken continue to reduce the infection and HIV and Aids-related deaths rate. United Nations Programme on HIV and Aids (UNAids) reports that the HIV infection rate has dropped from 68 000 per year in 2009 to 42 000. Worldwide nations have agreed to work towards a free HIV and Aids generation. This is also in line with the just adopted Sustainable Development Goals (SDGs) goal number three which asks all nations to ensure healthy lives and promote well-being for all.
UNAids country director Amakobe Sande says: “With the favourable legislative environment, we need to seriously address the fact that the highest infections are occurring among young women and girls.”
She warns that Malawi may not effectively deal with the epidemic if there are groups of people that do not participate in HIV and Aids-related services because they are either stigmatised or discriminated against because of their HIV status, gender, sexual orientation or age.
“Malawi has done brilliantly in mobilising international and domestic resources, but we must begin to explore the issues around efficiency more seriously. Are we investing every kwacha efficiently,” queries Sande.
On October 21 2015, President Peter Mutharika signed a $378 million (about K223 billion) grant from the Global Fund for HIV and Aids, Malaria and Tuberculosis (TB). Of this, $346 million (about K204 billion) has been allocated to HIV and Aids and TB components. About 80 percent of the funds will be used to procure ARVs. Government also intends to reach about 40 000 homosexuals with testing and counselling and treatment, condoms and prevention of risky behaviour programmes.
No stone is left unturned. Apart from the above steps, government is implementing the ‘Test and Treat’ strategy and also an ambitious 90-90-90 strategy, which builds on the “Getting to Zero” strategy. The programme targets to build momentum to ensure that by 2020, 90 percent of people living positively know their status, 90 percent of people diagnosed with HIV receive ARVs and that 90 percent of people on treatment have suppressed viral loads.
While this is an achievable dream, world leaders call for strict measures towards this goal. Among others is prudence in resource use. Malawi has a poor record on managing health resources. Minister of Health Dr Peter Kumpalume recently admitted that huge amounts of drugs continue to be stolen and recently it was exposed that ARVs are being sold outside the country. n