Marseille 2007
Marseille 2007
Abstract book
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Abstract #587  -  Obstacles to Accessing Free AIDS Medicines (ARVs) in Public Health Care Settings in Tanzania and Zambia: Qualitative Findings
Session:
  19.2: Universal Access to care (Parallel) on Monday @ 14.00-16.00 in HC Chaired by Shirin Heidari, Jean-Paul Moatti
Authors:
  Presenting Author:   Dr Eileen Moyer - University of Amsterdam, Netherlands
 
  Additional Authors:  Dr Gideon  Kwesigabo, Dr Joe Lugalla, Dr Phillomen Ndubani, Dr Fiona Samuels,  
Aim:
This paper will present the preliminary qualitative findings of an ongoing study examining the social and economic costs that limit HIV+ peoples access to free AIDS treatment in Tanzania and Zambia.
 
Method / Issue:
Comparative research is being carried out in three public and three private settings where free ARVs are being provided to determine the range and severity of factors that hinder equitable and sustained access to AIDS treatment among vulnerable groups. Our findings are based on observation, interviews, and focus group discussions carried out with policy makers, health care professionals (doctors, nurses, counselors, etc.) and targeted patients from vulnerable populations.
 
Results / Comments:
Preliminary analysis suggests that even when ARVs are free, HAART is never inexpensive. Patients must be routinely counseled and monitored, laboratory equipment and tests are costly, and patients often develop resistances to first line drugs. Patients must often pay hospital registration fees, cover the costs of treating opportunistic infections, and pay for transport (particularly problematic in rural communities) and food. In addition, these costs must be met in the context of wider social and economic committments, not least of which is the payment of school fees. Other informal costs may result from various modes of corruption.
 
Discussion:
We argue that although providing free access to ARVs in public health care settings is a step in the right direction, it is not enough to guarantee equitable and sustained access to AIDS treatment. Problems associated with gaining and maintaining access to AIDS medicines are exacerbated for vulnerable populations among whom economic and social assets are already too thinly stretched. Any successful effort to reach and treat such populations will require a re-positioning of AIDS care in a wider spectrum of improved public services, including health care and education.
 
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