Editorial»
Something’s missing
AUG 23 -
There are reportedly over 70,000 people living with HIV/AIDS in Nepal, and considering the growing number of migrants most at risk of contracting the disease, without proper intervention, this number is sure to rise. In the past two rounds of funding received by the government from the Global Fund (GF) dedicated to fighting HIV/AIDS, evaluation of the grants’ performance shows that under some indicators, the impact of the funding has exceeded the expected targets. By the end of 2008, the government came out ahead in certain areas suggesting a solid structural base for voluntary counselling and testing as well as facilities for those receiving the anti-retroviral treatment (ART) necessary to fight HIV/AIDS: 18 more centres than had been planned were constructed. In addition, the number of people receiving testing and counselling during the initial round of funding ending in 2008 surpassed the set target. The availability of diagnosis and treatment in public healthcare institutions for opportunistic infections—the common infections those with HIV/AIDS are more susceptible to—for those already living with HIV/AIDS has been more than 12 times as effective as planned. In this, the government has clearly shown a strong commitment to quelling the latent HIV/AIDS pandemic in the country before it is allowed to explode.
But a look at the results from the funding provided during Round 2 and Round 7 highlight some clear weaknesses in the campaign. Most prominently highlighted is the recurring problem of insufficient health personnel in Nepal. In both rounds of funding, the number of care providers, service deliverers, pharmacists and National Centre for AIDS and STD Control (NCASC) staff trained to deal with the disease has fallen drastically short. The simple truth is, no matter what facilities are available, without the staff to implement these programmes, their construction is in vain. Reports from the active round of funding show that less than half the anticipated number of people utilised the available counselling and testing resources. As testing is a key part of thwarting the spread of HIV, this is a disheartening fact.
The programme has had success in the last year providing the most at-risk groups—the migrant-worker community, representing 62.5 percent of the current HIV/AIDS positive cases, and injecting drug users—with peer education. But for the youth at large this vital information has failed to spread as anticipated. Sometimes overshadowed by the critical needs of those suffering from HIV/AIDS and immediate community at risk of contracting the disease, this important aspect of prevention, risk-prevention education, has not been adequately addressed in Nepal. Increasing youth education can provide the push needed to translate awareness into behavioural changes.
At the end of November, the most recent round of funding from GF will reach the end of its course. And after being overlooked the past two rounds for failing to meet the minimum criteria, the government has submitted a final proposal seeking Rs. 4.26 billion for Round 10 with a high possibility of its request being granted thanks to its dedicated performance as well as its shored up commitment to the future success of the programme. Should the government’s request be approved, it is vital for the long-term success of HIV/AIDS prevention that more emphasis be put on bolstering the healthcare workforce. And though the needs of those currently fighting the disease cannot be discounted, strengthening risk-prevention education of youth is the key to preventing the spread of the disease in the future.
Posted on: 2010-08-24 09:52
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