Kampen gælder tusinder af liv i en slumby, hvor 80.000 ud af en halv million indbyggere er testet positiv for den frygtede hiv-virus, der kan føre til aids i udbrud
KHAYELITSHA, 17 May 2011 (PlusNews): Ten years ago, Khayelitsha, in Cape Town, was the first place to make antiretroviral drugs (livsforlængende medicin) available to the public sector, marking a milestone in the beginning of the end of AIDS denialism (Sydafrikas regering afviste først, at aids var noget problem) and the fight for treatment in South Africa.
With more than half its population unemployed, Khayelitsha is one of South Africa’s largest and fastest-growing townships, and home to one of the highest burdens of HIV and TB infection nationally and globally.
In 2009, antenatal HIV prevalence (hos svangre kvinder) was 30 percent and the case notification rate for TB was at least 1.500 per 100.000 people annually – among the highest estimated TB incidence rates in the world.
Alarming as those figures may be, Khayelitsha is a beacon of hope for the AIDS epidemic in South Africa, where the provision of ARVs had been fraught, marked by a bitter stand-off between AIDS activists and government over the slow pace of the rollout.
– It was scary back then in the late 1990s. No one would say “I am HIV positive”. It was very stigmatized (brændemærkede personen), recalled 42-year-old Xoliswa Liba.
An estimated 80.000 of Khayelitsha’s population of 500.000 are HIV-positive. Liba was tested positive in 2006.
– At first, I would not have even spoken to you about my status. But as time goes on and I am around people who are HIV-positive and we talk about it, it has become easy for me to say “I am HIV-positive”, Liba told IRIN/PlusNews.
The Khayelitsha story
– I rushed to Khayelitsha … expecting everyone speaking about HIV, everybody dealing with HIV, people in the streets, pamphlets being distributed. But actually it was total silence, recalled Eric Goemaere, medical coordinator for Médecins Sans Frontières (MSF) in South Africa, describing his first days in the township in 1999.
Goemaere, who was supporting a provincial pilot programme preventing mother-to-child-transmission of HIV, was shocked to discover it ran in a “semi-clandestine” manner because of government denialism (en ANC-minister blev kaldt “fru rødbede”, fordi hun mente aids kunne kureres med denne rodfrugt, red.).
– ARVs were not available before 2002, so people used to die in high numbers. There was much denialism – also from the government’s side if you remember, Monde Kenneth Hobongwana, 37, who was tested positive in 2008, said.
After a two-year struggle to gain permission from pharmaceutical patent-holders to use generic drugs (kopimedicin) without government involvement, in May 2001 the first patient in Khayelitsha received antiretroviral therapy through an MSF-supported pilot programme.
In 2002, MSF’s treatment programme had 180 slots (pladser). That number grew to 400 by the end of the year. In 2004, the national government finally came on board with free treatment for anyone whose CD4 count was below 200.
Stigma and adherence
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