August 24, 2006
HIV/AIDS treatment can be successful even in war-torn regions, according to a report from Doctors Without Borders (DWB). Patients receiving HIV/AIDS drugs in countries like the Democratic Republic of Congo, Haiti and Burundi achieved "comparable results" to patients elsewhere, according to the research, which was presented prior to the 16th International AIDS Conference.
In 2003, DWB launched seven pilot projects treating 861 patients in DRC, Ivory Coast and Burundi. Seven additional projects are treating 2,317 patients in post-conflict countries such as South Sudan, Angola, Sierra Leone and Liberia.
"There are stresses and challenges of living in an unstable environment, so it's not unreasonable to think that people wouldn't adhere to treatment, but these were chronic conflict settings where people had become accustomed to relative calm with punctuated levels of insecurity," said David Tu of DWB. "They developed a survivor mentality, and survival for some meant taking their medicines."
Globally, refugees account for 0.2-0.3 percent of those in need of antiretroviral treatment, said Gebrewold Petros, a surgeon with the UN High Commissioner for Refugees in South Africa. "Doctors are often reluctant to provide [refugees] with drugs," he said, due to the misconception that they will not adhere to treatment regimens and possibly facilitate the development of drug resistance. Also, "Often, people are wrongfully perceived as supporting one side or another in a conflict and so they are not given treatment," Petros said.
Additional challenges in war-torn regions include the devastation of roads and health care facilities, together with a lack of political will, Petros said. Furthermore, refugees are typically poor, uneducated, and tend to move frequently from camp to camp, said Elizabeth Madraa of Uganda's Ministry of Health.
Still, "It was shocking to learn that people were committed to treatment even in conflict zones," said Tu.