The Elizabeth Glaser Paediatric AIDS Foundation (EGPAF) Technical Advisor for Chiradzulu District Suleman Issah observed that the performance of the district’s health facilities supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) was quite encouraging unlike the non PEPFAR sites.
Issah made the sentiments on 8 October, 2021 at a stakeholders meeting on Updates on Defaulter Rate and Cervical Cancer organised by the Network of Journalists Living with HIV (JONEHA) in Salima with funding from Bill and Melinda Gates Foundation through AVAC under the COMPASS Project. JONEHA is running a Community Led Monitoring (CLM) project which is targeting 5 of the PEPFAR 11 scale up districts -Mulanje, Mangochi, Chiradzulu, Mzimba South and Phalombe.
On defaulter rate for July to September 2021 the EGPAF District Technical Officer reported that PEPFAR sites had an average of 2.3 % of defaulter rate while non PEPFAR sites defaulter rate was relatively high such as Chimwawa which had 8% and PIM 6% of making an average of 7%.
ART defaulting as per the National HIV guidelines classifies one as a defaulter when one does not report to the clinic for 60 days and is expected to have run out of drugs with no information on whether one stopped nor transferred out or dead.
The Southern African Journal on HIV Medicine published online on 31 October 2016 says Antiretroviral therapy (ART) improves patients’ health-related quality of life (HRQoL).
It adds that defaulting from ART has detrimental consequences, including the development of viral resistance, treatment failure and increased risks of disease progression.
On cervical cancer screening the PEPFAR sites which were only 4 – Mbulumbudzi, St. Joseph, Nkalo and Bilal reported a total number of 1461 screened between July and September 2021 and 42 of them found positive were treated while 9 facilities that had no PEPFAR cervical cancer program screened only 805 in July and August 2021 and it was not known if 9 of them found positive got treatment.
The 2021 Peoples Country Operational Plan; a document that informs CSO engagement in the development of the Country Operational Plan; PEPFAR and Ministry of Health are called upon to working hand in hand to ensure that cervical cancer services are fully integrated with HIV services.
In facilities where cervical cancer screening is being offered, screening should be conducted on an ART Clinic day. Where gaps in human resources, infrastructure or equipment exist, PEPFAR should come in to fill those gaps.
