Sustainable ARVs

2009-11-07 14:18

THE village of Nyuswa in Mondini, KwaZulu-Natal, is not far from the N2 near Tugela Mouth. It’s a place of rolling hills and poverty where more than 40% of pregnant women are living with HIV. It is also the home of Ma Busisiwe Hlongwane, her two-year-old granddaughter Anele, and the five other children under her care.

Inside her home, Ma Busisiwe holds a picture of Anele. The child is lying in a hospital cot, attached to a drip. Hlongwane took Anele to hospital when she had taken sick and she tested positive for HIV. But the tiny, emaciated little girl in the picture is a far cry from the happy, sturdy, two-year-old playing at her grandmother’s feet today.

The reason for Anele’s remarkable turnaround is the antiretroviral syrup that Hlongwane gives the toddler every day. Each morning, she mixes the ARV syrups in a precise combination. The amount of syrup changes as Anele grows, and it has to be done exactly.

Anele is lucky. There are more than 600 000 children living with HIV in South Africa, and only 50 000 of them are on ARVs.

The majority will die before the age of five, while those on ARVs could live a near normal life. No one knows really knows the life expectancy for a child raised on ARVs.

Far from Nyuswa, in Cala in the remote Goso Forest district of the Eastern Cape, another grandmother follows a similar daily ritual. Ma Mantle Dedele is a great-grandmother in her 70s. Tall, gaunt and regal, she peers out from behind very thick spectacles.

She cares for Mbali Dedele, a playful three-year-old on ARVs. She explains how difficult it is for someone with poor eyesight to measure the right amount of ARV syrup to mix for the child. She seeks daily help with this from younger women in the area, so that at 7am and 7pm, young Mbali gets her medicine. No professional nurse could be sterner.

But, says Dedele: “I think it would be easier if all those syrups could be made into one, especially for us elderly people. I think the people who make the medication can help us and make one tablet.”

In fact, there are single-dose tablets for children with HIV that are safe. They are available very cheaply, in generic formulations from of ­India. The US Food and Drug Administration has pre-approved them.

It is unclear why single-dose ARV tablets for children are not yet available in South Africa. These inexpensive pills would do away with syrups and syringes and measuring, and would make life much easier for mothers and grandmothers like Hlongwane and Dedele. They would also be a huge help in making ARVs available to the other 550 000 HIV positive children who need them.

The stories of Ma Hlongwane and Ma Dedele are taken from Siyayinqoba/ Beat It, which can be seen each Thursday on SABC1 at 1.30pm. It is repeated on Soweto TV, CTV (Cape Town) and Bay TV (Richards Bay-Empangeni) each Saturday at 11am. The show can also be viewed at  

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