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Life prolonging line extended to PLWHA's in Zimbabwe
Margaret Chinowaita, Women and AIDS Support Network (WASN)
Extracted from WASN Newsletter – September 2004
September 2004

A Life prolonging line has been extended to People Living with HIV and AIDS through the free distribution of Diflucan, a donated drug at 53 health centres across the country. 

Diflucan, also known as Fluconazole, is an antifungal medicine that has proved effective in the treatment of HIV-related Cryptococcal Meningitis (CM) and Oesophageal Candidiasis (OC).

United States -based pharmaceutical giant, Pfizer, donated the drug, which is being administered at public health institutions.

Dr Chakanyuka responsible for the programme of distributing the drug at the Ministry of Health and Child Welfare said since the programme was started in March last year 74 377 people living with HIV and AIDS are now on it as of May this year.

However, Chakanyuka said the statistics that are being supplied from the health centers do not show the exact numbers of women who are accessing the drug.

The drug is also not being administered to children because it is not available in suspension form to enable children to take it However, Chakanyuka said the ministry of health has made requests for the company supplying the drug to supply it in the suspension form and intravenous form.

WASN wish that the drug should be supplied in the suspension form that children will be able to take it.

Recipients of the drug are obtained from patients who visit the public health centres and are diagnosed to ascertain if they are eligible to be on the Diflucan drug. An accurate diagnosis is often done through a lumbar puncture or spinal tap.

A certain special needle is needed for the spinal tap and in some instances this need to be provided by the patients, Chakanyuka said. “Some patients have come to us complaining that they are being made to buy this special needle but they should understand that the donation that we are getting is only for the drug and they need to chip in somewhere. The ministry is responsible for transporting the drug into the country.”

For the drug to be administered at a health institution there should be a medical doctor or a clinical officer trained to do the diagnosis. There should be a laboratory for the investigations of the diagnosis and a pharmacy for the health personal to be able to dispense the drug.

Once diagnosed, patients are expected to take this treatment for the rest of their lives by way of prophylaxis. Cryptococcal meningitis keep on recurring on a patient so there is need for the patient to keep on taking Diflucan to prevent the illness after an initial attack.

However, people suffering from Oesophageal candidiasis, known as thrush of the digestive tract can be treated with the use of Diflucan, over a period of about two weeks.

This condition of thrush of the digestive tract makes swallowing painful and can result in overall physical deterioration of a patient.

However, the ministry has faced constraints in the delivery of the drugs into the country. There has been delays resulting in supplies being depleted but they have never run out.

According to the conditions of the donor the drug would be used strictly to treat CM and OC, but not for prophylaxis or other conditions such as vaginal thrush. This has not gone down well with our organization that stands for women’s sexual and reproductive health rights in this era of HIV and AIDS. We feel that the donor should extend its gesture of goodwill to also meet women’s health needs by providing the drug for vaginal thrush. 

The drugs are only accessible through the public health system, in line with the donor’s conditions.

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