Increasing cost of HIV services putting lives at risk in Zambia

In Zambia, new bottlenecks and increasing costs are impeding smooth delivery of services in private sector HIV treatment clinics and putting lives at risk.

In Zambia, new bottlenecks and increasing costs are impeding smooth delivery of services in private sector HIV treatment clinics and putting lives at risk.

Last year Kara clinic in Lusaka introduced user fees where clients were asked to pay an equivalent of USD 10 per visit. This sparked discontent among people living with HIV who petitioned the Ministry of Health to intervene.

The minister of health reprimanded the clinic management and ordered them to stop charging any fees. The clinic was receiving free anti-AIDS drugs from the government and the minister warned it should continue providing free antiretroviral therapy services in accordance with government policy.

Charging patients for HIV tests

User fees were stopped immediately but in April this year Kara clinic introduced charges for CD4 count tests to a tune of around USD 15 per visit, citing the reason as the cost of reagents, which are chemicals used to carry out laboratory CD4 testing.

The acting sister-in charge said the clinic uses different reagents from the government-owned CD4 testing machines and they are outsourcing this service, so individual clients have to bear the extra cost.

Mrs Kalumba, board chairperson for Kara Counseling and Training Trust, stated that the charges were necessary because a donor, the Centre for Infectious Disease Research In Zambia (CIDRZ), who were previously doing the CD4, viral load and other HIV-related testing, had pulled out.

This is contributing to many patients defaulting on getting life-prolonging medication and attainment of the health Millennium Development Goals remains an impossible dream in this part of the world.

Increasing costs of HIV treatment

One patient said: “I am not in gainful employment so I can’t afford to pay for a CD4 test. In the meantime I will collect my drugs without testing but the pharmacy staff said I can only collect drugs for two weeks instead of three months if they don’t test me.”

Public health centres test CD4 counts for free but they are very congested. The problem is now looking even more complex with news of shortages of the antiretroviral drugs Nevirapine and Truvada.

People living with HIV are appealing to well wishers to help provide this vital service or facilitate training so they can run their own laboratories and help save lives. The Kara clinic services over 4,000 patients and each one has to test twice per year, in accordance to antiretroviral therapy protocol. Each test costs USD 15, which amounts to USD 120,000 per year that the clinic is expecting to extract from people living with HIV.

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