Govt policy on ARVs might change

In an exclusive interview with Health-e, Dr Nomonde Xundu, Chief Director of the HIV/AIDS cluster in the national Department of Health, indicated that discussions are underway on the issue.

“Yes, indeed we started the process consulting, getting views, getting inputs and we put together recommendations that have been processed internally in the Department of Health and I’m saying after much consultation with expert groups and so on, the Department of Health has interrogated the recommendations quite extensively and made some further inputs which were incorporated,” she said.

However, Xundu refused to disclose detailed information, saying doing so “would jeopardize discussions” that are currently underway.

Nonkosi Khumalo, chairperson of the Treatment Action Campaign (TAC), says her organization has been calling upon the government to follow the World Health Organization’s recommendations – which advise that people with HIV should start ARVs when their CD4 cell count drops to 350.

“The recommendations around the globe, which is what we are also advising, is that people start treatment at around 350 than the proposed 200 at the moment, because that’s already late,” Nonkosi said.

“When you reach a CD4 count of 200 you are more susceptible to more opportunistic infections, and so it means your pill burden is much more at that point in time than you are at 350 where there are very few cases of people who would have active TB and actually needing to take antiretrovirals,” she added.

Although it is still not clear what  the final outcome will be, a source close to the discussions said current deliberations appear to be suggesting that the cut-off CD4 cell count measure to qualify for ARV treatment be reduced to only 250.  

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