Access to ARV Treatment in People with AIDS in Tanzania, South Africa and Zimbabwe

Optimal use of HIV services including utilization of antiretroviral therapy (ARV) is essential for survival and improvements in quality of life of individuals living with AIDS. One of the major breakthroughs in the global management of HIV/AIDS has been the initiation of ARV treatment in sub-Saharan Africa, a region with the hardest HIV hit countries in the world. However, with nearly 10 years of ARV treatment in Africa, there are major deficiencies in access, availability and effectiveness of the critical intervention. To a large extent, these factors are responsible for the high numbers of people still dying of HIV/AIDS in sub-Saharan Africa compared to other regions of the world where ARV is utilized. There were 3.7 million patients in need of ARV treatment in Tanzania, South Africa and Zimbabwe in 2010. Of these, only about a half (52%) received such treatment. Tanzania had the lowest coverage rate of 42%. Poor ARV coverage leads to many patients who are eligible for treatment dying quicker and increases the burden of HIV to the already impoverished economies of their countries. Based on the experiences of Tanzania, South Africa and Zimbabwe, this study investigates patient, clinical and structural factors impeding extended use of ARV. International, government and non-government organizations' involvement in drug distribution and treatment delivery is examined. Necessary recommendations for improving access and affordability of ARV treatment are provided. Collective interagency efforts based on local needs, human resources and infrastructure have the potential to reach traditionally marginalized patients in ARV treatment.