Non-communicable Diseases: The Unwanted Burden Adding to HIV

Mirirai Nsingo

FOR more than a decade, 53-year-old Cathrine Murombedzi from Zimbabwe’s capital, Harare, has been positive.

Not even her HIV positive status deterred her.

Cathy has been consistently taking antiretroviral treatment over the last 15 years. And this has made her ‘HIV champion’, publicly speaking about her status.

Diabetes and hypertension have brought a new dimension, and left her shaken.

She fears the new burden can “derail the HIV gains” made over the years.

“I’m HIV positive and over the last few years I was diagnosed with both diabetes and hypertension so that means am on three chronic medications. The threat of these non-communicable diseases is what scares me the most,” Cathy says.

And as she speaks, you will not miss the great concern. Her voice, judging from the Cathy of 8-years ago, shows much uncertainty.

As she explains her situation, you can’t tell whether it is the costs that comes with managing diabetes and hypertension to worry about, or the fear of unknown about the combination of the three.

“Remember it’s only anti-retroviral treatment which is for free in the country, I’m so grateful for the consistent supply I have received since I was initiated.

“Now my fear is what if one day I wake up and cannot afford to buy medication for diabetes and hypertension, what is going to happen?”

This is the case of many in Zimbabwe and Africa. And she is aware she is not alone in this predicament.

Experts recently noted people living with HIV, and facing the threat of non-communicable diseases are in a tough situation.

During a media tour of Parirenyatwa Group of Hospital’s Opportunistic Infection Clinic, AIDS Healthcare Foundation medical officer, Dr Pascal Shambira said the growing burden on non-communicable diseases such as diabetes, hypertension and cancers in people living with HIV, called for urgent attention.

“With people now living longer owing to the success of anti-retroviral therapy in the country, we are now seeing the emergence of non-communicable diseases in people living with HIV.

“Most of our clients are being diagnosed with these non-communicable diseases and its emerging to be a threat that while they are adhering to treatment, have their viral load suppressed, it is this new threat that is posing as a challenge.”

Dr Shambira adds the high treatment costs of managing diseases like diabetes and hypertension for people like Cathy have potential to reduce the quality of life for people living with HIV.

“Now the challenge is the costs that comes with the management of diseases such as diabetes and hypertension, while anti-retroviral treatment is for free, the treatment of these NCDS is not for free hence this is a challenge to most patients.

“The issue of access and affordability of treatment of these diseases now becomes a challenge and so you will see that some end up dying because they cannot access treatment,” Dr Shambira told journalists.

The Government admits the non-communicable disease threat in people living with HIV was high and is already working on integrating services as part of its HIV response to alleviate the burden.

Zimbabwe’s Health and Child Care Deputy Minister Dr John Mangwiro has since called for the incorporate NCDs in HIV management to arrest the challenge

“While we incorporate NCDs in our HIV response, we also need our local scientists to research more on the links between HIV and some ailments such as diabetes, hypertension among others.

“We have seen more and more people living with HIV being affected by these so we really need to look at how we can manage this burden even at primary health care level. So as clients go to collect their anti-retroviral treatment, they have to be screened for diabetes, hypertension and cancers so that we have a preventive care approach.”

With a prevalence rate of 11, 8 percent, the country has made significant gains in HIV response owing to a successful antiretroviral therapy national programme which was rolled out in 2004 with an estimated reach of 347 000 people then.

To date, according to the Ministry of Health and Child Care, the country has 1 211 030 people on anti-retroviral treatment.

According to the United Nations Programme on HIV and AIDS, people like Cathy are now living longer due to the success of antiretroviral therapy success but however are now becoming susceptible to non-communicable diseases.

Death rates from non-communicable diseases are nearly as high in developing countries with cardiovascular diseases, cervical cancer, depression and diabetes accounting for the greatest number of comorbidities.

With the non-communicable diseases fast becoming a global health threat, Zimbabwe owes it to ensure people like Cathy have access to medications for diseases like diabetes, hypertension to ensure HIV gains made over the years are not reversed.