SOUTH AFRICA-ZIMBABWE: Cross-border healthcare response needed

durban, 3 April 2009 (PlusNews) - As over 4,000 delegates convened in the port city of Durban this week to talk about how to improve South Africa’s HIV/AIDS response, a sobering presentation on Thursday reminded them that just across the border in Zimbabwe, people living with HIV lacked even the most basic services.

Prof Chris Beyrer of Johns Hopkins University in the United States was among a group of investigators from an international non-profit organization, Physicians for Human Rights, who visited Zimbabwe in December 2008.

Their mission was to assess the country’s cholera epidemic, which has claimed over 4,100 lives so far, but they soon learned that far more widespread problems, including the total breakdown of the healthcare system, lay at the root of the crisis.

Zimbabwe’s average life expectancy has dropped from 62 years to 36 years, the lowest in the world, with HIV/AIDS alone claiming an estimated 400 lives a day.

Beyrer told delegates that the state of public healthcare, which had been in decline for years, abruptly worsened after a strike by healthcare workers in November 2008 over the lack of essential medicines, food, and running water at hospitals in Harare, the capital.

The Physicians for Human Rights investigators found evidence of deliberate suppression of data by the government on health issues, including cholera and malnutrition. “Malnutrition is very political; we’re not supposed to have hunger in Zimbabwe, even though we see it, we can’t report it,” one nurse told them.

About 205,000 people are thought to be accessing antiretroviral (ARV) treatment from both the public and private sectors, but Beyrer said no programme was enrolling new patients and the supply of ARV drugs was often interrupted, which meant patients had to keep switching regimens. HIV testing is now only available in the private sector at a cost of US$100.

“The TB programme in Zimbabwe is a joke,” said one expert the investigators interviewed, who told them that the national TB laboratory had only one employee, data collection effectively stopped in 2006, and there was no one trained to conduct drug sensitivity tests to determine whether patients had drug-resistant TB strains.

Beyrer described Zimbabwe’s healthcare crisis as a “direct consequence of the malfeasance of the[President Robert] Mugabe regime, and systematic violation of a wide range of human rights”. Physicians for Human Rights advocated referring the healthcare crisis in Zimbabwe for investigation by the International Criminal Court.

According to Beyrer, a prosecution for crimes against humanity based on the denial of the right to healthcare would be unprecedented, but was warranted in the case of Zimbabwe.

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The Zimbabwean authorities accused Beyrer and his colleagues of being spies and they were forced to flee the country before completing their mission, but their findings were compiled in a report released in January 2009, Health in Ruins: A Man-Made Disaster in Zimbabwe.

The Ministry of Health in Zimbabwe’s new unified government falls under the Movement for Democratic Change (MDC), but Beyrer pointed out that the permanent secretary for health was affiliated with Mugabe’s ZANU-PF party.

Beyrer urged the delegates in Durban to view the collapse of Zimbabwe’s health system as a regional problem that required a regional response. Millions of Zimbabweans have fled to neighbouring countries, in particular South Africa, where they are still often unable to access healthcare.

Zimbabwe’s medical schools have been closed since November 2008, and Beyrer recommended that neighbouring nations support Zimbabwean medical students to attend universities in their countries. He also called for increasing assistance to the Ministry of Health, with strict measures to ensure that funds were not diverted to support the Mugabe “regime”.

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Theme (s): Care/Treatment - PlusNews, Economy, Governance, Health & Nutrition, HIV/AIDS (PlusNews), Prevention - PlusNews,

[This report does not necessarily reflect the views of the United Nations]