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ANGOLA: HIV/AIDS plan moving "too slowly"

Photo: IRIN
Government's Clinica Esperanca in Luanda supplies free ARVs
Luanda, 30 August 2004 (PlusNews) - Eight months after its launch, people living with HIV/AIDS say Angola's programme to fight the epidemic is inadequate and moving too slowly.

The US $160 million national strategic plan, a five-year collaboration between the government and the United Nations, is focused on prevention, building institutional capacity and helping HIV-positive people.

Yet those living with HIV/AIDS in the capital, Luanda, which is supposed to have some of the better treatment facilities in the country, say the benefits so far are slim.

Pedro Mande, 26, goes to the government's Clinica Esperanca in the city centre for his supply of antiretroviral (ARV) drugs, which prolong life and are provided free as part of the project.

An emaciated Mande picks at the last scraps of fish from his plate with his fingers. The clinic appears clean, but there is a strong smell of urine, and flies are a constant irritation.

"I get drugs here, but that is all. Everything else, like this food, I have to pay for," he told IRIN. "The doctor only comes to see me once every two weeks, so I am never sure if I'm going to get my antiretrovirals or not. I feel abandoned."

Mande is too weak to return to his work as a taxi driver. He has no money and his family has broken ties with him because of his HIV status.

Donations from the local HIV/AIDS charity, Accao Humana, pay for some of his basic needs but he has to rely on friends to give him a bed for the night.

"Every time I leave the clinic I have no idea where I am going to end up - sometimes I sleep on the street," he said. "If I could live in a proper house and have proper food, I would grow stronger, but with this life, without any support, I am only getting weaker."

Teresa Pegado, who is also HIV-positive, relies on handouts to get by. Disowned by her mother and living in a roofless room with no stove or running water, she fears the imminent rainy season will make her and her three-month-old daughter, Rosa, homeless.

While not as sick as Mande, Pegado visits the Accoa Humana office often, knowing that from its donations, or the generosity of its staff, she will be able buy milk for her child.

Fearing prejudice, Pegado has told only a few close friends about her condition. "I try not to tell anyone because they will discriminate: they will not let me drink water from their glass - that would make me feel very alone," she said.

Pombal Maria, secretary-general of Accao Humana and coordinator of the Coalition for the Rights of the HIV positive, said desperate stories were commonplace.

"This is the reality," Maria told PlusNews. "The national government plan is just paper; it is having little practical effect."

UNAIDS representative Dr Alberto Stella acknowledged the current situation was far from ideal, but said patient care was the most problematic area when it came to implementation.

"From the point of view of the patient, the situation is bad - they cannot see the logistical problems. [Dispensing] antiretrovirals is complex in terms of the public health strategy and, considering the lack of capacity in the country, it is not surprising that we have not managed to establish a network within a year - it will not take less than three years," he told IRIN.

"I appreciate it [treatment facilities for people living with HIV/AIDS] is not the best. But the level of implementation is not bad for a country like Angola: in a post-conflict situation and considering the difficulties we have in an institutional context," he said, adding that the government would shortly expand its ARV treatment from 2,000 patients to between 4,000 and 4,500.

With official figures showing that HIV prevalence in Angola is just 5.5 percent, much lower than in neighbouring countries, humanitarian workers have long emphasised Angola's "window of opportunity" - a chance for it to take action to curb the spread of HIV/AIDS.

But conditions are ripe for the virus to explode. Millions of refugees are returning home after three decades of civil war and there are fears they will bring HIV/AIDS with them. Coupled with one of the world's highest birth rates and widespread poverty, a rapid increase in the pervasiveness of the virus seems inevitable.

Many observers worry that the scale of the problem has already been grossly underestimated.

"The official figure of 5.5 percent is much too low: it only takes [into account] people who have been tested in provincial capitals and, even then, it only looks at five of Angola's 18 provinces," said Maria.

"In my opinion, we are going to be nearer to nine percent [HIV prevalence rate]," Stella said, referring to the upper end of the statistics' error margin.

The government, supported by UNAIDS, the US-based Centres for Disease Control and the World Health Organisation, is beginning a countrywide survey this week to determine prevalence rates and the number and state of facilities available to treat the disease. The results are due to be published by the end of this year.

But even in Luanda, where television programmes, theatre groups and hip-hop hits spread the facts and dangers of the disease, stigma, shame and denial are still rife.

The reaction of Pegado's ex-boyfriend, Rosa's father, is typical. Insisting that she contaminated him, he has refused to take an HIV/AIDS test or change his sexual behaviour.

"His family does not know, neither does his new woman. She is pregnant now and she and her baby will probably have the virus too," Pegado said.

The national plan and organisations like Accao Humana are trying to fight the ignorance and stigma around HIV/AIDS, but they fear the situation in the provinces is much worse - figures from the UN Children's Fund show almost one-third of Angolans have never heard of HIV/AIDS.

Stella said the national strategic plan was trying to take the problem into account, but urged the authorities to use the capacity and resources of the international NGO community and civil society.

"Our big objective now is to increase access and open other centres at a provincial level. That is not easy, but we and the government are trying to do something," Stella said.

But many, like Maria, believe time is running out fast. "It's never too late to do something, but at this moment the resources do not exist. We do not have the finances or the materials to lower the prevalence of HIV/AIDS," he said. "We need to work harder to produce a good result and while the government plan is a good one, it is moving much too slowly."

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

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