Global fund approves US$28 million grant for Zambia

By Meluse Kapatamoyo

Zambia has received US$28 million for its Malaria and Tuberculosis (TB) fight from the Global Fund. The grant is part of the US$419.2 million to fund prevention, treatment and care services of people affected by AIDS, Malaria and TB in 37 countries worldwide.

According to a statement from PartnersZambia, the proposals, approved on August 30, 2012 were part of the Transitional Mechanism.

The mechanism was established by the Global Fund Board in November 2011 on an exceptional basis to ensure that essential programs are not disrupted, at a time when there was uncertainty on the availability of resources.

The approved funding will bridge the financing of essential interventions until the next opportunity to apply for grants.

Gabriel Jaramillo, General Manager of the Global Fund said, "We are proud that this investment can assure continuation of live-saving services to countless patients."

From the US$ 419. 2 million grant, a total of US$111.7 million is to be spent on HIV activities in 16 countries, while TB is set to gobble US$103.8 million in 18 countries, with a further US$ 202.2 million going to Malaria in 11 countries.

About 48 applicants presented 61 proposals but 11 proposals worth US$ 91.2 million from 10 countries were sent back for revision.Unlike regular grant proposals, which can last five years, the requests were limited to a two-year period.

Other African countries to benefit from the fund include Angola, Benin, Botswana, Burkina Faso, Burundi, Chad, Central African Republic, Ethiopia, Guinea Bissau, Malawi, Mozambique, Niger, Sierra Leone, Swaziland, Tanzania, Togo and Abidjan-Lagos Corridor organisation, Djibouti and Egypt. PYM

Your Male Circumcision Q and A

                                                                       By Meluse Kapatamoyo

A discussion on Male Circumcision (MC) posted on this blog a few weeks ago ignited a fierce debate. Centred on whether or not it would be a move in the right direction for MC to be considered a prerequisite to civic centre, church or any other lawfully sanctioned marriages in Zambia, readers, especially the male folk, had a lot to say on the topic.

MC also known as ‘The cut’  is the removal of the foreskin from the head of the penis. The ministry of Health is currently on a drive to circumcise 198,000 men in the country this year. Scientific evidence shows that MC reduces HIV transmission by at about 60 percent.

However, doubts surrounding the surgical procedure and the benefits of MC have seen more men shunning the operation. Circumcision is mainly traditionally practiced by the Luvales, Lundas and Kaondes in North-Western Zambia.

In a bid to find answers to questions sent to Pokeyourmind by readers, I came across three small easy to read booklets being distributed by the Health ministry and its partners- Marie Stopes International, USAID and Partnership For Integrated Social Marketing (PRISM). 

The booklets give a low down on circumcision, from its benefits, the surgical procedure and healing process.

Benefits of MC

MC improves hygiene and can reduce a man’s chance of getting some sexually transmitted infections (STIs) including HIV, syphilis, chancroid and human papilloma virus (HPV). HPV is a virus that can cause penile cancer in men and cervical cancer in women. And because MC keeps the penis clean and dry, baby boys who are circumcised are less likely to get urinary tract infections.

Appropriate age for MC

MC can be done very safely for baby boys below the age of 90 days old. Healing takes less than one week. Note that MC is not offered to children between the age of two months and seven years because children in this age group are very active and do not follow instructions. After seven years old, the procedure can be done on boys and men at any age.

Safety

MC is a very safe procedure if done by a trained health provider. But as with all surgical procedures there are some risks, including pain, bleeding, swelling, infection or reaction to the medicine. It is therefore important to speak with the MC provider about the possible risks and follow instructions to the latter.

Surgical Procedure

A clinical assessment is done before each procedure. This includes an examination of the genital area to rule out the presence of any genital diseases. If any are found, they must be treated before the procedure can take place.

You will be given a few small injections to numb the pain at the base of the penis. This will ensure that the person feels no pain when the foreskin is being removed. After the foreskin is removed you will be stitched and bandaged.

Healing period

You should be able to return to work or school within 2-7 days but the patient will need to return to the MC centre after two days to have the bandage removed and again after one week so that the provider can access if the wound is healing properly.

Sexual performance after MC

MC does not change sexual pleasure and it does not affect a man’s ability to have children. However, there is a six week healing period, and during this time the man is expected to completely abstain from sex or masturbation.  A man is actually more at risk of contracting HIV and some other STIs if he has any sexual contact during the six week healing period.

How to tell a circumcised man from one who is not

A man is circumcised if the head of his penis is fully exposed all the time. A man is not circumcised if there is a bit of skin that folds over and covers the head of the penis while the penis is not erect.

Protection

MC only provides about 60 percent protection and not 100 percent. Thus, after the procedure, always use a condom or abstain from sex and be faithful to one partner who is faithful and know your status. PYM

QUAD PILL: The HIV adherence booster

By Meluse Kapatamoyo

Adherence to medication is critical for people living with HIV. However, the number of tablets a patient is required to take on a daily basis makes it difficult to stick to a regular time-table, a situation which can lead to drug resistance.



Clemetine Mumba

For people like Clementine Mumba, who has been on anti-retroviral therapy (ART) for the last 12years, she soon may no longer have to worry about the number of pills she would have to take on a daily basis.

A recent US study has revealed “Quad pill” tablet which combines four HIV drugs into a single daily treatment. The four in one pill is intended to make it easier for patients to stick to their medication, improving the effects of their treatment.

Mumba was diagnosed with Tuberculosis in 1998 and immediately commenced treatment but tested HIV positive eight months later.

In the year 2000, she started the antiretroviral therapy (ART) but had to discontinue due to prohibitive cost of Antiretroviral (ARVs) drugs at the time. The drugs cost K1.5 million per month (U$300).

“The stress of taking so many drugs was too much and as if that was not enough, storage of (Kaletra) was also difficult for me, especially when I was travelling.  I used to move with a small cooler box all the time when I was travelling out of my base.

I remember one time, my friend lost her father in Mpulungu (Northern Zambia) and I escorted her for a funeral in the village where there was no electricity and no refrigerator.  I would buy ice water at the market and put it in the small cooler box just to keep my drugs cool.”

Though Mumba restarted her treatment two years later, she had already developed resistance to the drugs.

In 2005 after becoming resistant to first-line treatment, Mumba was put on 2nd line drugs and started taking Aluvia and Truvada which she says require her to take fewer tablets daily.

Instead of the earlier 7 tablets, she now only takes 5 (2 Aluvia tablets, twice daily and 1 Truvada tablet daily)

The Quad pill is said to be the first multi-pill to include a type of anti-HIV drug known as an integrase inhibitor, which stops the virus from replicating.

Researchers say the solitary once a day pill was found to be faster acting and had fewer side-effects compared to two widely used drug regimes.

Mumba says “for me taking one pill a day would make a great difference in my life, it will christmax, especially that it has fewer side effects.  Some of the drugs that I have taken have left me with fatal side effects which are physically irreversible.

So the news of one pill, once per day and fewer side effects, will be truly good news for a woman like me, who has come a long way from taking so many TB drugs, so many ARV drugs to one tablet only once per day.”

According to the World Health Organisation (WHO), standard ART consists of the combination of at least three ARV drugs to maximally suppress the HIV virus and stop the progression of HIV disease.

An estimated 34 million people are currently living with HIV worldwide. At the end of 2011, over 8 million people living in low- and middle-income countries had access to ART, reported the WHO and UNAIDS organisations.

While access of ARVs by infected people remains vital, finding a lasting solution to drug resistance, that would ensure patients take their medication daily and on time is equally important.PYM

Breastfeeding- the healthier choice for babies

By Meluse Kapatamoyo

With an upsurge of various diseases and pressures of daily living affecting most women, some mothers are being forced to reduce or stop breast feeding altogether before the
recommended six months, denying their infants the much needed nutrients from breast milk.

From August 1 to 7, mothers in more than 170 countries celebrate World Breastfeeding week, a period meant to encourage breast feeding and the improvement of the health of babies.

The week commemorates the Innocenti Declaration made by World Health Organisation (WHO) and UNICEF policy-makers in August 1990 to protect, promote and support breastfeeding.

WHO recommends excluse breastfeeding until a baby is six months old, and continued breastfeeding with the addition of nutritious complementary foods for up to two years or beyond.



Eliva Mwewa Mwansa, a mother of one,  said, “I went back to work after 3months but wish I could have spent more time exclusively feeding my baby for the recommended months. Unfortunately, my baby refused formulae so I started giving her light cereal at 3 months. I am still breast feeding and she now eats solid foods, so I only breastfeed her when I get home, mostly in the night. Luckily she is a very healthy child.”

According to UNICEF, despite compelling evidence that exclusive breastfeeding prevents diseases like diarrhea and pneumonia that kill millions of children every year, global rates of breastfeeding have remained relatively stagnant in developing countries, recording a minimal growth from 32 percent in 1995 to 39 in 2010.

“If breastfeeding were promoted more effectively and women were protected from aggressive marketing of breast milk substitutes, we would see more children survive and thrive, with lower rates of disease and lower rates of malnutrition and stunting,” said UNICEF executive director Anthony Lake.

He believes that strong national policies supporting breastfeeding could prevent the deaths of around 1 million children under five in the developing world each year.

In 2008, the Lancet Nutrition series revealed that a non-breastfed child is 14 times more likely to die in the first six months than an exclusively breastfed child.

“Breastfeeding needs to be valued as a benefit which is not only good for babies, mothers, and families, but also as a saving for governments in the long run,” said Lake.

In June, world leaders meeting in Washington, DC, pledged as part of the “committing to Child Survival: A promise Renewed” movement to work toward ending preventable child deaths. PYM