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Patients may choose
Khopotso Bodibe. 11 February 2004. Health-E News. Republished courtesy of Health-E News Service.
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Government?’s HIV/AIDS Care and Treatment Plan is not only about making antiretrovirals available in the public health sector for the first time. The programme also includes a strong focus on nutrition and traditional medicines. Health-e News Service asked Dr Nono Simelela, co-ordinator of the Plan, how the three components come together in the programme.
Below is a transcript of a radio broadcast package, produced by Health-E News.
Dr. SIMELELA: We will buy supplement meals for patients who are food insecure. We will provide micro-nutrients for all patients who are HIV infected. In terms of traditional medicines, what the Plan says is that we will acknowledge the role of traditional medicines?… We actually are working with the MRC and other institutions to evaluate the safety and efficacy of such medicines. What we?’ve said is that where patients are taking traditional medicines we will document it. We will not discourage it, but we will try and follow up patients to see if there are any interactions between traditional medicines and antiretrovirals.
Khopoto Bodibe: Simelela further went on to say that the Plan is about giving people a choice.
Dr. SIMELELA: What we have said and re-emphasised is that patients have a choice. People will not be forced to take anything that they are not willing to take. But, at least, when we?’re providing the full comprehensive package, then people will be able to say ?“No, I don?’t want antiretrovirals, I want to just have good nutrition?”, we should be able to support that. And if they say ?“Well, I?’m taking my traditional medications from my traditional practitioner?”, we should be able to support that.
Khopotso Bodibe: But, who will bear the cost for traditional medicines, government or the people?
Dr. SIMELELA: We will not necessarily be able to procure it for patients, but we will not necessarily condemn them for using such interventions.
Khopotso Bodibe: What work has been done with traditional medical practitioners to accredit that segment of the programme?
Dr. SIMELELA: We have, in the national HIV/AIDS Directorate, two traditional healers, fully employed, by the sub-unit to work with traditional healers. We?’ve got eight provincial chapters where traditional practitioners are working very closely with government?… Remember, traditional health practitioners are not a homogeneous group of people. They are sangomas, and other. So, it?’s all a mix. We have said that they will set up a forum for them to monitor each other because doctors in the traditional Western experience will not necessarily be able to tell what is right, what is wrong, what?’s working, what?’s not working. So, there is a forum that the Minister has already established for traditional health practice in the country.
Khopotso Bodibe: Dr Anthony Mbewu, Executive Director of the Medical Research Council, and former chairperson of the HIV and AIDS Care and Treatment Plan task-team, says there is scant evidence to suggest that nutrition and traditional medicines are effective in improving the quality of life of people living with HIV and AIDS, but anecdotal evidence argues they do work.
Dr. ANTHONY MBEWU: The scientific evidence that we have on the effectiveness of interventions mainly applies to anti-retroviral drugs. And that?’s why this Plan has, as it?’s primary intervention, the access to anti-retroviral drug therapy for people living with AIDS?… However, nutrition, we know, is an important intervention in people living with AIDS, and possibly also, in people whose status has not declined to the level of severe immune deficiency?… The scientific evidence for the effectiveness of nutrition interventions is lacking and the Medical Research Council?… is undertaking research in that regard.
Khopotso Bodibe: The Medical Research Council is also assessing how safe and effective traditional medicines are in raising CD 4 counts and reducing the viral load in an infected person?’s system.
Dr MBEWU: We estimate that something like 80 % of the South African population as a whole uses traditional medicines and consults traditional healers. So, we were aware that it was essential in terms of the success of this Operational Plan that we, firstly, should acknowledge that patients are using traditional medicines. Often, because of the stigma associated with traditional medicines in South Africa, patients will not report that they are using a traditional medicine. And it is essential when you are instituting anti-retroviral therapy to know all the medicines the patient is taking ?– traditional, complementary and orthodox ?– because there can be drug-drug interactions. |
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