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There was no integrated government programme for people living with HIV (PLHIV) and TB in Nepal until six years ago. Therefore, treatment used to be complex for PLHIV when diagnosed with TB. Pranesh (name changed), an HIV positive person in Kathmandu, says, “At that time, HIV positive people suffering from TB would have to visit different healthcare facilities. Now, the situation has changed.”
It was a huge relief to people like Pranesh when the government introduced a policy in this regard in 2009. National Tuberculosis Centre (NTC) has stated that the implementation process has been enforced as the integrated programme for PLHIV co-infected with TB. Physician Dr. Santosh Neupane says, “HIV positive people have very weak immune system. That is why they are susceptible to many other infections. Most of them succumb to TB. This fact was taken into account when the integrated program for both HIV and TB infected was launched.”
According to National AIDS and STDs Control Centre, about 50,000 people are infected with HIV in Nepal; and 2.4% of them, (around 1,200 people), are co-infected with TB. Currently the NTC and National AIDS and STDs Control Centre have treatment services for such people in 25 districts and counseling services in 5 districts. But the government aims to run the integrated programme in all districts, and a detailed plan is being chalked out to deliver services to the doorstep of HIV and TB co-infected ones. Dr. Neupane says, “The government has been launching unified programmes, partnering with its lower level agencies or partnership organizations, and plans to expand this programme gradually.”
As per the government’s plan, organizations working on HIV/AIDS control and care have to work in the sector of TB and the organizations working on TB have to increase their reach in the sector of HIV/AIDS. According to Dr. Dirgha Singh Bam, Former director of National Tuberculosis centre, “Diagnosis of TB and HIV in the same person is a common problem. That is why an integrated programme becomes effective and this will help the government achieve the goals.”
The government has envisaged to deliver care and assistance to persons infected with HIV and/or TB. Under the programme, HIV diagnosis and treatment, along with the DOTS treatment for TB co-infected persons has been initiated in anti retroviral therapy (ART) centres. Similarly, the diagnosis and counseling services for HIV infected have been initiated in TB clinics. Integrated treatment for TB and HIV co-infected have been initiated in Dhanusha, Doti and Rupendehi districts.
Preventive Therapies are also being effectively run as stated by National Tuberculosis Centre. Various donor agencies have been assisting government programmes to control HIV/AIDS, Tuberculosis and Malaria in Nepal through the gateway of Global Fund. Global Fund has been providing assistance for the treatment, counseling and care of the HIV and TB infected people.
This would go a long way in ensuring high quality healthcare to at least people living with HIV and/or TB. Hopefully the Nepal government would extend similar facilities for people grappling with other diseases as well, by offering Universal Health Coverage to its citizens so that every person, everywhere, has access to high quality healthcare and does not suffer risk of financial hardship simply because they get sick. This human right —to attain the highest attainable level of health—is enshrined in the World Health Organization’s constitution
On December 12, 2012, the United Nations unanimously endorsed universal health coverage. On this day this year in 2014, a coalition of more than 500 organizations representing more than 100 countries came together to celebrate the first-ever Universal Health Coverage Day, giving the clarion call for universal health coverage for all people around the world.
Chhatra Karki, Citizen News Service - CNS
25 December 2014