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EPIDEMICS
'Live positively': Togo's 'Tino' sets example for HIV/AIDS
By Emile KOUTON
Lome (AFP) Nov 30, 2015


HIV drug stocks not reaching African patients: report
Harare (AFP) Nov 30, 2015 - Efforts to get lifesaving antiretrovial drugs to HIV-positive patients in many sub-Saharan African countries are routinely failing at "the last mile", an international medical group said Monday.

Despite stocks being available, the drugs often do not reach clinics because of "cumbersome procedures, logistical challenges or lack of resources," Medicins Sans Frontieres said in a report released at the International Conference on AIDS and STI (sexually transmitted infections) in Africa in Harare.

Nationwide surveys conducted in South Africa showed that between 20 and 25 percent of local health centres were unable to dispense the complete amount of one or more HIV or TB medication.

In 80 percent of the cases, the drugs were available in the country but did not reach the clinics.

"National and international shortages of medicines do get donor and government attention, but the availability of medicine in local health centres is not routinely monitored," said Tinne Gils, MSF's regional pharmacist.

Similar problems affecting an even larger percentage of clinics were experienced in the Democratic Republic of Congo and Mozamique, MSF surveys found.

"Improving medicine delivery to the last mile will require the commitment of countries and international donors," the report said.

"Antiretroviral treatment needs to be taken for life, without interruption," said Gilles Van Cutsem, MSF's medical coordinator in South Africa.

"But how can patients be expected to remain adherent to their treatment if their medicines are not available when and where they need them?"

Augustin Dokla is arguably Togo's most famous person with HIV, having lived with the virus -- against the odds -- since 1999. Sixteen years later, he's still fighting for the rights of those infected.

"I will not succumb to this infection but rather I will die with it. I am resolved to bear the heavy burden," he told AFP.

Among friends at Espoir-Vie, the West African nation's largest non-governmental association for people living with HIV, Dokla exudes optimism.

He's still unsure how he contracted the the virus. But, he says, none of that matters in a region where people with HIV are often shunned and access to the right drugs is limited, through supply and cost.

"The important thing now is to live positively with this infection," said the 44-year-old.

- Shock diagnosis -

Dokla tested positive for HIV in 1999 after a bout of serious pneumonia, which saw him spend three months in hospital.

"I had only flesh and bone left after losing close to half of my normal weight of 75 kilograms (165 pounds, 11 stone 8 pounds)," he said.

"One day, I decided to go for an HIV test. When the nurse told me of my status, I let out a long sigh and we stared at each other for some seconds because at that time AIDS was synonymous to a death sentence, with drugs being scarce and very expensive.

"My mother cried her heart out when I broke the bad news to her. But it was a big relief for me that I knew what was going to make life difficult for me."

For two months in 2000, Dokla was treated in a Paris hospital. He was discharged -- and determined to survive.

"It was this treatment that saved me. I refused to die to enable me commit myself the fight against this damned virus," he added.

Since then, he has become a powerful speaker at seminars and awareness campaigns and also heads an agency supporting people living with HIV/AIDS.

- Changing attitudes -

Togo once had the third-highest rate of HIV/AIDS infection in West Africa. A transient population and low spending on healthcare was blamed.

In 2014, 2.5 percent or 110,000 of Togo's 7.5 million people had HIV, according to UNAIDS and Togo's national committee on the virus.

AIDS-related deaths have declined in recent years from 10,330 in 2009 to 6,641 last year, in part due to vigorous campaigning from charities such as Dokla's.

At the same time, the number of people living with HIV/AIDS taking anti-retroviral (ARV) drugs seen as key to suppressing the virus and preventing new infections has gone from 16,225 to 37,511 in the same period.

Dokla, or "Tino" to his friends, however, knows that overcoming social attitudes is also part of the battle.

"I do not undergo special treatment apart from my tablets, which I take every day before I go to bed," he explained.

"I travelled a lot for big conferences in the United States, France, Mexico, Belgium, Italy, Spain, etc. In Africa, I have been to some 30 countries and in my native Togo, I have travelled to all the provinces."

- 'The only battle in my life' -

Eight years ago, Dokla mobilised more than 500 people with HIV for a protest march to denounce a lack of ARV drugs and is a regular feature on the public speaking circuit.

"It is the only battle in my life to assist other people not to catch this infection. I give a meaning to my existence each time I give testimony and sensitise ignorant youths on the virus," he said.

"Others living with HIV/AIDS do not have the courage and are hiding for fear of being stigmatised."

"Tino plays a major role in taking care of people living with AIDS in Togo. He knows our problems and he does not hesitate to defend our interests at major events," said Amoussou, who has been undergoing anti-retroviral (ARV) treatment in the past nine years.

"He is an indefatigable fighter. Each time I see him in public, my hope is boosted," said Afiavi, a former sex worker who contracted HIV six years ago.


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