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ART adherence failing in Zambia due to lack of food

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A regular food supply is vital for people living with HIV as nutrition plays an important role in improving their general standard of health. Many Zambians with HIV however are failing to adhere to treatment regimes because they don’t have enough to eat.

In Mkushi’s Chalata village, poverty has robbed some HIV patients of the physical strength they need to take antiretroviral drugs (ARVs). The drugs increase people’s appetites and many choose to stop taking them when they are unable to buy the food they need.

People living with HIV who stop taking ARVs are more likely to develop opportunistic infections or a resistance to first-line drugs.

Donor countries have invested billions of dollars into antiretroviral treatment (ART) and other medications to counter the growing impact of AIDS in developing countries but the benefits of their investments are mitigated by poverty and a lack of food and clean water.

ARVs are most effective when taken by people who are adequately nourished. Food support can play an important role in ensuring that these people receive the full benefits of their treatment.

“It is irresponsible to ignore the issue of hunger and malnutrition particularly in the battle against AIDS,” said Dennis Muponda, an HIV-positive father of four from the Mulila area in Chalata.

Mr Muponda lost his job in Ndola’s Chifubu town in 2004 after he became sick and was diagnosed with HIV. He was immediately placed on ARVs but his loss of income meant his children dropped out of school and he did not have the support he needed to cope with his marriage breakup and failing health.

“When my health failed me, I had no option but to be back to the village in Mkushi where my mother is, this was after my relatives that were living in town abandoned me because of my illness,” he said.

Mr Muponda said life in the village was unbearable for him and his children and that he would often go for days without food and medication.

“I had stopped taking my ARVs because of lack of food until the home-based care givers from Family Health Trust found me home on my death bed, and encouraged me to start the drugs again,” said Mr Muponda.

The care workers are helping Mr Muponda with food and he hopes to see his children go into school but he does not see the point in continuing to live in such difficult and stressful circumstances.

He has reached a point where death seems like his only option but if he just had enough food to eat he would be stronger and would not be prone to opportunistic infections.

Many more people in Mkushi are experiencing the effects of hunger and are compromising their ARV adherence. According to World Health Organization, the energy needs of adults on ARVs increase by 20% to 30% because of poor absorption in the intestinal tract.

Chalata Rural Health Centre Officer Lackson Chisenga said the facility had started providing food assistance to the villagers in a bid to encourage people in the area to adhere to their medication.

“We are sensitizing people to the importance of adherence through our officer nurse trained in that area, although it will take time for people to grasp the message, our campaign for a change of attitude among the villagers would help us,” Chisenga said.

The United States Secretary-General’s Special Envoy for AIDS in Africa said nutrition interventions for HIV programs were often overlooked in the international HIV policy debate and remain critically under-funded.

The Joint United Nations Program on HIV and AIDS has forecast that 900,000 people receiving ARVs for the first time in 2008 will require food assistance and that the average cost of providing food to a patient is just US $0.66 a day, or less than 2% of the cost of current drug programs.

The Ministry of Health should consider supporting the distribution of drugs with the provision of food.

Africa Science News Service

64 COMMENTS

  1. Very sad to read. I hope the government can find a solution. I don’t know however if they can “afford” to provide food for these people when they fail to provide medicine in the hospital.

  2. thats true i handle patients on HAART everyday, those drugs need good nutrition to help restore immunity to to pre morbidy levels. the other issue is excesive alcoholism en poor adherence to therapy

  3. It’s not surprising to hear that treatment is failing. There’s so much poverty in Zambia! Number 2 you are right, one can wonder if the Government can fail to provide medicine in hospitals, what about food?

  4. People, prevention is better than cure we all know HIV is incurable let’s upgrade our moral standards to avoid the infection and re-infection of the virus.It’s sad that a country so rich in resources still has such high poverty levels.All the more reason for us all to vote and to vote wisely.We need a president that can deliver and lead this country pout of poverty.

  5. # 3. Doesn’t Zambia have high energy protein supplements anymore? I remember buying some for my grandparents in Lusaka.

  6. Helo,
    most of the replies seem to suggest that voting wisely will bring food on the tables of the people on ART. please be realistic even if the president we elect is to put good policies in place, we must move away from the dady feed me mentality. I know it is hard as i is to survive, but i see alot of people doing nothing and wanting to get things for free.
    If you take an example of n’gombe compound for example, people have to go into roma to buy fruits for resale and have been doing this for over ten yrs i ve been there, but stops a person rom n’gombe to plant a fruit tree or gaint rape so that he/ she can have Vit C they need for their ART food suppliment.

  7. #9 Iye if only you knew the levels of poverty here and just who can afford thos high energy stomfyos?If one can’t afford food for a family of six you think they will afford those stomfyos for themselves?When did you leave Zambia?

  8. This is the same point that Mbeki (former SA president) made when he said poverty is a huge contributor to the HIV/AIDS epidemic, and that before you issue ART/ARV you have to make sure that the eating plan/ diet is corrected or else the is no point as one cannot take medication on an empty stomach

  9. # 9. Supplements increase apetite so bottom line is more food. I hope Govnt is aware of this and will act asap.
    # 8. how does Tonga come in. If it is true about Tongs and its not news what makes it so?

  10. A new government should take this serious , when we elect you in power you candidates you should remember our friends with this problem. My word are, let the government address itself to this situation.
    Personally I will help those in my reach and will pray for those who are far.
    With lots of love, pep-c.

  11. Shi Mulase…..i saw your comment,i will take you up on your offer same time….am busy right now….lets do our country proud and not lazy around

  12. #8, get real man, go to the ART statistics office and ask for the statistics booklet or probably the google docs will help you know what you are talking about. Let us promote lofe for each other even in the fight against HIV, not the way you are doing things boyi please God love you. Do not allow yourself to go to hell on things like this one. Watch your comments and go back to school for more skills on how to approach public sites. If you want you can reply my blog and you will see what happens when you go for an HIV test.That I promise you boyi. I’m not Tonga but what you’ve said have affected me negatively. Watch and please do.

  13. Some of these Aids activists should reduce on buying expensive pajeros and instead help out with those monies people are dying. Some actvists have even stopped politics because the Aids campaign is highly paying. Lets not benefit at the expense of peoples misery

  14. Food can only come on our tables through hard work. Let us work hard so that we have enough on our tables. Let us vote wisely on October 30 and only hardworking people with a vision for Zambia should be voted into office.

  15. IF YOU ARE HIV NEGATIVE, TRY KEEPING THAT WAY. KEEP THE PROMISE. BUT IF YOU CAN NOT, ALWAYS USE A CONDOM-IT IS CHEAPER.GOVERNMENT WILL NOT HELP YOU WITH MORALS OR SELF IMPROVEMENT, THAT IS FOR YOU.

  16. If they vote for HH and he will give them presidential salary.

    If they vote for RB he will give them sugar and fertiliser

    …… Sata will try to finish them off in 90 days.

  17. The problem when someone has HIV is that they look as if they slept with a hundred people. You already imagine them in bars surrounded by alot of girls, but how wrong we are. These guys need understanding,

  18. saddenning guys!!! lets donate a few cents for our sickly brothers and sisters in a sickly nation. These are issues i expect politicians to talk about and not the cheap rhetoric staff.
    By the way, lets fight this spirit of Bembatongalism.. its bad coz division starts from few remarks uttered to an unwilling listener.

  19. I too worked in the ART program sector targeting mothers and their children. The particular program I was on, provided food supplements from a UN organisation (as well as ARVs), to individuals or families that were identified as food insufficient by their caregivers. But guess who was benefiting first from this aid?

    Governement has partnered with organisations to provide this programme already. They may not be everywhere but maybe the lack of accountability is hampering the delivery to the rest of the communities that need them.

    This service is not unique to the govt of the day but is a humanitarian one by the UN.

  20. Zambians are such pretenders. Most people who look decent during the day have very low moral standards in the dark. Avoid HIV and you wont need ART or Heps!! Most people now think they can be promiscuous because there’s ART….they forget the side efects of these drugs not to mention taking drugs for the rest of your life.Be wise…take care of your health which God gave freely to you.

  21. I think the AIDS issue and Food has no political inclination because it is based on a long term program of ensuring food for all and also behavior change by the majory bloggers here!!!whether in Zambia or out AIDS is every where and a lot of poeple have died with Food or without (Check the statistics in developed worlds)

  22. Some of ustuchili tulelosha nalunya pa zed
    I just came accros the Late President mwanawasas funeral video mega video if interested follow the link there is more there but it looks like some of the links have gone dead

    megavideo.com/?v=VHH8B430

  23. The food componet is related more to nutrition and having the knowledge of what to eat. The problem is that most people in Villages and out there think good food is beef or pizzer etc and yet they forgotten in that it is in the same chiwawa and ntwilo etc were the nutrition is, hence food or no food knowledge is power.

  24. #7. Pilot, do not just open your spout without thinking. A child getting HIV from the mother is because of low moral standards? Or a faithful married women infected by an abusive, two-timing bastard is low moral standards? There are thousand of people who need ART not because they got the virus via irresponsibility or immorality. The issue here is food. People need food. With or without ART, food is a basic right.

  25. #34 Osama, shag them in their millions and let us see where that takes you. Maybe you will get an Oscar or a Nobel Prize for Shagging. I am happy you are not in Zambia because we don’t need people like you who don’t care about the sick in Zambia. I am sure you include your cousins, uncles, friends and other family members who have HIV when you say you don’t care. Remember every 7th Zambian is infected.

  26. #29. Summer Cool, don’t show your ignorance here iwe. A child getting HIV from the mother is because of low moral standards? Or a faithful married women infected by an abusive, two-timing bastard is low moral standards? There are thousand of people who need ART not because they got the virus via irresponsibility or immorality. The issue here is food. People need food. With or without ART, food is a basic right. Who shags more Zambians or Cubans but who is worse off? I thought so.

  27. Musiye atompinge umoyo. Amwelepo yenangu muzako, ndaba chalo chinzuna. Kapena azaonako mailo.

    I’m sure you have all heard this song. Very creative. Matenda yaliko, mankwala yaliko, umoyo ni wako mune topingapo.

    Contact me for full lyrics.

  28. osama bin zed will be topping soon. Real men sleep with one woman coz it’s easier to sleep with more. Nothing to be proud of in that.

  29. I’m surprised LT didn’t cover this. Our own athlete Rachael Nachula has just won gold and set a Commonwealth Games record in India. I also discovered that there is no single website with full info on her and there is only on photo of her on the Internet.

    So I decided to blog on her and you can read about her achievements and history at shalalaoliversepiso . blogspot . com .

  30. osama bin zed: Demadone not demadome. I mean who sounds empty, you or me? vi Xenophobia uko vavuta. It’s getting into your mind. Now you are always indoors posting on this forum. Go outside and breath some fresh air.

    Prof AKULU MPUNO: who is blogging in nonsense language?

  31. I rebuke this nosence in Osama in Jesus’s Name. You need to be delivered my brother. You just haven’t gone for VCT – Go and check yourself.

  32. Mulenga thanks for a good input. I was in Swaziland last week for my PhD research project. its disastrous there man. however the ART satellites are quite effective that in Zed. Perhaps we can learn from there.

  33. #50. Jesus didn’t sound appropriate in that comment. Don’t blasphem my brother. Coz I don’t see the link in the real Osama and Christ.

  34. It is very telling to see the number of blogs posted regarding this very important issue. Compared to the number of rants posted when people are talking about our wanna be presidents the number of posts here is lamentable. This is a developmental, social and economical issue and yet people are unwilling to discuss it. This should be one of the most important issues during this election instead of trading tribal insults and yet people seem not to care when we are all affected as Zambians.

  35. This is a real situation giving a real picture on why the global fight against the hiv pandemic has always been an uphill battle to surmount

  36. #8 i guess its your mum who told you what she endured from a Tonga.If not shut up and use your brain before posting anything. Its a long time since we stoped stereotyped way of reasoning where you attack a tribe instead of of individuals

  37. Someone coming from a country with poor soil and imported water can laugh at us.Honestly speaking, God has blessed this country with vast land and water resources yet poeple still die and leave thier children as orphans because of starvation. We need pioneers, revolutionisers to steer this country into the right direction. We need food barns, giant ones in this country not just FRA. like in the days of Joseph ,which are enough to keep this country and population for 7 years without cultivating (for instance). THis country has got that capacity we have underutised, may God open our eyes to see.Eish its so annoying!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

  38. The moment we lessen Governments participation in the HIV LIVING=FOOD+ARV equation the better we’ll be off.

    Government will never provide food for anyone no matter how touching their circumstance.

    The best Government can do for us individuals living with the HIV virus is to ensure that we have jobs that can help us buy the food we so desperately need for our continued survival.

  39. How much food could have been given to those poor sick people instead of buying a car for 300 Million Kwacha for former president Chiluba? It is all about priorities in life!

  40. NEVER EVER SAY U DO NOT CARE ABOUT HIV AND PEOPLE LIVING IN POVERTY.. UNLESS U TAKE STRONG IBANGE TO IGNORE THE REALITY OF LIVING-
    LETS WORK TOGETHER. THE BIGGEST PROBLEM IS ZAMBIA IS MAGINALISATION..

  41. No. 28, what are you saying? I am sick of people talking about HIV/Aids statistics in the same breath as promiscuity! The west has painted a bad picture of sex-mad africans and we are buying into it! The Uk has the highest prevalence of teenage pregnancies, and two years ago Dublin city was the chlamydia capitol of Europe. What does that say? Are we worse? I don’t think so. Our problem is silence. People still not talking about sex with their children as if it is bad or dirty, treating young abandoned pregnant women as if they are some kind of prostitute. Before we can talk about abstinence, we need to talk about sex itself, teach our children respect for it, then we can go somewhere!

  42. How are we going to brainstorm about Hiv/Aids if we keep pointing fingers at the Tongas and Bembas?Therefore this is a serious matter,

  43. Valuable info. Fortunate me I discovered your site by accident, and I am stunned why this coincidence didn’t happened earlier! I bookmarked it.

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