Vancouver AIDS conference: special report. Zambia criticised for "missed opportunities"
Whiteside, A.; Winsbury, R.
Aids Analysis Africa 6(4): 3
1996
ISSN/ISBN: 1016-8974 PMID: 12347380 Document Number: 300097
Dr. Connie Osborne of the University of Zambia School of Medicine criticized Zambia's government for missing opportunities to strengthen the extent and quality of care provided to people living with HIV/AIDS (PLWA). The government has missed opportunities to get suspected or known PLWA to enter the continuum of care. While HIV/AIDS awareness and prevention have been integrated into all basic health programs, HIV testing is done only in hospitals due to the lack of testing facilities at the program level. Testing, when done, is usually not done properly due to staff shortages, an excessive client load, and/or health personnel burn-out. It is argued that Zambia's health sector reforms fail to address the issue of HIV/AIDS care. Sick PLWA whose serostatus is known to health workers are not exempt from paying user fees at health institutions and most are unable to pay medical insurance. It remains questionable, however, whether exempting such clients from paying user fees would increase their access to effective care. Dr. Osborne noted the case of Kara Counselling, a local nongovernmental organization which has been offering both voluntary counselling and testing since 1993. An HIV test at Kara costs US$0.50. Since January 1996, Kara has tested more than 1000 clients. While approximately 40% of these individuals were found to be HIV-seropositive, only 70 seropositive clients were seen at the counseling service over the same period. Attention needs to be given to this wide gap between client testing and counseling.