No ARV no life for PLHIV

By Chhay Sophal

Holding an Anti Retro-Viral (ARV) pill in her hand, 8-year-old Cambodian Heang Sok Heng, whose mother and younger sister died of disease related to AIDS in several years ago says “my grandmother gives me to take it everyday”. Living with her grandmother, Heang Sok Heng was diagnosed as HIV-positive when she was one year old. “She cannot live without ARV. If she does not have it, she will die and leave me alone,” says Chhoeu Voeun, Heang Sok Heng’s 58-year-old grandmother.

The young girl takes ARV twice a day -- in the morning before going to school and before going to bed – while Opportunistic Infection preventatives are taken at lunchtime. “Without these medicines, my granddaughter cannot survive,” said Chhoeu Voeun bursting into tears. “ARV has given my granddaughter a second chance at life, she cannot live without it.”

Heang Sok Heng is one of tens of thousands of Cambodian People Living with HIV (PLHIV). Although the country’s HIV infection rate has dropped from 1.2% in 2003 to 0.9% in 2006, the prevalence amongst married women infected by their husbands is still high, while one third of new infections result from transmission from mothers to children.

An official from the National AIDS Authority (NAA) said ARV will remain in high demand for at least the next two years. “Some 18,300 women and 17,000 men will need ARV between 2008 and 2010,” said Dr. Hor Bun Leng, NAA Deputy Secretary General. He estimated that an HIV-positive person could spend about US$1,000 each per year for ARV. Dr. Bun Leng also warned that the epidemic can return if the country is reluctant to take steps for additional prevention. Vulnerable groups such as people aged 15-49 years mobile populations, sex workers, men who have sex with men, drug users and married women are at high risk and the high mortality rate from AIDS has resulted in many orphans and widows, he added.

This situation is replicated across the world. The efforts of researchers and medical workers, who work together to produce and deliver ARV, are saving the lives of those with HIV/AIDS. “Three million people on antiretroviral therapy worldwide is not just the greatest public health achievement of the new century, it is a tribute to all of you who have fought so hard to understand HIV and to make available the drugs that are saving these lives,” Festus G. Mogae, former president of the republic of Botswana, said in his opening remarks on August 3 at 17th International AIDS Conference in Mexico City. Mogae also said he salutes and acknowledges “the leading role of pharmaceutical companies of the world who are often maligned.”

Speaking in his opening speech at the conference, UNAIDS Executive Director Peter Piot, also urged scientists and funders to continue their efforts to develop an HIV vaccine allow more people to access ARV. “In the long run the best way to stop people dying from AIDS is to reduce new infections in the first place. But in the meantime, the treatment imperative remains as strong as ever, because let’s never forget that this is about people. Because this is about entitlement to life,” he said. “One of the main lessons of providing antiretroviral therapy to millions of people is that we should not wait until systems are fixed before acting, because I know what would have happened to the 3 million people on ART today if we had waited: most would be dead by now.”

In his opening session speech at the conference, Dr. Luis-Soto Ramirez, the Conference Co-Chair and International AIDS Society Governing Council Regional Representative for Latin America and the Caribbean, said several countries in the region have challenged the idea that treatment could only be accessible to “the lucky few who had the money to pay for antiretroviral drugs,” and are fighting hard to lower drug prices to bridge the gap between north and south. “It is time to bring drugs to everyone in need, regardless of who they are, where they live, or how much they earn. It is time for Universal Action NOW,” he said.

In his closing session remarks, Dr. Julio Montaner, Director of the British Columbia Centre for Excellence in HIV/AIDS in Vancouver, Canada, and the new President of the International AIDS Society, said though the number of children infected with HIV/AIDS fell from 410,000 in 2005 to 370,000 in 2007, this was hardly a victory,…”

If the appeals of the leaders and delegates at the conference are realised, there will be good news for Heang Sok Heng and PLHIV across the world. “I am really happy if all PLHIV can get regularly enough ARV with free of charge. We do not fear any more,” said Heang Sok Heng’s grandmother. “I would like to call on the world doctors to produce more ARV for PLHIV and find HIV vaccine so that my granddaughter and other people living with AIDS can live longer.”