STAKEHOLDERS in the HIV and Aids sector have complained over “deterrent” Antiretroviral Treatment (ART) user fees saying they are discouraging efforts to contain the disease.
In Zimbabwe, ART is over 90% funded by the Global Fund, PEPFAR, the Melinda and Bill Gates Foundation and the United Kingdom’s Department for International Development (DFID), among other partners.
Domestic funding of the disease is raised through the Aids Levy which is administered under the National Aids Trust Fund.
While these funding mechanisms provide free ART services at public hospitals, some centres, however, charge user fees for administration to those in need of the drugs, a move which has been described as a stumbling block in fighting HIV and Aids.
Pan African Positive Women’s Coalition Zimbabwe national director Tendai Westerhof said there was need to relook the issue of user fees and to align them to suit all users regardless of economic standing.
“We do not have a policy around user fees, hence you discover that some areas charge user fees, some don’t and where they charge user fees, there is no uniformity. You find one centre is charging US$1, another is charging US$3 or US$5 and so on. When user fees are charged, they become a barrier to treatment access.
“Remember, the policy in the country is that all HIV treatment is free. You find that some centres are charging user fees in the name of administrative fees, for instance, for the paperwork, the stationery they give you, that is what they are charging and they say they do not charge the actual treatment,” she said.
Zimbabwe HIV and Aids Activist Union Community Trust secretary-general Angeline Chiwetani said the issue of user fees was a painful experience for most users.
“We had community health advocates from the areas we worked in. The issue of user fees was a constant pain in all the discussions we had at health facilities in Manicaland province for clients accessing ART at the City of Mutare’s council clinics,” said Chiwetani.
“User fees ranged from US$1, US$2 to US$5 at facilities run by Mutare City Council. The user fee is a barrier to accessing services for many who cannot afford the required fees. Imagine a family with both parents and two children on treatment. They need US$20, it is too much, and it’s expensive, beyond their reach.”