28 Jun 2005
Marthe Tepi(not real name) is a 39 year-old mother of two. She was referred to PETAO (counselor pharmacists) at Douala’s Laquintinie hospital because she has skipped her ARV therapy for the fourth time. “It is not because I am negligent that I find myself before you again” recounted Marthe to a pair of volunteer pharmacists. “ I have seen the benefit of these medicines but I am unfortunate that I always run short of money. The father of my two children abandoned me two years ago when I became ill and my junior brother that opted to help me got into problems and is in detention. I promise never to interrupt my treatment again now that the Social service of the hospital has taken over the responsibility of paying for my medicines.” Struggling to fight back tears, Marthe said in an answer to a question about her five year-old ailing last child, “I was hoping that by now I should have been well enough to look for money and carry out an HIV test for him but you can see that my own health has instead deteriorated. I have lost more than twenty kilograms since I last discontinued treatment.”
Marthe is one of the lucky patients that has been placed under the care of the social service. The Cameroon government is trying to set up a programme that will enable the social service to finance the drug purchase of 10% (of the very poor) people on ARVs.
Since medications became available for managing HIV/AIDS as a chronic (long lasting) disease, many Cameroonians are still confused as to how much a patient that is placed on ARVs (the drugs that treat HIV/AIDS) is expected to spend during the course of one year.
Politicians may quickly point out that the monthly cost of these medicines range from 3000 to7000cfa (6 to 14 USD) for majority of patients. This is true if we are considering solely the cost of medicines. The important thing everybody should know is that the management of HIV/AIDS goes with routine (mostly mandatory) medical exams that have their cost also.
Research carried out at Laquintinie Hospital Douala (a leading AIDS treatment centre) shows that a patient placed on ARVs will spend this amount a year on medical tests. Pre-therapeutic tests = 20,000cfa, evaluation tests on the 15th day from day of commencement of therapy = 7,500 cfa, evaluation tests on 45th day = 7,500cfa, CD4 count test = 10,000cfa, follow up tests on the 6th month = 18,000cfa, follow up tests on 12th month = 18,000cfa. During the course of the year, the doctor may require that another test called viral load (costing 43,000 cfa) be carried out or may ask for a repeat of CD4 count test.
Patients that take their medication properly may from the second year be required to do only two or three follow up tests of 18,000cfa each annually. It should be recalled that the cost of these tests used to be higher until the government announced a reduction early January 2005.
If an adult patient is to be placed on ARVs, at the Laquintinie treatment centre, he/she should budget at least between 150, 000 to 200,000 cfa (300 to 400 USD) within the first year or 13,500 to 17,500cfa/month for tests and medication. There may be slight variations at other treatment centres but the above estimates are good indicators for most patients in the country. It is clear that Cameroon (GDP-per capita of about 2000 USD) has come a long way from the days when antiretroviral therapy was only for the very rich.
Copyright ã 2005 by Njei Moses Timah
N.B. From early 2007, the first line antiretrovirals were given free of charge to patients in Cameroon.
Njei Moses Timah [e-mail]