Plight at an ART Center in Tirupati

[Guest guest]

Dear Forum members,

It was a pioneering effort by the AP government when it decided to open nine new

ART centers in various districts of Andhra Pradesh.

The centers were formally inaugurated on 1st September 2006 and with the already

existing three centers, now count to 12 ART centers in AP (there are 23

districts). A veritable boon for PLHAs, you would say.

The ART Center in TIRUPATI was also inaugurated on 1st September this year. But

the CD4 count testing machine is yet to arrive.

Rumors are rife among PLHA circles that the testing machine meant for Tirupati

was diverted to Kadapa for political reasons, but I shall refrain from dabbling

in politics as it would subvert the message I wish to convey. Suffice to say the

Tirupati ART Center does not have a CD4 count testing machine almost two months

since the center was started. So how do you administer ART?

The Medical Officers have decided to first register all PLHAs who would come

with a govt. VCTC report. Around 450 PLHAs have registered so far in the two

months that the ART center has been opened. They are then given dates ranging

from 10 to 30 days when they should ring up the center and find out about the

possibilities for testing their CD4 count. There is also a move to get a

volunteer to take blood samples once in a week to Kadapa – (a three and half

hour journey) and get the CD4 test results the next day. This has not yet

materialized. In the meanwhile, there are also reports coming through that the

CD4 count testing machine in Kadapa is “not working properly” (whatever it

means).

The brighter side of the story is that medicines have arrived and are being

given to those who were already on ART in other centers, based on transferring

their cases to Tirupati. But it is really a criminal act when medicines are in

stock doctors are unable to help PLHAs who need ART because of the lack of the

CD4 testing machine.

While it is easy to blame the medical officers in the ART center because they

are in the frontline, govt. / APSACS should show more apathy towards PLHAs

rather than continue to talk about 3 X 5 or Millennium Development Goals. It is

not just the number of ART centers that are opened, but how many are functioning

as they should. It is also a moot point here that the State level PLHA networks

are silent about it (at least in public).

It is with great pain that I voice my concern for the thousands of PLHAs in

Chittoor District whose only hope is the ART center at Tirupati where medicines

are available for the past two months but people are unable to access them. I

implore upon APSACS to look into the matter with haste.

Sreeram

Sreeram Varadadesikan

e-mail:<setlurs01@...>

[Guest guest]

Dear Sreeram & the FORUM,

Any PLWA who is HIV positive and also has ANY symptoms of AIDS, such as fever,

night sweats, weight loss, or any other often more serious opportunistic

infections, should be immediately started on ARV treatment. There is no need to

wait for CD4 testing.

These are the guidelines from the World Health Organization and should be put

into practice in India. When the CD4 comes, it can be given to confirm the need

for ARVs, which of course, will be confirmed if the PLWA has the systems as

above.

Sincerely,

Stern

(Currently in New Delhi).

e-mail: <rastern@...>

[Guest guest]

Dear FORUM,

Re: Plight at an ART Center in Tirupati

The criteria of CD4 is for asymtomatic patients; it should be clear to those

manning ART's. In case the CD4 testing is not possible (for reasons a plenty,

including the machine going out of order -like in Amritsar, as told by PLHA

here) then one can rely on a cheaper alternative like absolute lymphocyte count.

Dr.Rakesh Bharti

e-mail: <rakesh.bharti1@...>