HIV activist, Casper Pound is walking with a spring in his step these days.
By Bernard Chiketo
Smiling ear to ear he extends his hand for a firm handshake before pulling me in for a hug and pat.
“We have finally won. Everyone is excited. It took a long time but we finally got exactly what we wanted,” Pound said of Mutare City Council’s (MCC) decision to suspend service charges for anti-retroviral therapy services.
Before this move, Mutare was the only local authority in the country charging service fees, said Zimbabwe National People living with HIV and AIDS (ZNNP+) Manicaland provincial coordinator Moses Chananuka.
Manicaland Provincial Medical Director, Dr Simon Nyadundu followed this up with a directive to suspend any charging of service fees by any public health facility in the province for children under five, the elderly who are 60 and above as well as for people living with HIV and AIDS (PLHIV) as they accessed anti-retroviral therapy.
Pound who heads Family AIDS Support Organisation and is Manicaland Meaningful Involvement of People living with HIV and AIDS (MIPA) chairperson ascribed the victory to persistence and unity among a diverse spectrum of civic organisations.
“It took us more than 10 years and the effort of many organisations to achieve this,” Pound said.
Sadly, many had been pushed to default leading some to be moved from the cheaper first line treatment to second and third with a number dying.
“On the way we lost many PLHIV who could not afford to pay. We are saddened by the fact that there are people who died because they could not afford to pay user fees,” Pound said.
Chananuka is also in celebratory mood with members of his organisation swarming his office to append their signatures on a letter thanking Ministry of Health and Child Care (MoHCC), National AIDS Council, Manicaland Secretary of State for Devolution Affairs and MCC for scrapping user fees.
“Many people had lost hope that we would ever be listened to. Even fellow stakeholders would just shelve our issue as we would raise it at every meeting since around 2010,” Chananuka said.
He started the journey back in 2010 when MoHCC was responsible for anti-retroviral drug re-supplies locally charging one USD as a service fee. When they successfully lobbied to its removal the process was decentralized to local health facilities.
“We were then again made to pay service charges and our lobbying and even protests would be answered with service fee hikes.
“This time they were increased from US two dollars to five US dollars,” Chananuka said.
Interesting the decision to scrap the charges by MCC had not sought government approval for the hike and Manicaland Secretary of State for Devolution Affairs, Edgars Seenza was investigating the hike with plans to challenge it either as an illegality or an act of corruption.
Vangrista Nyambuya one of the beneficiaries who has to pay USD 12 for hypertension medication and an extra five US dollars every three months for resupplies expressed relief that she will not have to delay collecting her medication or default.
“This is the best news we have had in years. Sadly, we have lost some of our colleagues while others have had complications due to defaulting on their medication as they were forced to share their medication after failing to raise enough for everyone to get their supplies especially one family l know which has three people on ART,” Nyambuya said.
Of late the lobbying for the removal of user fees had also grown to incorporate Women’s Coalition of Zimbabwe (WCoZ) and anti-graft body Transparency International Zimbabwe (TIZ) which has been running Accountability Forums and Constitutional Hub dialogues in which the issue has been featuring prominently.
“Charging these prices when government has mandated that these services be free in order to cushion the vulnerable from a crumbling economy contributes to public sector corruption which puts a heavy burden on the citizenry,” WCoZ and TIZ said in a statement soon after the announcement.
They said since women and children constituted the bulk of people who were being affected by service charges to children under five, people living with HIV and AIDS and the elderly this had begun to raise concerns around gendered corruption.
They said the issue had been adversely affecting vulnerable groups’ access to basic healthcare services.
“Vulnerable groups such as women and children could not afford these steep prices.
“When it comes to women it constitutes a form of gendered corruption against women since that are the ones who use public services institutions such as hospitals and clinics,” the special interest organisations said.
Pound said his organisation was beginning to suspect that government’s efforts to end AIDS by 20230 was being deliberately sabotaged even after development partners like Global Fund, PEPFAR and NAC through AIDS Levy were buying the medication on behalf of PLHIV.
“We call the government to take stern measures on council clinics and mission hospitals who are charging user fees. We view this as a way of discrediting government efforts to end AIDS by 2030 by derailing all gains and efforts made so far,” Pound said. “We would like to thank all the stakeholders from all angles in persuading Mutare City Council to remove user fees.”
