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New cases in Pous 2064, HIV = 175, AIDS = 26, Death = 2. HIV rate is very high in Housewives than sex workers in Nepal ! ! ! HIV status in Nepal till 2005: Total Adult=70000, Adult Prevalence (15-49)=0.55%, Number of Women (15-49) LWHA=15,310 (22%), HIV Prevalence rate in IDUs=32.7%, HIV prevalence rate in sex worker=3.8%, HIV prevalence rate in client of SW=2.1%. The latest U.N. report shows that 65 million people have been infected with HIV since it was first identified 25 years ago. Twenty five million people have died of AIDS.

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महिनौं औषधि कुर्दै संक्रमित
Published by RAAZ
01-12-2006
महिनौं औषधि कुर्दै संक्रमित

काठमाडौं, मंसिर १४ - औषधि पाउन उनलाई महिनांै कुर्नुपर्*यो । नवलपरासी त्रिमुनी चौककी ३४ वषर्ीया आशा कुमालको सिडि फोर काउन्ट एक सय ५४ भए पनि उनलाई औषधि लिन डेढ महिनाभन्दा बढी समय लाग्यो । मुलुकमा सिडि फोर काउन्ट दुई सय हुने वित्तिकै एचआईभी/एडसविरुद्घको औषधि चलाउनुपर्ने हुन्छ ।
आशा हाल शुक्रराज ट्रोपिकल तथा सरूवा रोग अस्पताल, टेकुबाट औषधि लिइरहेकी छन् । 'असार १० गते लाइनमा राख्यो, साउन ३० गतेदेखि औषधि पाएँ, अझ अरूलाई त ६ महिनासम्म कुर्नुपर्छ', आशाले कान्तिपुरसँग भनिन् । उनले त्यतिकै औषधि पाएकी होइनन् । 'सधैं कराइरहन्थंे, ६-६ महिनाको टाइम लगाउँदा हामी मरिहाल्छौं नि', आशाले भनिन् ।

औषधि पाउने पालो पर्खने लाममा आशा एक्लो छैन । चितवनकी सरस्वती बुढाथोकीलाई आठ वर्षअघि एचआईभी देखिएको हो । ५ वर्षअघि श्रीमान वितेका र १० वषर्ीया जेठो छोरो समेत एचआईभी संक्रमित रहेका सरस्वतीको पालो ३ महिनापछि आउने अस्पतालले जनाएको उनी बताउँछिन् । 'सिडि फोर काउन्ट दुई सय जति छ । मुटु दुख्ने, ज्यान चिलाउनेजस्तो हुन्छ । सकेसम्म र्चाडो खान पाए हुन्थ्यो', उनले कान्तिपुरसँग भनिन् ।

हालसम्म सरकारी प्रयासमा करिव ४ सय १५ जनालाई औषधि खुवाइएको छ । औषधिको साइड इफेक्टले कति जनाको मृत्यु भयो भन्ने तथ्याङ्क अस्पतालमा उपलब्ध छैन ।

'भन्नलाई मात्र हो तर सर्वसुलभ छैन एचआईभीको औषधि', स्पर्श नेपालबाट औषधि सेवन गरिरहेका एचआईभी संक्रमित कृष्ण बज्राचार्य भन्छन्, 'सरकारले २०६० सालमा एक हजारलाई एआरभी निःशुल्क खुवाउने भन्यो तर त्यति खेर पनि सरकारले खुवाउन सकेन ।'

स्वास्थ्य निकायले संक्रमितलाई दिइने औषधिको साइड इफेक्ट अनुगमन गर्नु पर्ने भए पनि विभिन्न कारणले हाल त्यो राम्ररी हुन नसकेको टेकु अस्पताल स्रोतले जनाएको छ । फलो अप, विभिन्न परीक्षण, अनुसन्धान लगायतका सुविधा औषधि दिने केन्द्रमा हुनुपर्ने आंैल्याउँदै स्रोतले भने, 'नकारात्मक असर देखिंदा बिरामीमा नैराश्यता आउँछ, त्यसैले औषधि दिने निकायले क्षमताअनुसार नै औषधि दिनुपर्छ र सरकारले केन्द्रलाई सबल बनाउनुपर्छ ।'

यसपालि सरकारको योजना १५ सय संक्रमितलाई औषधि खुवाउने भए पनि हालसम्म उक्त संख्या ४ सय ३७ मात्र पुगेको छ । 'यसपालिको योजना १५ सयलाई खुवाउने भए पनि हालसम्म ४ सय ३७ मात्र पुगेको छ', केन्द्रका निर्देशक डा.राजेन्द्र पन्त भन्छन् ।

डा.पन्तका सरकारी लक्ष्य बढी भए पनि औषधि लिनेको संख्या कम हुनु पछाडि त्यो वर्गमा सन्देश नपुगेर भएको हुन सक्छ । उनी पहुँचको अभावले औषधि लिनेको संख्या कम भएको बताउँछन् ।

खर्च झन्डै डेढ अर्ब
एचआईभी एड्सका लागि सञ्चालित उपचार र रोकथामका कार्यक्रम सफल नभएपछि समस्यामा बृद्घ िभएको छ । नियन्त्रणको नाममा चलेका असफल कार्यक्रममा एक वर्षमा करिव एक अर्ब ३८ करोड रूपैयाँ खर्च भएको छ ।

सरकारी, गैरसरकारी तथा अन्तर्राष्ट्रिय संघसंस्थाले एचआईभी/एडसमा गरेको खर्चर् मुलुकको कुल स्वास्थ्य बजेटको करिव १५ प्रतिशत छ । वर्षेनी यतिका खर्चले समेत संघसंस्थाले लगानीको उपलब्धि बाहिर देखाउन सकेको छैन ।

मुलुकमा एचआईभी/एडस नियन्त्रणका लागि विश्वव्यापी रूपमा चलेका प्रायःजसो सवै कार्यक्रम सञ्चालित छन् । देशको कुल एचआईभी संक्रमित मध्ये करिव ८ हजारलाई एचआईभीविरुद्घ प्रयोग गरिने एन्टिरेटोभाइरल औषधि दिने भनी सरकारले सहयोग मागेको भए पनि हालसम्म औषधि लिनेको संख्या चार

सय १५ मात्र छ । औषधि लिनेले

समयमै औषधि नपाएको गुनासो समेत गरिरहेका छन् । 'हामीलाई समयमै औषधि दिइँदैन', सहारा प्लसका सचिव दिपक खडगीले भने । उनी महिनौंसम्म लाइनमा राखिने, समयमा जाँच नहुने लगायतका दुखेसो समेत पोख्छन् । सन् २००६ को अक्टोवरसम्ममा एचआईभी/एडसको रिपोर्टेड केसको संख्या ८ हजार ७३ पुगेको छ ।

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By RAAZ on 01-12-2006, 04:40 PM
ARV target unattained - WORLD AIDS DAY

KATHMANDU, Nov 30 - Asha Kumal,34, of Nawalparasi had to wait for more than a month to get Anti Retro Viral (ARV) treatment, when her CD 4 count was down to 161. Kumal had contracted HIV some nine years ago.
People at the National Center for HIV and STD Control (NCASC) told her that it would take some six months for her to get the treatment. "As I had the lowest count, I visited the center every day," she said. Finally, she got ARV treatment.

Kumal was sold to a brothel in Mumbai at the age of 17 by her husband.

Kumal's struggle to get treatment, ironically shows the government has received huge funds from donors to provide ARV treatment to some 8,000 HIV infected persons, but it has provided the service to only 415 persons in three years' period. Those seeking treatment have to wait for months.

The treatment, in general, is provided when the CD 4 count of HIV infected persons reaches 200. The machine which tests the CD count is available only at Teku hospital.

"We are not receiving medicine on time," said Deepak Khadgi, secretary of Sahara Plus, an organization, run by HIV positive people. Out of 14 people living with HIV who are taking shelter in the organization, only four have received ARV, while the rest are waiting for treatment.

Saraswati Budathoki of Chitwan, whose CD 4 count reached 204, registered her name five days back. But she was told at the center that she would get treatment only after three months. "I don't have money to keep on traveling to Kathmandu," Budathoki, a widowed mother of two children said. Budhathoki contracted HIV from her husband who worked as a driver in India. He died five years ago.

Rajendra Pant, director at NCASC said there are very few treatment centers in the country. He said until the center is sure that the person gets proper monitoring once the treatment begins, the center can't provide treatment. "It's difficult for us to monitor many cases as we have to be very sensitive because the treatment can have serious side effects," he said. He also said there are only eight sites providing ARV treatment throughout the country and they are also confined to urban areas. "The center aims to meet the target of 1,500 this year," he said. "We have to keep HIV infected persons in a queue until the sites are ready to start treatment.

Of the total health budget that comes from donors and the government, 15 percent is spent on HIV prevention and treatment programs.

Shivu Giri, program field officer of Nava Kiran Plus (NAPN), another organization working with HIV and AIDS, said his organization has been providing ARV to people living with HIV before the government provides them the service.

He said one person, in general, has to wait for about three months to get the treatment from the government. "We have been gathering them through our centers in Surkhet, Biratnagar, Butwal, Chitwan and Hetauda," he said. "We observe them for some time if there are any side effects and then send them back to the centers."

It costs about Rs 2,000 for a person to receive ARV treatment, apart from nutritious food and other care.

The Kathmandu Post
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