AFRICA: Streamlining ARV provision for refugees 

[This report does not necessarily reflect the views of the United Nations]


NAIROBI, 29 January (IRIN) - The United Nations refugee agency, UNHCR, has 
launched a new policy to ensure that HIV-positive refugees and other displaced 
people around the world have access to life-prolonging antiretroviral (ARV) 
medication. 

The policy, designed to offer guidance to UNHCR and its partners as well as 
host governments, aims to integrate ARV provision as part of a comprehensive 
HIV/AIDS programme for refugees that includes prevention, care and support. 

"In certain situations, for example in camps, the refugees have had difficulty 
accessing ARVs, and even those in urban areas sometimes failed to get treated 
within the national programmes of the host countries," Paul Spiegel, UNHCR's 
senior HIV/AIDS technical officer, told IRIN/PlusNews on Monday. "The way many 
of them have been accessing the drugs is innovative, but has largely not been 
standardised." 

In line with international human rights and refugee law, the new policy calls 
for ARVs to be planned for and included in "the earliest possible stages of an 
emergency response to forced displacement". 

It also outlines interventions for refugees who were on ARVs in their countries 
of origin; for those who had not yet started a regimen before their 
displacement; and for those participating in voluntary repatriation to their 
home countries. 

For instance, where repatriation is considered imminent, UNHCR said it "must be 
agreed that in exercise of their freedom of movement, returnees should be 
allowed and assisted to return to areas where continuation of ART 
[antiretroviral therapy] can be secured". 

Refugees, the policy document points out, often live for years in relatively 
stable settings, making it practical to roll out the drugs in the medium to 
long term. The strategy deals with both long-term ARV provision as well as 
shorter-term measures such as, for example, post-exposure prophylaxis in cases 
of sexual assault, and prevention of mother-to-child HIV transmission. 

Spiegel stressed that UNHCR was aiming for equity with host populations in 
terms of access to ARVs for refugees, rather than special treatment for them: 
in Ghana, for instance, both refugees and the host population had equal access 
to low-cost ARVs, while countries like South Africa and Zambia included 
refugees in their national policies. 

"We'd like to see refugees able to get the drugs the same way local populations 
do," he said. "We are advocating for governments to include refugees' ARV needs 
in their proposals for funding, for example, from the Global Fund [to fight 
AIDS, Tuberculosis and Malaria]." 

UNHCR estimates that refugees make up between 25,000 and 35,000 of the 
approximately 6.5 million people around the world who need ARVs. 

kr/oa/he
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Keyword: AFRICA

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