Volunteers key to Canadian initiative to combat HIV-AIDS in Uganda

Access to antiretroviral drugs has restored the quality of life of millions of HIV-positive people, but the cost of this medicine is prohibitive to populations in some areas of the developing world. Arif Alibhai and his colleagues from the University of Alberta have been working with volunteers in rural Uganda to change this.

 Community volunteers proudly display their certificates following the completion of their training programme. Arif Alibhai

Millions of HIV-positive people around the world today are able to live longer and healthier lives because of antiretroviral (ARV) drugs. Populations with access to effective ARV therapy see fewer people progressing from HIV to AIDS, and witness a significant decline in the death rate from the disease.

But the cost of this medicine places it beyond the means of many who live in the developing world, particularly in rural and remote areas. Since 2003, Arif Alibhai and his colleagues from the University of Alberta (Edmonton, Canada) have been working to change this through the Community-Based ARV Project.

 The new AIDS Clinic in rural Uganda, set up by the University of Alberta research team. Arif Alibhai

Based in Kabarole, Uganda, where 10 per cent of adults are HIV-positive, their pilot project aims to create a sustainable system for delivering drugs to rural populations, explains Alibhai, a senior project manager.

With funding from the Canadian Institutes of Health Research, the team has made use of existing clinic infrastructure, health care staff and free drugs from the Ugandan government. They have augmented these resources by providing a project physician, an AIDS clinic and most importantly a volunteer programme.

“One of the most extraordinary things about this project,” says Alibhai, “is to be able to work with individuals who, despite their poverty and hardships in life, find the time and motivation to volunteer to help others.”

Alibhai works with local volunteers in Uganda to distribute ARVs to HIV and AIDS patients. Photo: Arif Karmali Alibhai works with local volunteers in Uganda to distribute ARVs to HIV and AIDS patients. Arif Karmali

Volunteers from the community take on many duties normally performed by health professionals. These include weekly visits to patients, ensuring that medication is taken regularly and checking for possible drug reactions. Since treating its first patients in March 2006, the team has reached more than 300 people, of whom 90 per cent have had successful treatment outcomes.

A key factor in determining the success of antiretroviral therapy is the extent to which the medicine is used as directed – a criterion known as adherance. Alibhai notes that drug adherence rates hover near 99 per cent – a success due in part to the volunteers who offer support and compassion to patients during personal home visits.

“I attribute that to the strong community commitment and the dedication of the local health workers,” he says. “I can't help but get shivers down my spine when I think that we now have 300-plus individuals who probably would not be alive today had we not been able to do this. I am grateful for the opportunity to play the small role that I can in this project.”

Arif Alibhai poses with local school children. Photo: Peter Rwakilembe Arif Alibhai poses with local school children. Peter Rwakilembe

The research team will continue to study and learn from the drug programme over a two-year period. During this time they will seek to maintain successful outcomes by avoiding drug adherence complacency among patients, and by keeping volunteers motivated to perform their duties. Alibhai hopes that in the next few years the team will also be able to expand the project throughout Uganda and extend it to other countries afflicted with high rates of HIV-AIDS.