Zinthu Zolimbikitsa Zimene Zachitika pa Ntchito Yolimbana ndi Edzi

Dr. Gerald J. Stine analemba m’buku lake lotchedwa AIDS Update 2003 kuti kafukufuku amene wachitika wokhudza HIV ndi Edzi ndi chinthu chimodzi chopambana kwambiri chimene asayansi achita. Pali zinthu zambiri zokhudza nthenda yovuta kuimvetsa imeneyi zimene anthu adziwa m’kanthawi kochepa chabe. Kodi ndi zinthu zolimbikitsa zotani zimene zachitika?

LUSO lamakono la zamankhwala lathandiza anthu ochita kafukufuku kupanga mankhwala amene tsopano akupereka chiyembekezo kwa anthu amene ali ndi kachilombo ka HIV. Kuwonjezera apo, m’mayiko angapo ntchito yophunzitsa anthu za Edzi yayenda bwino. Koma kodi kuyenda bwino kwa zimenezi kukusonyeza kuti mliri wakuphawu udzatha tsiku linalake? Kodi sayansi ndi maphunziro amakono angaletse kufalikira kwa Edzi? Taganizirani mfundo zotsatirazi.

Chithandizo cha Mankhwala

“Pali Chiyembekezo pa Ntchito Yolimbana ndi Edzi,” unatero mutu wa nkhani ya mu magazini ya Time ya pa September 29, 1986. “Chiyembekezo” chimenechi chinabwera chifukwa cha zomwe zinachitika anthu ena atagwiritsa ntchito mankhwala otchedwa AZT, ochepetsa mphamvu ya tizilombo ta HIV. Zinali zochititsa chidwi kuona kuti anthu amene anali ndi HIV omwe ankamwa mankhwalawa ankakhala ndi moyo wotalikirapo kuposa kale. Kuyambira nthawi imeneyo, mankhwala ochepetsa mphamvu ya kachilombo ka HIV atalikitsa miyoyo ya anthu masauzande ambiri. (Onani bokosi loti “Kodi Mankhwala Ochepetsa Mphamvu ya Kachilombo ka HIV Amagwira Ntchito Motani?” patsamba 7.) Kodi mankhwalawa athandiza bwanji anthu amene ali ndi kachilombo ka HIV?

Pamene mankhwala a AZT anangotulukiridwa kumene, anthu anakondwera kwambiri, koma magazini ya Time inati anthu ofufuza za Edzi “anali kukhulupirira kuti AZT [si] chida chochiritsira Edzi.” Ndipo zomwe ankakhulupirirazo zinalidi zoona. Odwala ena sanagwirizane nawo mankhwala a AZT, choncho ochita kafukufuku anapeza mankhwala ena ochepetsa mphamvu ya kachilombo ka HIV. Kenaka bungwe loona za zakudya ndi mankhwala ku United States lotchedwa U.S. Food and Drug Administration linavomereza kuti odwala amene matenda awo anali atalowerera kwambiri angathe kugwiritsa ntchito mitundu ingapo ya mankhwala ochepetsa mphamvu ya kachilombo ka HIV. Ogwira ntchito za Edzi anasangalala kwambiri kutabwera njira yatsopano yolimbanirana ndi matendawa yomwa mitundu itatu kapena kuposa pamenepo ya mankhwala ochepetsa mphamvu ya kachilombo ka HIV. Ndipo pa msonkhano wina wokhudza Edzi wa mayiko osiyanasiyana umene unachitika mu 1996, dokotala wina mpaka analengeza kuti n’kutheka kuti mankhwalawo angathe kupheratu tizilombo tonse ta HIV m’thupi.

Koma zomvetsa chisoni n’zakuti pomatha chaka chimodzi zinaonekeratu kuti ngakhale kutsatira mosamalitsa ndondomeko ya kamwedwe ka mankhwala atatuwo sikunkapheratu tizilombo ta HIV. Ngakhale zili choncho, lipoti la bungwe la UNAIDS linati: “Kumwa mitundu ingapo ya mankhwala ochepetsa mphamvu ya kachilombo ka HIV kwathandiza anthu amene ali ndi kachilomboka kuti azikhala ndi moyo wautali, wathanzi,  ndiponso waphindu.” Mwachitsanzo, ku United States ndi ku Ulaya, kugwiritsa ntchito mankhwala ochepetsa mphamvu ya kachilombo ka HIV kwachepetsa kwambiri anthu amene akufa ndi Edzi. Kuwonjezera apo, kafukufuku wosiyanasiyana wasonyeza kuti kugwiritsa ntchito mitundu inayake ya mankhwala ochepetsa mphamvu ya kachilombo ka HIV kungathandize kuti azimayi oyembekezera asamapatsire kwambiri ana awo HIV.

Komabe, anthu ambirimbiri amene ali ndi HIV salandira mankhwala ochepetsa mphamvu ya kachilomboka. Chifukwa chiyani?

“Nthenda ya Anthu Osauka”

M’mayiko olemera anthu ambiri akulandira mankhwala ochepetsa mphamvu ya kachilombo ka HIV. Komabe, bungwe la World Health Organization (WHO) linafotokoza kuti m’mayiko amene akutukuka kumene, ndi anthu 5 okha pa anthu 100 alionse ofunikira mankhwala ochepetsa mphamvu ya kachilombo ka HIV amene amalandira mankhwalawa. Ndipo nthumwi za bungwe la United Nations zafika mpaka ponena kuti kulandira mankhwala kosiyana kumeneku ndi “kupanda chilungamo kwakukulu,” ndiponso ndi “khalidwe lonyansa la dziko lamakonoli.”

Ngakhale anthu a m’dziko limodzi akhoza kumalandira mankhwala mosiyana. Nyuzipepala ya Globe and Mail inati munthu mmodzi pa anthu atatu alionse a ku Canada amene amafa ndi Edzi amakhala oti sanalandirepo mankhwala ochepetsa mphamvu ya kachilombo ka HIV. Ngakhale kuti mankhwalawa ndi aulere ku Canada, pali anthu ena ake amene sapatsidwa mankhwalawo. Nyuzipepala ya Globe inati: “Anthu amene sakulandira mankhwalawa ndi anthu amene akufunikira kwambiri thandizo, monga eni nthaka m’dziko muno, azimayi, ndi anthu osauka.” Nyuzipepala ya Guardian inagwira mawu mayi wina wa ku Africa kuno amene ali ndi HIV yemwe ananena kuti: “Sindikumvetsa ayi. N’chifukwa chiyani azungu aamuna amene amagonana amuna okhaokha akupatsidwa mankhwala kuti akhale ndi moyo pamene ineyo ndikufa?” Yankho la funso lakelo lagona pakuti kapangidwe ndi kagawidwe ka mankhwala kamayenderana ndi kapezedwe ka ndalama.

Mtengo wa chithandizo cha mitundu itatu ya mankhwala ochepetsa mphamvu ya kachilombo ka HIV ku United States ndi ku Ulaya ndi pakati pa madola 10,000 ndi 15,000 pachaka. Mankhwala ofanana ndi amenewa koma opanda dzina lodziwika bwino tsopano akugulitsidwa m’mayiko ena amene akutukuka kumene pa mtengo wa madola 300 kapena osakwana pamenepa pachaka. Komabe ndalama zimenezi n’zoti anthu ambiri amene ali ndi HIV ndipo akukhala kumadera kumene mankhwala ochepetsa mphamvu ya kachilombo ka HIV akufunika kwambiri, sangazikwanitsebe. Pofotokoza zimenezi mwachidule, Dr. Stine anati: “Edzi ndi nthenda ya anthu osauka.”

Malonda Opanga Mankhwala

Kupanga mankhwala ofanana ndi mankhwala okhala ndi dzina lodziwika bwino n’kuwagulitsa pa mtengo wotsikirapo kwakhala n’zovuta zake. M’mayiko ambiri, malamulo okhwima oletsa kupanga zinthu zofanana n’zimene wina anatulukira amaletsa anthu kupanga mankhwala ofanana ndi mankhwala okhala ndi dzina lodziwika bwino. Mkulu wa kampani ina yaikulu yopanga mankhwala anati: “Vuto lagona pofuna kupeza ndalama.” Iye anati kupanga mankhwala ofanana ndi mankhwala okhala ndi dzina lodziwika bwino, n’kuwagulitsa ku mayiko amene akutukuka kumene kuti mupezepo phindu “n’kulakwira anthu amene anatulukira mankhwalawo.” Makampani amene ali eni mankhwala okhala ndi dzina lodziwika bwino amanenanso kuti kuchepetsa phindu limene amapeza kungachepetse ndalama zimene amasunga kuti azichitira kafukufuku wa mankhwala atsopano. Ena akuda nkhawa kuti mankhwala ochepetsa mphamvu ya kachilombo ka HIV otsika mtengo amene anayenera kupita ku mayiko amene akungotukuka kumene angapezeke kuti akugulitsidwa mwakabisira m’mayiko otukuka.

Anthu amene akulimbikitsa makampani kupanga mankhwala ochepetsa mphamvu ya kachilombo ka HIV otsika mtengo amapereka mfundo yoti mankhwalawa  akhoza kupangidwa pa mtengo wotsika kwambiri poyerekezera ndi umene makampaniwo amatchula. Iwo amanenanso kuti kafukufuku amene makampani omwe si aboma amachita wofuna kupeza mankhwala atsopano amanyalanyaza matenda amene amagwira anthu okhala m’mayiko osauka. Choncho Daniel Berman, wotsogolera bungwe linalake lomwe cholinga chake n’kupezera anthu osauka mankhwala, lotchedwa Access to Essential Medicines, anati: “Kuti papezeke mankhwala atsopano, pakufunika kuti pakhale njira imene mayiko onse azigwirizana nayo yochepetsera mtengo wa mankhwalawo kuti ukhale woti anthu okhala m’mayiko amene akungotukuka kumene akhoza kukwanitsa.”

Poona kufunika kwa mankhwala ochepetsa mphamvu ya kachilombo ka HIV padziko lonse kumeneku, bungwe la WHO lakonza ntchito imene cholinga chake n’choti anthu mamiliyoni atatu amene ali ndi HIV kapena Edzi adzakhale akupatsidwa mankhwala ochepetsa mphamvu ya kachilombo ka HIV pomadzafika kumapeto kwa chaka cha 2005. Nathan Ford, amene amagwira ntchito m’bungwe lotchedwa Médecins Sans Frontières anachenjeza kuti: “Lonjezo limeneli lisangokhalanso lofanana ndi malonjezo ena amene bungwe la United Nations lalephera kukwaniritsa. Anthu mamiliyoni atatu akuimira theka chabe la anthu amene ali ndi HIV kapena Edzi panopa amene akufunikira thandizo, ndipo [pomadzafika chaka cha 2005] adzakhala ambiri kuposa pamenepo.”

Zovuta Zina

Ngakhale mankhwala ochepetsa mphamvu ya kachilombo ka HIV okwanira atati aperekedwe ku mayiko amene akungotukuka kumene, pali mavuto ena amene angafunike kuthana nawo. Mankhwala ena amafunika kuti munthu akamamwa adye chakudya ndiponso amwere madzi abwino, koma anthu ambirimbiri m’mayiko ena amati akadya lero amadzadyanso mkucha. Mankhwala ochepetsa mphamvu ya kachilombo ka HIV (amene nthawi zambiri amakhala mibulu 20 kapena kuposa pamenepo patsiku) amafunika kuwamwa panthawi inayake tsiku lililonse, koma odwala ambiri sakhala ndi wotchi. Mitundu ya mankhwala imene wodwala akumwa iyenera kusinthidwa malinga ndi mmene wodwalayo akusinthira. Koma m’mayiko ambiri muli madokotala ochepa kwambiri. Mwachionekere, kupereka chithandizo cha mankhwala ochepetsa mphamvu ya kachilombo ka HIV m’mayiko amene akungotukuka kumene ikhala ntchito yovuta kwambiri kuikwanitsa.

Ngakhale odwala a m’mayiko otukuka amakumana ndi zovuta akamamwa mitundu ingapo ya mankhwala ochepetsa mphamvu ya kachilombo ka HIV. Kafukufuku wasonyeza kuti anthu ambiri amalephera kumwa mankhwala onse amene akuyenera kumwa panthawi imene akuyenera kutero, zomwe zili zoopsa kwambiri, chifukwa zingayambitse kuti matendawa azikana mankhwala.  Kenaka anthu ena akhoza kutenga tizilombo ta HIV tokana mankhwala toteroto.

Dr. Stine anatchulanso vuto lina limene anthu amene ali ndi HIV amakumana nalo. Iye anati: “Vuto la mankhwala othandiza anthu amene ali ndi HIV n’loti nthawi zina chithandizocho chimakhala chopweteka kuposa matendawo, makamaka munthu akayamba kulandira mankhwala asanayambe kusonyeza zizindikiro za HIV.” Anthu ambiri amene ali ndi HIV omwe akulandira mankhwala ochepetsa mphamvu ya kachilombo ka HIV amayamba kudwala matenda ena chifukwa cha mankhwalawo, monga matenda a shuga, kusokonekera kwa mafuta m’thupi, kuchuluka kwa mafuta m’mitsempha, ndi kusalimba kwa mafupa. Mavuto ena amene amabwera chifukwa cha mankhwalawo munthu akhoza kufa nawo.

Ntchito Yothandiza Anthu Kupewa

Kodi ntchito yoyesayesa kuchepetsa kufalikira kwa Edzi ndi kusintha khalidwe la anthu limene angatenge nalo Edzi yayenda bwanji? Maphunziro ochuluka a Edzi amene anachitika ku Uganda m’zaka za m’ma 1990 anachepetsa anthu otenga kachilombo ka HIV kuchoka pa anthu 14 pa anthu 100 alionse kufika pa anthu 8 pa anthu 100 alionse m’chaka cha 2000. Mofanana ndi zimenezi, kuyesayesa kwa dziko la Senegal kuti liphunzitse anthu ake za mmene angatengere kachilombo ka HIV kwachititsa kuti anthu achikulire okhala ndi kachilomboka akhale ochepa kwambiri. Zotsatirapo ngati zimenezo n’zolimbikitsa.

Komabe, maphunziro a Edzi sanayende bwino choncho m’mayiko ena. Kafukufuku amene anachitika m’chaka cha 2002 pakati pa achinyamata 11,000 ku Canada anasonyeza kuti theka la ophunzira m’chaka choyamba cha kusekondale ankakhulupirira kuti pali mankhwala ochiritsa Edzi. Malinga ndi kafukufuku wina amene anachitika ku Britain chaka chomwecho, anyamata 42 pa anyamata 100 alionse a zaka zapakati pa 10 ndi 11 anali asanamvepo za HIV kapena Edzi. Komabe, ngakhale achinyamata amene akudziwa zoti kuli HIV ndi Edzi ndiponso kuti matenda amenewa alibe mankhwala, siziwakhudza kwenikweni zimenezi. Dokotala wina anati: “Kwa achinyamata ambiri, HIV yangokhala limodzi mwa mavuto ambirimbiri amene ali nawo, monga vuto loganizira kuti kaya adya chakudya chabwino tsiku limenelo, kaya azikhala ndi ndani, ndiponso kuti kaya apita ku sukulu kapena ayi.”

Choncho n’zosadabwitsa kuti bungwe la WHO linanena kuti “kuganizira makamaka achinyamata ndiyo njira imene ingathandize kwambiri kuti tilimbane ndi mliriwu, makamaka m’mayiko amene muli anthu ambiri odwala nthendayi.” Kodi achinyamata angathandizidwe bwanji kuti azitsatira malangizo amene apatsidwa okhudza Edzi? Ndipo kodi n’zomveka kuyembekezera kuti mankhwala a Edzi adzapezeka?

[Mawu Otsindika patsamba 6]

Chaka chatha, pa anthu 100 alionse amene anafunikira mankhwala ochepetsa mphamvu ya kachilombo ka HIV, ndi anthu awiri okha amene analandira mankhwalawa ku Africa kuno, poyerekezera ndi anthu 84 pa anthu 100 alionse amene analandira mankhwalawa ku America

[Bokosi/Zithunzi patsamba 7]

Kodi Mankhwala Ochepetsa Mphamvu ya Kachilombo ka HIV Amagwira Ntchito Motani? *

Munthu akakhala wathanzi, maselo enaake amachititsa mphamvu ya thupi lathu yotiteteza ku matenda kuyamba kulimbana ndi tizilombo toyambitsa matenda tomwe talowa m’thupi mwathu. Tizilombo ta HIV timakawononga makamaka maselo amenewa. Timagwiritsa ntchito maselowa kuti tichulukane, ndipo timawafooketsa ndi kuwawononga mpaka mphamvu ya thupi lathu yotiteteza ku matenda imachepa kwambiri. Mankhwala ochepetsa mphamvu ya kachilombo ka HIV amaletsa tizilomboti kuti tisachulukane m’njira imeneyi.

Pakadali pano, pali mitundu ikuluikulu inayi ya mankhwala ochepetsa mphamvu ya kachilombo ka HIV amene akuperekedwa kwa anthu. Pali mitundu iwiri ya mankhwalawa imene imaletsa kachilombo ka HIV kuti kasadzisinthe n’kuyamba kufanana ndi maselo a m’thupi mwa munthuyo. Ndiyeno pali mtundu wina umene umaletsa maselo a m’thupi amene awonongedwa kale ndi kachilomboka kuti asayambe kupanga tizilombo tina ta HIV. Kenaka pali mtundu womaliza umene umalepheretsa kachilombo ka HIV kulowa m’kati mwa maselo. Poletsa tizilombo ta HIV kuti tisachulukane, mankhwala amenewa angachedwetse HIV kuti isasanduke msanga Edzi, imene imabwera HIV ikafika pachimake.

[Mawu a M’munsi]

[Chithunzi]

KU KENYA Dokotala akuphunzitsa wodwala Edzi za mankhwala ochepetsa mphamvu ya kachilombo ka HIV

[Mawu a Chithunzi]

© Sven Torfinn/Panos Pictures

[Chithunzi]

KU KENYA Wodwala Edzi akulandira mankhwala ake ochepetsa mphamvu ya kachilombo ka HIV kuchipatala

[Mawu a Chithunzi]

© Sven Torfinn/Panos Pictures

 [Bokosi/Chithunzi patsamba 8]

Mmene Edzi Imakhudzira Azimayi

Tsopano theka la anthu onse amene ali ndi HIV kapena Edzi ndi azimayi

Mu 1982 pamene azimayi anapezeka ndi Edzi, anthu ankaganiza kuti anatenga nthendayi pogwiritsa ntchito masingano obayira mankhwala amene anali atagwiritsidwa ntchito ndi munthu wina amene anali ndi nthendayi. Kenaka anthu anadzazindikira kuti azimayi akhoza kutenga matendawa pogonana ndi mwamuna ndiponso kuti ali pangozi yapadera yoti akhoza kutenga kachilombo ka HIV mosavuta. Padziko lonse lapansi, theka la anthu onse achikulire omwe ali ndi HIV kapena Edzi tsopano ndi azimayi. Lipoti la bungwe la UNAIDS linati: “Mliriwu umakhudza kwambiri azimayi ndi atsikana amene sanafike zaka 20 kuposa azibambo. Zimene zimachititsa kuti zikhale zosavuta kuti azimayi ndi atsikana atenge nthendayi ndi chikhalidwe chathu, miyambo yathu, chibadwa cha azimayi, ndi kapezedwe kawo ka ndalama. Ndiponso, azimayi ndi atsikana ndi amene amagwira ntchito yaikulu yoyang’anira anthu odwala ndi anthu amene akumwalira.”

Kodi n’chifukwa chiyani kufalikira kwa nthendayi pakati pa azimayi kukudetsa nkhawa kwambiri anthu ogwira ntchito za Edzi? Azimayi amene ali ndi HIV amachitiridwa tsankho kwambiri kuposa azibambo, makamaka m’mayiko ena amene akungotukuka kumene. Ngati mzimayi ali woyembekezera, thanzi la mwana wake limakhala pangozi. Ngati ali kale ndi ana, amavutika kwambiri kuti awasamalire, makamaka ngati akulera yekha anawo popanda mwamuna. Kuwonjezera apo, poyerekezera ndi azibambo, ndi zinthu zochepa zokha zimene zikudziwika zokhudza mmene azimayi omwe ali ndi kachilombo ka HIV amadwalira, ndi mmene madokotala angawathandizire.

Miyambo ina imachititsa kuti makamaka azimayi akhale pangozi kwambiri. M’mayiko ambiri, akazi sayenera kufotokoza maganizo awo pa nkhani zokhudza kugonana, ndipo akhoza kumenyedwa akakana kugona ndi mwamuna. Azibambo nthawi zambiri amagona ndi azimayi ambirimbiri ndipo amawapatsa HIV mosadziwa. Azibambo ena ku Africa kuno amagona ndi azimayi ocheperapo msinkhu kuti apewe kutenga HIV kapena chifukwa cha chikhulupiriro chabodza choti kugona ndi anamwali kungachiritse Edzi. Choncho n’zosadabwitsa kuti bungwe la WHO linati: “Ntchito yothandiza kupewa Edzi iyenera kukhudza azibambo (komanso azimayi) kuti azimayi atetezedwe.”

[Chithunzi]

KU PERU Mayi amene ali ndi HIV ndi mwana wake wamkazi amene alibe HIV

[Mawu a Chithunzi]

© Annie Bungeroth/Panos Pictures

[Chithunzi]

KU THAILAND Monga mbali ya maphunziro awo, ophunzira akuchezera munthu wodwala Edzi

[Mawu a Chithunzi]

© Ian Teh/Panos Pictures

[Chithunzi]

KU KENYA Kukumana ndi azimayi amene ali m’bungwe lotchedwa Women Living With AIDS (Azimayi Amene Ali ndi Edzi)

[Mawu a Chithunzi]

© Sven Torfinn/Panos Pictures

[Bokosi/Chithunzi patsamba 9]

Zikhulupiriro Zabodza Zokhudza Edzi

▪ Anthu amene ali ndi kachilombo ka HIV amaoneka odwala. Dr. Gerald J. Stine anati: “Nthawi zambiri, pamatenga pafupifupi zaka 10 mpaka 12 kuti munthu amene ali ndi HIV ayambe kudwala Edzi. Panthawi imeneyi, munthuyo amaonetsa zizindikiro zochepa zoti akudwala, kapena saonetsa zizindikiro zilizonse, koma amatha kupatsira anthu ena kachilomboka.”

▪ Edzi ndi nthenda imene imagwira azibambo amene amagonana ndi azibambo anzawo, kapena azimayi amene amagonana ndi azimayi anzawo basi. M’zaka za m’ma 1980, Edzi poyamba inkadziwika kuti ndi matenda a azibambo amene amagonana ndi azibambo anzawo, kapena azimayi amene amagonana ndi azimayi anzawo. Koma masiku anu, kugonana kwa mwamuna ndi mkazi ndiyo njira yaikulu imene HIV ikufalikira m’mayiko ambiri padziko lapansi.

▪ Munthu sangatenge kachilombo ka HIV pogonana m’kamwa. Malinga ndi bungwe loona za kapewedwe ka matenda lotchedwa Centers for Disease Control and Prevention, “kafukufuku wambiri wasonyeza kuti anthu angapatsirane kachilombo ka HIV ndi matenda ena pogonana m’kamwa.” Si anthu ambiri amene amatenga kachilombo ka HIV akamagonana m’kamwa poyerekezera ndi njira zina zogonana. Komabe, kugonana m’kamwa kwafala kwambiri moti madokotala ena akuyembekezera kuti kudzakhala njira yaikulu yofalitsira kachilombo ka HIV m’tsogolo muno.

▪ Pali mankhwala ochiritsa Edzi. Ngakhale kuti mankhwala ochepetsa mphamvu ya kachilombo ka HIV angathandize odwala ena kuti asayambe msanga kudwala Edzi, pakadali pano palibe mankhwala kapena katemera wa Edzi.

[Chithunzi]

KU CZECH REPUBLIC Akutenga magazi kuti akayeze Edzi, imene tsopano pali mankhwala amene amaichepetsa mphamvu koma palibe mankhwala amene amaichiritsa

[Mawu a Chithunzi]

© Liba Taylor/Panos Pictures

[Chithunzi patsamba 6]

KU ZAMBIA Atsikana awiri amene ali ndi HIV akudikira kuti alandire mankhwala awo

[Mawu a Chithunzi]

© Pep Bonet/Panos Pictures