Antiretroviral therapy (ART) is recommended for everyone who has HIV.
ART cannot cure HIV, but HIV medicines help people with HIV live longer, healthier lives.
This means HIV patients have to take antiretroviral drug (ARV) for long term in their life.

In 2017, 12.9 million people were accessing ART.
It is 66% of total estimated number of people living with HIV in Eastern and Southern Africa, while only 24% can be covered in 2010. This is due to the new guideline from the World Health Organization was adopted by more countries to provide treatment to people who are diagnosed with HIV immediately.

Although more patients are able to access ART, the risk of Long Term Side Effect of taking ARV should not be neglected.

Kidney Toxicity

・Increase risk for future comorbid CKD (chronic kidney disease)

・Decrease creatinine clearance or GFR (glomerular filtration rate)

・Dialysis/ renal transplant may be needed

Liver Toxicity

・Direct cause of hepatotoxicity and idiosyncratic liver injury

・Accumulation of toxic metabolites

・Liver transplant

15% of adults in sub-Saharan Africa suffers from CKD (chronic kidney disease).However, only a small portion of patients can reach a dialysis treatment center.
Most of them quit within 2 weeks, since they cannot afford to continue. This also reflects that the cost of dialysis poses a financial burden on patients.Also, patients with failing kidney maybe required to do dialysis 3 times a week.
This makes them more difficult to work.

Due to the negative perception of organ donation and religious and cultural beliefs of South African, they are reluctant to donate their organs. In fact, in South Africa, there are about 4,300 listed to wait for the organ and cornea transplant. However, there were only 361 solid organ transplants occurred in 2017.

Price of Dialysis
R250,000/year
(before drug and hospital admission)

Annual Income
R257,184/ year

Financial support is generally low in Africa. Universal Health Coverage (UHC) which is a foundation aiming to make healthcare services accessible and affordable to everyone is launched A Framework for Action in Africa in 2016. This also reflects that financial burden of medical care in Africa has been the world's concern. Therefore, prevention by screening regularly kidney and liver function is strongly recommended and should be part of treatment to prevent patients suffering from huge financial burden on dialysis or organ transplantation.