LAC: ARV treatment is neither accessible nor universal

Latin America has made great strides recently on ARV treatment access. Countries like the Dominican Republic, Peru, Honduras, Guatemala, and Ecuador started with a handful of people but now have registered thousands more in treatment programs, while Bolivia and Nicaragua, countries with low HIV prevalence rates, are providing ARV’s to around 900 PLWHA in each country.

GF funds and increased public monies have significantly contributed to shrinking the access gap. However, increased access has revealed other related drug provision problems, ones that we have at this time not attended to, namely timely purchases of drugs and monitoring test materials, country specific essential medicines lists (which can be obstacles to procuring new ones), drug prices, and PLWHA related poverty, stigma, and discrimination.

Lately, several stories coming from Argentina in South America, Nicaragua in Central America, and the Dominican Republic in the Caribbean have been issued which are ripping the covers off these treatment access-related problems.

One Argentina story recounts what life is like for Buenos Aires families living with HIV and in poverty, the latter making it difficult for them to get medical treatment and proper nutrition. Another letter describes the unwieldy processes the government must follow to purchase needed medication as well as the hoops PLWHA have to jump through if they wish to register in Social Security run treatment programs. The red tape keeps government from buying sufficient quantities and limits the number of PLWHA who can join. Both situations are jeopardizing people’s health, whether for a lack of drugs or for a lack of treatment access or continuance.

In Nicaragua, some PLWHA held a press conference in which they criticized stockouts of ARV and opportunistic infection drugs, stressing the fact that this is keeping them from receiving complete treatments and blaming the Ministry of Health for not planning in advance to procure them from international sources. 

News from the Dominican Republic concerns the stoppage of CD4 lymphocyte (measures the strength of a body’s immune system) and viral load (measures HIV RNA) testing, which began three and four months ago, respectively, as well as the situation of some medicines have not been supplied continuously.  

Since the start up of ARV treatment programs and their rapid amplification, health systems have been put under the microscope, and many limitations have come to light, whether caused by red tape or poor planning. Accordingly, we see that HIV responses cannot succeed without strengthening health system and community systems, the latter having a profoundly positive effect on the former.

Therefore, it is imperative for countries to analyze their needs vis-à-vis strengthening those two systems such that treatment access becomes a reality and responds to the needs of the poorest people.

We, at Observatorio Latino, wish to congratulate what activists in different countries are doing… be it legal aid, press conferences, public criticism, whatever; we encourage them to continue spreading the news of their advocacy so they become examples for the rest of the region.

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