The Dominican Republic (DR) is one step closer to ensuring that all people living with HIV (PLHIV) access treatment. The Caribbean country’s National Social Security Council has established a commission to look into the technical, financial and operational implications of including antiretroviral treatment (ART) in the Basic Health Plan. UNAIDS Country Coordinator, Dr. Ana Maria Navarro, said yesterday that the development comes at a critical time and is largely due to the collaboration of United Nations agencies in the DR on a feasibility study.
“This resolution brings us nearer to securing the sustainability of the AIDS response,” Navarro said.
Last year the United Nations Development Programme, (UNDP), United Nations Children’s Fund (UNICEF), Pan American Health Organisation (PAHO) and Joint United Nations Programme on HIV/AIDS (UNAIDS) in the DR worked together on a report about the financial viability of including people living with HIV in the country’s Family Health Insurance. The study points to new evidence that the correct use of ART significantly decreases the risk of HIV transmission. It also argues that a universal approach to treatment lowers the costs associated with opportunistic infections and other complications related to HIV and AIDS. Researchers further found consensus among local stakeholders that the Dominican state must use its own resources to support treatment “because Global Fund resources for this purpose have been depleted”.
The DR is classified as a middle-income country despite marked inequalities in income distribution. At present access to HIV treatment is completely financed by international donor agencies. While over 20,000 people are currently receiving treatment, more than 2,500 individuals known to be living with the disease do not access the life-saving drugs.
This is despite a guarantee of universal access to treatment for PLHIV made in the country’s 2007 – 2015 National Strategic Plan on HIV and AIDS . The treatment gap also contradicts the principles of universality and equity that form the basis of a 2001 reform of the Social Security System. Moreover, a new HIV law introduced last year provides for the comprehensive healthcare of people living with HIV and AIDS.
But a 2002 regulation for the operationalisation of the Basic Health Plan excludes coverage of antiretroviral drugs on the basis of their high cost. A primary objective of the feasibility study was to provide evidence that treatment is not as expensive as local authorities believed.
In April people living with HIV in the DR also launched an initiative to draw attention to the fact that the availability of generic drugs has significantly reduced treatment prices in the global market. The Dominican Network of People Living with HIV (REDOVIH+), Alianza Solidaria de Lucha contra el SIDA (ASOLSIDA), Fundación Grupo Paloma and Grupo Clara jointly launched a petition which calls for their 2012 presidential candidates to address the financial sustainability issues related to their treatment ahead of elections later this month.
“This is one giant step for the DR,” said UNAIDS Caribbean Director, Dr. Ernest Massiah. “It is a step towards ensuring not only that treatment is maintained, but that the lives of Dominicans are ensured. People can continue to work, to support their families, and to participate in the simple joys of life to which we are all entitled. This is about respect, dignity and life.”