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Lifesaving drugs out of the reach of Jamaican people living with HIV
by Simone Brown, Freelance Writer
Toronto, 16 August 2006 (Panos). Jenny died a year ago after repeatedly contracting several opportunistic infections (OIs). She had been diagnosed with HIV for two years.
Her friend Sean, who is also HIV positive and helps to take care of her twin boys is angry. He believes she could have lived longer had she been able to afford the OI drugs that she so desperately needed.
Now Sean is concerned that if the Jamaican government does not offer the drugs at a lower cost, he too could suffer a similar fate. He says he is unable to afford the J$1,500 (US$23) to J$6,000 (US$94) range that most of these drugs cost. On the other hand, ARVs cost $1,000 (US$15) per month down from a high of J$40,000 (US$625) charged 10 years ago. He believes that the purpose of taking ARVs is defeated if he is unable to treat his OIs.
"I am happy that we can get the ARV if we explain to them that we don't have the $1,000 but it is kind of pointless if you can't afford the $4,000 being charged for some simple antibiotics," he said.
Sean is one of many Persons Living with HIV and AIDS (PLHIV) who have been urging the Jamaican government to subsidise the cost of the OI medication, a request which has been denied by the Ministry of Health.
Dr. Kevin Harvey, HIV/AIDS specialist in Treatment and Care at the Ministry of Health said with the significant HIV treatment programme already in place to provide ARV at a subsidised cost, HIV infected persons have to play their part in paying for the medication for OIs.
"If you get a cold and you have to take antibiotics like everybody else, can we subsidise that? Is that what we are being asked to subsidise?” he asked.
Dr. Harvey argued that if HIV infected persons follow the advice of their doctors in taking the ARV and go for regular check-ups they will not get opportunistic infections and would have no need for OIs medication.
But the PLHIV reject this claim. They point out that even those who consistently take their ARVs do get OIs at some point throughout the disease.
"Is not that we are asking for freeness. All we are saying is that a lot of us are not working, because we lost our jobs due to our status. So how are we expected to buy medication for up to $6,000 (US$94) when we don't have medical insurance and we can hardly buy food," asked Simone* a mother of three children.
She explained that there are days when her children go to school without lunch because she just cannot afford it. At times Simone says she gets some money from family members but when she does, it has to be saved towards paying rent for the small board structure they call home.
"Now with all of my expenses it is hard to find a few thousand dollars to buy these medications and nobody seems to be doing anything about it," she said.
And while ARVs do reduce the incidence of opportunistic drugs, Simone says it does not eliminate it all together.
"We are very grateful that the Global Fund has been helping us with a subsidy to get the ARV but at the same time most of them have side effects, which can be a whole lot of things," she said.
She said the cheapest OIs medication cost $1,500 which is a stretch for many persons who are unable to afford it.
Michelle who is an adherence counsellor says she is fortunate to have friends and family who assist her in buying her OI medication. However there are many persons whose relatives are not even aware of their HIV status.
"Some of these people just don't bother to fill the prescription and just allow the disease to run its course because they have enough problems worrying about getting work, feeding their family and keeping a roof over their heads," she said.
She said it is important that persons start advocating for the subsidy to be imposed so more lives can be spared.
But Dr. Harvey says it is just not possible to offer a subsidy on OI drugs as both HIV infected persons as well as non-infected persons get similar infections such as common colds, skin rash and chest infections to name a few.
"How do you identify those persons separately?" Dr Harvey asked. "If you are not taking the ARV properly and not paying attention to your doctor’s advice and you develop opportunistic infection then you are asking us to pay for your not being responsible and at the same time we are giving you ARV for free," he argued.
"ARV is there to prevent OIs. Prevention is better than treatment and we are preventing opportunistic infections. We don't want to encourage having to treat them," he said.
But Tony*, a member of Jamaica AIDS Support, maintains that even on a strict regime, PLHIV are getting OIs which they are finding more and more expensive to treat.
"Last week I had a little pneumonia because I got wet in the rain and the doctor put me on some strong antibiotic and because it was for $4,000 and I couldn't afford it she had to change it to something that cost $2,000" he explained.
"We can't really expect that the government is going to give us everything free but there are some persons who just can't afford it on a regular basis and would love to see the cost lowered. That is all we are saying.
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