The Dominican Republic to confront its HIV treatment gap

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The Dominican Republic to confront its HIV treatment gap

23 August 2012

Image from an initiative by people living with HIV in the Dominican Republic launched to draw attention to the fact that the availability of generic drugs has significantly reduced treatment prices in the global market.

The Dominican Republic is one step closer to ensuring that all people living with HIV access treatment. The country’s National Social Security Council has established a commission to look into the technical, financial and operational implications of including antiretroviral therapy (ART) in the Basic Health Plan.

The establishment of the commission comes after a financial feasibility study about covering people living with HIV under the country’s family health insurance. The study was done in 2011 by the United Nations Development Programme (UNDP), United Nations Children’s Fund (UNICEF), Pan American Health Organisation (PAHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

The newly-established commission—whose membership includes several national health system offices in addition to regional and global partners such as PAHO and UNAIDS—is set to complete its work during the last quarter of 2012.

It is a step towards ensuring that treatment is maintained, and lives of Dominicans living with HIV are saved.

UNAIDS Caribbean Director, Ernest Massiah

According to UNAIDS Country Coordinator, Ana Maria Navarro, the development comes at a critical time and is a direct consequence of a feasibility study elaborated by United Nations agencies in the Dominican Republic. “This resolution brings us nearer to securing the sustainability of the AIDS response,” said Dr Navarro.

The Dominican Republic is classified as a middle-income country even though there are marked inequalities in income distribution. At present access to HIV treatment is completely financed by international donor agencies. While more than 20 000 people are currently receiving HIV treatment, more than 2 500 individuals known to be living with AIDS do not have access to life-saving drugs.

This is despite a guarantee of universal access to treatment for people living with HIV 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 informed the 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.

But a 2002 regulation for the operationalization 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 HIV treatment is not as expensive as local authorities believed.

“This is one giant step for the Dominican Republic,” said UNAIDS Caribbean Director, Ernest Massiah. “It is a step towards ensuring that treatment is maintained, and lives of Dominicans living with HIV are saved. People living with HIV can continue to work, support their families and participate in the simple joys of life to which we are all entitled. This is about respect, dignity and life.”

In April 2012, people living with HIV in the Dominican Republic 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 called for the 2012 presidential candidates to address the financial sustainability issues related to their treatment ahead of elections at the end of May.