Feature story

Taking action against HIV medicine stock-outs in the Bolivarian Republic of Venezuela

14 February 2019

Raiza Farnataro lives in the bustling city of Barquisimeto, in the Bolivarian Republic of Venezuela, about five hours away from Caracas. Having lived with HIV for 18 years, she used to access treatment through the public health-care system. However, as the economic situation in the country worsened, medicine became scarce and she began fearing for her life. After two years without treatment, she travelled to the Colombian border, where she could either buy overpriced medicines from pharmacies or access donated medicines from nongovernmental organizations.

Ms Farnataro is just one among an estimated 62 000 people living with HIV in the country who started treatment but lack consistent access to antiretroviral medicines, according to the Venezuelan Network of Positive People. The fallout has been severe. Hospitalization rates among people living with HIV have soared and there are an estimated 20 to 30 AIDS-related deaths every day. By September 2018, an estimated 7700 Venezuelans living with HIV had joined the migrants streaming into neighbouring countries.

“The current humanitarian crisis is leading to a drastic and alarming regression of the national AIDS response that is comparable to, and even worse than, what was experienced at the beginning of the HIV epidemic in the 1980s,” said HIV activist Alberto Nieves of Citizens Action against AIDS (ACCSI). “Deaths, progressive deterioration of health, hunger, denial of access to health-care services and HIV treatment, discrimination, mass migration and xenophobia are the main implications of this crisis for all people with HIV in the country.”

In 2017, UNAIDS-commissioned research by ACCSI generated the first concrete evidence of shortages of antiretroviral medicines, other medicines and HIV reagents.

HIV prevention has also been undermined. Experts are concerned that irregular treatment access could fuel drug resistance in both the Bolivarian Republic of Venezuela and neighbouring countries. Only about a quarter of pregnant women are being screened for HIV and syphilis. Because of food shortages, some mothers living with HIV are opting to breastfeed.

Over the past two years, UNAIDS has coordinated with the Venezuelan Ministry of Health, civil society, the Pan American Health Organization (PAHO) and other United Nations entities and development partners to improve treatment access for adults and children living with HIV in the country, as well as people on the move. UNAIDS joined with civil society and PAHO to support the advocacy that resulted in a Global Fund to Fight AIDS, Tuberculosis and Malaria US$ 5 million allocation to the HIV component of a plan to coordinate support to combat HIV, tuberculosis and malaria in the country. 

UNAIDS, in partnership with Aid for AIDS International, received more than 60 tonnes of antiretroviral medicines, which were distributed to people through state-run dispensing centres. UNAIDS has also coordinated the donation and distribution of testing kits and breast-milk substitutes.

“Thanks to the support of UNAIDS, the Venezuela Network of Positive People and other strategic partners we managed to ensure that treatment was received and distributed in the country in 2018. Our efforts helped to reduce the impact of the crisis, assuring treatment to a significant percentage of people with HIV,” explained Aid for AIDS Executive Director Jesús Aguais. “Otherwise,” he added, “the tragedy would have been greater.”

This action has saved lives. Over the past six months Ms Farnataro has received her antiretroviral medicines through the public health system, thanks to the donation from Aid for AIDS International.

As a member of the Regional Inter-Agency Coordination Platform for Refugees and Migrants from Venezuela, UNAIDS also advocates for the rights and treatment access needs of migrants living with HIV. Priorities include the establishment of a civil society observatory to monitor access to health services and discrimination, distribution of communication materials around prevention, treatment and care and advocacy to address discrimination and xenophobia.

Amid all this, UNAIDS insists on the need to continue strengthening the country’s HIV response. “We need ongoing work with diverse national and international actors for the welfare of all Venezuelans, and to guarantee the health and quality of life of all people living with HIV in the Bolivarian Republic of Venezuela,” said the UNAIDS Country Director, Regina Lopez de Khalek. “We are working so that the country is not left behind in the global effort to end AIDS.”