An important new report “Resurging epidemics, a broken health system, and global indifference to Venezuela’s crisis documents the collapse of Venezuela’s HIV Program, the surge in malaria, and the heretofore unsuccessful efforts to get the Global Fund to address the situation.
The report documents how Venezuela’s HIV program–once a model for the global South–has been decimated. Shortages of medical supplies are always tragic, but stock-outs of antiretroviral therapy (ARVT) drugs are especially cruel. ARVT works by suppressing HIV to the point that it cannot produce AIDS and even to the point that a person is no longer contagious. Successful ARVT can allow HIV positive individuals to lead long and productive lives.
Going a month or two or six without ARVT drugs allows HIV to flourish, exposes the person to developing AIDS, and makes them contagious. Worse yet, they tend to develop drug-resistant strands of the virus that can no longer be contained by the drugs. And going back on therapy is hindered by the lack of the viral-load tests that doctors need in order to know which ARVT drugs and how much of them to use.
Pregnant mothers can prevent transmission of HIV to their babies if they receive treatment and substitute breastmilk for baby formula. But lack of ARVT drugs as well as baby formula mean that transmission is likely.
The report also documents the surge in malaria in Venezuela. Leaked epidemiological bulletins show 60-70% year-on-year increases from 2015 to 2016 to 2017.
A year ago activists wrote a letter the Global Fund asking them to send assistance to Venezuela. The Global Fund is an international health financing mechanism with public and private funds that focuses precisely on HIV, malaria and tuberculosis. The Global Fund responded in January of this year that Venezuela did not qualify for assistance.
Venezuela is classified by the World Bank as an “upper middle income” country which means it can receive aid only if it has a 1% rate of prevalence in the general population or a 5% rate in a “key population” as defined by the Global Fund (men who have sex with men, sex workers, people who use drugs, or transgender persons). Venezuela does not have a 1% infection rate in the general population and simply does not have data on key populations.
The authors criticize the Global Fund’s response and urge it to act.
“The criteria used to evaluate eligibility today have narrowed significantly from the founding approach of the Fund, which viewed the funds mobilized as a ‘war chest’ to fight the three diseases. Fifteen years later, the Global Fund has positioned itself more as a development actor, supporting countries as they move along a ‘development continuum’ towards a permanent state of ‘sustainability.’ However, the case of Venezuela challenges these linear concepts of development, as a country that once achieved everything that might be hoped in economic development – including the elusive goal of malaria eradication – and now has rapidly lost ground.”