In the bustling city of Barquisimeto, about five hours away from Caracas, lives Raiza, a Venezuelan woman who’s lived with HIV for 18 years. It used to be possible for her to access treatment through the public healthcare system but as the political and economic situation in the country worsened, medicine became scarce and Raiza began fearing for her life. After two years without treatment, she embarked on a venture to the Colombian border, where she could either buy overpriced drugs from pharmacies or access donated antiretrovirals from non-governmental organizations.
Raiza is just one among the estimated 62000 people living with HIV in Venezuela who started treatment but lacked consistent access to antiretrovirals last year. The fallout has been severe. Hospitalization rates among people living with HIV have soared and there are as many as 20 to 30 HIV-related deaths every day. By September 2018 an estimated 7,700 Venezuelans living with HIV were among the migrants streaming into neighbouring countries in hopes of accessing medicine.
“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 healthcare services and HIV treatment, discrimination, mass migration and xenophobia are the main implications of this crisis for all people with HIV in Venezuela and neighboring countries”.
In 2017 a UNAIDS-commissioned research by ACCSI ("Monitoring of HIV care and treatment services in 14 Venezuelan regions") generated the first concrete evidence of shortages of antiretrovirals, other drugs and HIV reagents.
HIV prevention has also been undermined. Experts are concerned that irregular treatment access could fuel drug resistance in both Venezuela and neighbouring countries. Only about a quarter of pregnant women are being screened for HIV and syphilis; because of the food shortages, some mothers living with HIV are opting to breastfeed; and among the indigenous Warao population, almost one in ten are living with HIV.
Over the last two years the Joint United Nations Program on HIV and AIDS (UNAIDS) has coordinated, with the Venezuela Ministry of Health, civil society, PAHO and other United Nations entities and development partners, actions to improve treatment access for adults and children living with HIV in Venezuela, as well as those on the move. UNAIDS joined civil society and PAHO at the table to support the advocacy that resulted in a Global Fund US$5 million allocation to the HIV component of a “Master Plan” meant to coordinate support to combat HIV, Tuberculosis and Malaria in Venezuela.
UNAIDS, in partnership with Aid for AIDS International, received more than 60 tons of antiretrovirals which were distributed to people in treatment through state-run dispensing centres. They have 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 (RVG +) and other strategic partners we managed to ensure that treatment was received and distributed in Venezuela 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 last six months Raiza has received her antiretrovirals through the public health system thanks to the donations from Aid for AIDS.
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.
Amidst 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 Venezuela,” said UNAIDS Country Director, Regina Lopez de Khalek. “We are working so that Venezuela is not left behind in the global effort to end AIDS.”