IAS 2019: Collapse of Venezuela's health infrastructure dismantles HIV response

 Science Speaks covered IAS 2019, the 10th IAS Conference on HIV Science from July 21 - 24.[/caption] MEXICO CITY - A decade ago, Venezuela had one of the most progressive responses to its HIV epidemic in the world. In the 1990s the country's Supreme Court mandated that the government provide lifesaving antiretroviral therapy, catalyzing a national HIV program which provided comprehensive care to everyone who qualified. Now, after more than five years of political conflict accompanied by human rights abuses, hyperinflation and shortages of necessities from food to water to electricity – leaving more than seven million people in need of humanitarian aid while another four million have fled the country – Venezuela’s failing response to the HIV epidemic is a crisis within a crisis, Carolina Jimenez of Amnesty International said here. “Until recently Venezuela was an upper-middle income country,” Jimenez said. “And now people are fleeing their homes because they live with HIV and are dying from AIDS.” Less than half of people living with HIV in Venezuela have access to the HIV medicines they need to survive, she said, and those who can access antiretrovirals – whether through aid organizations or by paying exorbitant amounts through the private sector – face additional challenges seeking medical care. “A lot of doctors and nurses have fled,” Jimenez said. “Remaining health centers face unsanitary conditions, severe shortages in basic medical equipment, supplies and medicine,” she said. The four largest cities, including the capital city, Caracas, have seen between 60 and 100% shortages of essential drugs, she said. The collapse of basic health services, including immunization efforts, have resulted in the reemergence of diseases that were eliminated or under control, including diphtheria and malaria, she said. Several cities are facing a complete shortage of all types of contraceptives, she said. “Blackouts have caused irreparable harm to the health sector,” she said. “There were four days when the whole country was in darkness.” It is unclear how the collapse of the health system has affected the rate of new infections, Jimenez said, as HIV diagnostic testing and testing of blood at blood banks has stopped completely. This, coupled with limited oversight from the government, has resulted in the complete cessation of epidemiological tracking, she said. A lack of data on the state of the epidemic impacts the ability to apply for and receive international aid, she said. The Global Fund to Fight AIDS, TB and Malaria only recently relaxed their funding criteria for Venezuela, allowing for $5 million in funding to be allocated for the purchase of antiretrovirals, Jimenez said. Among those few HIV aid organizations still operating in the country, aid workers face harassment and violence from government authorities who deny the existence of a crisis and refuse to allow international aid, she said. In one instance, officials allegedly raided an HIV service organization and confiscated antiretrovirals, clinical supplies, testing kits, condoms, and even confidential patient records and infant formula, Jimenez said. “Humanitarian aid is being increasingly politicized because the government is denying the existence of a crisis,” she said. “We are all responsible for defending our civil society partners,” Jimenez said, calling for IAS attendees to push for the United Nations Human Rights Council to establish a commission of enquiry for truth and justice to examine the government’s human rights abuses. “Any HIV response is first and foremost a human rights issue,” she said. “Failing to provide HIV services is a human rights violation.”