AIDS cases on the rise in Latvia due to delayed treatment
Apskatīt komentārus (0)


11.07.2015

---

| Source: http://www.aidsactioneurope.org/news/announcements/aids-cases-rise-latvia-due-delayed-treatment |
The Latvian guidelines are the only guidelines in Europe that indicates the start of HIV therapy at 200 CD4 count. The European AIDS Clinical Society (EACS) guidelines recommend starting therapy at 350-500 CD4 count, in some cases above 500 and the WHO guidelines advise to start treatment at 500. New findings from the START study published in May 2015 show proof that early treatment is beneficial for people living with HIV. To start treatment at a CD4 count over 500 cells/mm3 count is safer than waiting till 350 CD4 count or even worse at 200.

The Latvian Government has promised to change the guidelines to the EACS and WHO-standard to start treatment at least at 350 CD4 count, but nothing has happened so far. Why is it so important to start therapy early in Latvia?

The basic argument to start therapy early in Latvia is the right to health and the right to life – our basic fundamental human right. Besides that there are other important reasons. It is important to treat people and to get them to the stage of being non-infectious to others in terms of public health. In some cases HIV is not controlled in the EU, there are gaps in the statistic about people who don’t receive therapy and don’t know about their status. It’s a threat for the European community if HIV is not under control in one part of the union it can affect other parts.

How many people live with HIV/AIDS in Latvia?

There are 6.214 people diagnosed with HIV in Latvia, according to the Infectiology Centre. To count all people living with HIV and people who don’t know their status you have to triple the number: an estimated 18 thousand people are living with HIV. 1.508 of them are in AIDS stage. About 700 died because of AIDS last decade. About 340 new infections are counted officially every year; 150 of them are new AIDS cases. Latvia has the highest AIDS rate in EU: 6.6. It’s seven times higher than EU average. It’s a clear indication that Latvia tops EU in AIDS cases because it does not provide ART (antiretroviral therapy) to its citizens according to the latest WHO guidelines. Latvians healthcare system treats people really late. When people don’t get treatment the infection spreads quite fast. 1.130 people receive treatment at the moment. Statistically it’s less than 20% of people living with HIV. Latvia’s government should adopt the WHO guidelines as fast as possible.

How many people are concerned?

I know about 100 people who live with HIV at CD4 cell count of 350, they need ART, but the treatment was denied on the accounts of old guidelines. If the treatment would be initiated at 350 CD4 count Latvia would spare at least 12 new infections a year and 100 new infections in 7 years and would save money in a long run, according to the calculation which was supplied by the Latvian Infectology Centre to the Ministry of Health. The Ministry of Health has all the data proving the cost versus benefit ratio and it has been also provided to the Ministry of Finance. They have many times refused to release necessary funding for ART.  The number of people living with HIV in Latvia, according to the health officials, is three times higher than the official rate.

You see, there is another reason why it’s important to start therapy early: the economic benefit. The number of people who are living with AIDS is growing. The job of ART is not only to treat people but, out of the economic perspective it’s bring them back into labour state.

Does the Latvian government have the necessary resources for starting treatment earlier?

First of all, the economic output data since 2010 provides the opposite picture. I am not going much in details here since all that information is available online. It is sufficient enough to mention that since 2012 the parliament’s deputy salaries increased by 370 euro a month, enough to cover ART cost for those 100 people living with HIV, whose CD4 cell count is 350. Every year the administrative costs for the government and government agencies increase at the rate of 2 to 4 million euros, the figured questions by the State Audit Office (SAO).

Second and most troubling of all, is the overspending the government contrary it could have been easily spent on curbing the HIV infection rate in Latvia.

Let me give you one example and there are others, it would take roughly 110.000 euro a year to treat people with ART starting at 350 CD4. The latest reports by SAO found out that the government agencies have overspent in the amount of 1,04 million euro on conferences taking place in palaces or for ministerial visits and conferences abroad in 2013. Out of 8,1 million euro allocated on EU presidency events only in 2013, a good portion of that was spent on substantial increase of salaries for EU presidency participants, unjustified visits abroad and colossal invoices that had nothing to do with the EU presidency. The troubling list could go on. The simple fact is that the government has money for HIV they just do not want to allocate it.

How much GDP does Latvia spend on healthcare?

The WHO recommends spending 7 % of the GDP on healthcare. Latvia is spending only 3%, just like many African countries, Russia and Syria. People who get sick are usually older than 50 and they have limited access to Latvian healthcare too, as their salaries or pensions cannot handle the partially privatized Latvia’s health care. We should work on universal access to healthcare for all people in Latvia and significantly cap the private sector that sets pricing unbearable for local residents.

How does HIV prevention work in Latvia? Are there awareness campaigns?

There is a good working network for HIV rapid testing. But public awareness campaigns are weak and the government backs away from HIV issues as it has been shown by its refusal to address HIV disease in its new budget. If you are living with HIV you will be in the system of Latvia Infectology Centre that provides treatment for HIV/AIDS. When CD4 counts drops to 200 you’ll get the treatment. If you’re eligible for treatment the government pays for your therapy. However, the problem is that below 200 CD4 cells the immune system is severely damaged and the patient is ultimately unrecoverable as the side diseases set in.

Is stigma a problem in Latvia?

Yes it is. I experience growing stigma in Latvian online media and social networks. The HIV/AIDS awareness is not included in the national agenda. HIV campaigns are mostly initiated by NGOs, never by the government. To raise HIV awareness the government needs to identify itself with the most at risk population, like sex workers, drug users and MSM. The government should work on the reducing stigma together with their NGOs. We, the activists of Latvia, addressed the government to include HIV awareness in the national agenda so many times. Comments on HIV awareness articles are homophobic and with full of hate. Most of the people living in Latvia don’t care about the most at risk population; they say that they deserve to die. The government don’t feel that there is an issue to intervene. It’s really hard to sustain attainable and a good public HIV awareness campaigns without official support. There is some funding available for harm reduction service, but that’s all.

How is the situation concerning hepatitis C?

The healthcare system covers only 75% of the cost of treatment. 100% coverage is only available for prisoners, 25% are paid by the department of justice. You need to be criminal to get Hep C treatment for free.

AIDS Action Europe has urged the Latvian government to ensure that the Latvian guidelines for HIV treatment follow the WHO guidelines, what has happened so far?

Two days after the letter was sent I attended a meeting at the Ministry of Health. The Minister told me that the letter was shared with other key stakeholders. He said that they will start treatment with 350 CD4 count as of the first of July. But there was no document which confirms his statement and the sustainability for the next years. In my opinion they’re going through a back door way. The politicians keep the authorisation of our request on hold.

You have been an activist in these fields for two years, what would you suggest to do right now?

I would say we should continue to stick to our call and keep this topic circulating in the press, media and most important on the diplomatic political level. Activists in Latvia are continuing to trying to convince the government to intervene. Being part of the European Union Latvia should keep its international obligations and approve the guidelines. Furthermore NGOs should be included in decision making processes and contribute with their experiences.

Thank you for your time!