BEFORE the Department of Health started offering free HIV medication to people living with AIDS, former Japan entertainer Hiro (not his real name) used to get his anti-retroviral (ARV) drugs from friends abroad where they are much cheaper.
Like other persons living with AIDS (PLWA), Hiro has to take a cocktail of two or more ARVs to suppress the multiplication of the AIDS-causing virus in his body. The virus wreaks havoc on the immune system, making the body more susceptible to all kinds of infection.
The 41-year-old former “hosto” (male guest relations officer) in Japan is one of 130 HIV-positive Filipinos who have been receiving free ARVs starting late last year under the Global Fund that has so far committed $5.5 billion (P282.5 billion) in 132 countries including the Philippines. The fund from donor countries approves and finances project proposals meant to fight AIDS, tuberculosis and malaria that altogether kill over six million people every year.
Aside from the free supply of ARVs to PLWAs in need of treatment, the country’s approved proposal includes advocacy among local government units to mount and sustain responses to HIV-AIDS, says Dr. Gerard Belimac, program manager of the HIV-AIDS Unit of the DOH’s National AIDS-STI Prevention and Control Program.
The five-year project, which ends in 2008, has been considered a success by an external evaluator, Belimac says. Generally, the project’s first phase which ends this month, has met all the targets, he adds.
“There is good collaboration between and among the national government and local government units and the nongovernment organizations working on HIV-AIDS. The level of sexually transmitted infections among sex workers is at 23 percent and HIV prevalence remains at less than 1 percent,” he says.
Free access to meds
The health department has also “capacitated several treatment hubs to do counseling and testing, and to provide technical assistance to social hygiene clinics on STI case management,” Belimac says.
The idea of providing PLWAs with free drugs came from the nongovernment group Pinoy Plus, whose members are all HIV-positive, Hiro notes. “In a meeting with DOH, Pinoy Plus had suggested that government should help us secure a more permanent supply of ARVs, since the expensive drugs are out of reach of most AIDS sufferers who have been rendered jobless by the disease.”
Hiro himself had to stop working as an entertainer after being diagnosed as HIV-positive in 2004. “It’s a good thing I had managed to save enough after 10 years in Japan so I have some means of getting the drugs I need,” he says of the three capsules he has to take daily.
Latest reports on HIV-AIDS show that only about 20 percent of the world’s 40 million AIDS sufferers have access to ARVs. Compared to this, the Philippines’ target of providing free ARVs to 40 percent of Filipinos with HIV-AIDS might seem ambitious, but the target is within reach, says Belimac. The project is targeting 200 recipients by the year 2008.
Although there are at least 2,566 reported HIV-seropositive cases in the country as of June 2006, Belimac says that not all people with HIV necessarily need ARVs.
But the DOH doctor does not discount the possibility that the fear of stigma has kept other PLWAs away. “Though we guarantee them 99 percent confidentiality, some HIV-positive individuals still hesitate to come out to access health services including free supply of ARVs.
Before the Global Fund project was put in place, Hiro had to get his ARVs from the Research Institute for Tropical Medicine (RITM) for at least P7,000 a month. Branded medication can cost as much as P30,000 a month, he says. Today, the DOH spends an average of P5,000 a month per recipient for the generic ARVs, Belimac says.
The drugs are dispensed through several government hospitals all over the country: the San Lazaro Hospital on Rizal Avenue, Manila; the RITM in Alabang; the Philippine General Hospital on Taft Avenue, Manila; the Ilocos Training and Regional Medical Center, the Davao Medical Center, and the Vicente Sotto Memorial Medical Center in Cebu.
Erratic supply
But the supply is erratic, complains Hiro, who has availed himself of the free supply only once.
“I was told that they’ve run out of Stocrin and that they’re still processing the next batch,” he says of his particular brand of ARV medication. Other medications disagree with him, so he can only use the more expensive Stocrin. Branded Stocrin costs P5,200 a month while its generic equivalent goes for P4,100, he says.
The government’s free ARV program has helped a lot, says Hiro, but the bureaucratic delays can be cumbersome, he complains. “Sometimes it takes them forever to process our requests. The Global Fund has already given the resources but we still cannot get some of the requested medication. Pinag-uusapan pa raw yata, eh. (They keep saying it’s still being worked out. What’s causing the delay?) When will they give us the drugs? When we’re dying?” he gripes.
Arlene, 47, who was infected by her husband, comments on the program’s “lack of reach.”
“There’s not enough information. Only those among us who are part of an AIDS network or NGO know about the free ARVs. The government should advertise in the tabloids so more people with AIDS will know about the program,” she says.
Diagnosed in 2000, Arlene and 15 other beneficiaries used to get their drug supply from donors to the Positive Action Philippines Foundation Inc. (PAPFI). She now gets her ARVs from RITM, and has had to shift to generics which, Arlene says, do not totally agree with her. “I’ve developed rashes but they said they have no other medication to give me.”
The government should also do more frequent monitoring of PLWAs to check if the medication is working.
“As it is, they do lab tests on us every six months. They’re saying that they don’t have the funds to do it more frequently,” Arlene says.
The lack of resources is admittedly one of the challenges that hound the Global Fund project, Belimac says. “We keep training health workers, only to lose them to more lucrative offers abroad,” he adds.
