Antiretroviral stock-outs are a serious public health problem in the Latin America region and represent an important risk to the sustainability of the HIV response, according to participants at AIDS2018.
On July 26, a session titled Sustainability of the response to HIV in Latin America; factors that impact access to drugs and health supplies addressed and analyzed the magnitude, the structural causes and the impact of stock-outs on the sustainability of the HIV response in Latin America. Participants discussed strategies to pave the way forward and highlighted best practices on joint purchases of antiretroviral (ARV) treatment like the PAHO/OMS strategic fund, which has helped prevent stock-outs.
In Latin America, one of the most important achievements in the HIV response has been the recognition that accessing HIV treatment is part of the right to health in the public health system, resulting in an increased number of people receiving antiretroviral treatment in recent years. However, a major challenge to fulfill the right to health is to guarantee uninterrupted supplies of ARV drugs and other essential health commodities.
According to the Pan American Health Organization (PAHO), in 2012 45% of the countries reported at least one stock-out episode; the figure had been 54% in 2010. Although some improvements are seen from 2010 to 2012, the region is still experiencing a high frequency of stock-outs.
Shortages of ARVs and other essential supplies result in changes and interruptions in patient treatment, threaten the lives of people with HIV and hamper the reduction of new HIV infections and AIDS-related deaths.
Participants at the session stressed the need for greater health system strengthening and joint procurement processes, including the incorporation of TRIPS flexibilities to reduce ARV costs, aligned with policies for simplified treatment regimens. According to participants, all these factors are essential to prevent and respond to stock-outs of ARVs and medical supplies.
“Situations of stock affect the adherence to treatment, and consequently increases morbidity and mortality through opportunistic infections/diseases. It is fundamental and urgent the increase of public financing to increase the budget for prevention and treatment. The purchase mechanisms should be efficient and timely”
Alma de Leon Regional Director, ITPC, ART sustainable access
“Latin America continues to be the region with the highest coverage rate of antiretroviral treatment. About 1.1 million people in the region were accessing treatment in 2017, which represents 61% of people living with HIV. To close the gaps, it is key to Improve the management of national programs and planning so there are no stock-outs of medication.”
César Núnez Director, Regional Support Team for Latin America and the Caribbean, UNAIDS
“Policies on access to generic medicines continue to be one of the key strategies for improving access to medicines, together with the strengthening of systems for the management and use of regional drug procurement mechanisms, including the PAHO Strategic Fund.”
Massimo Ghidinelli OPS
"70% of countries have been or have been at risk of interruptions in delivery of drugs and / or supplies in the past 2 years. The main identified causes were related to the management of supplies "
Susana Cabrera Uruguay HIV national programme
“Civil society has been playing a key role in the monitoring and auditing public management and procurement in order to ensure universal access to health. And we can improve this work by using several tools that are available in different countries of our region such as the law that guarantees access to public information, follow-up of public procurement (including e-procurement) and open parliament.“
Maikol Porras HIVOS
