Meeting with the Republic Fund for Health Insurance
We would like to inform all the members on the results of the meeting with the director of the Republic Fund for Health Insurance, Dr Aleksandar Vuksanović. The meeting was organized as a response to our pen letter on key problems of PLHIV in Serbia, and took place in the offices of the Fund in Belgrade, on February 10 2012.
We were very dissapointed to be received by the team of Dr Vuksanović, and not by him persnally, as we have previously agreed. With the team we have discussed the first two problems from the open letter – prescription of medication for people receiving treatment for the HIV infection, and options for broadening the positive list of medicines with newer ARV therapies.
Unlike in the written reply we have received from the Fund, the hosts of our meeting were unanimous about the problem on prescribing long term HIV medications for more then 60 days, as it is now, since that would require changes in the Regulations of the Fund – speciffically article 14, which defines that particular issue. We have concluded that longer prescription periods would make the treatment of patients on stable therapies much easier. The patients wouldn't have to get their presrciptions monthly – which would reduce queues at the clinics, while the doctors and the medicall staff can direct their attention to more urgent patients. The representatives of the Fund have agreed that this request is just, and promissed to push for adequate changes in the Regulations as soon as possible.
The second problem was the issue of insufficient ammount of modern HIV treatment medications in Serbia, which is also in juristiction of the Fund. Only a few medications have been registrated and put into the Fund's procedure for inclusion on the positive list. The expert group said last year gave the positive opinion on necessity of these medications, which are currently lacking in treatment of more than 10% of patients. We found the reply to our request very unprofessional (coming from public servants) – that the therapies are very expensive, and that the Fund lacks the money to procure them, and that the way to go about this problem is to get the pharmaceutical companies to reduce prices and give the medicines as donations. For us, excuses like these demonstrate that the Fund doesn’t approach solving of this problem seriously. The representatives further told us that “they understand the problem, and are putting some efforts in finding a solution for it (at least a partial one) by considering options.” They wouldn’t share any of the potential options with us at the time. A pharmaceutics-economic study is needed to show the expenditure and effects of obsolete medicines, and a cost study is needed to show the cost-effectiveness of introducing new ones. All of these studies have been done in other countries, and have shown that there are many benefits of HIV treatment, not only to health and quality of life of PLHIV but also for the public health. Our hosts in the Fund kept repeating that the Fund doesn’t have the money. We have taken on an obligation to address the pharmaceutical companies and ask them to adapt the price to our market.
However the meeting said that there is a lack of will to improve treatment of people living with HIV – confirming large stigma and neglect of this illness. We still have hope that these problems will be reassessed when the conditions in the country improve.
We had another suggestion we considered would be very beneficial for treatment of PLHIV – to have one of the patients take part in work of the subcommittee deciding on HIV medications and their inclusion on the positive list. The suggestion was rejected out of hand on the account of the committee being very highly expert based. We will reconsider this, and if needed address the Fund again.
We will continue our efforts to provide for adequate treatment for PLHIV, and consider it to be the key to HIV response, and in the interest of the entire society.
Members of our Q-club were received today by the Cabinet of the President of Republic of Serbia, Boris Tadić. We had a warm welcome, met with the councillors of the President and discussed the key problems of people living with HIV in Serbia, mostly within the healthcare system.
The meeting was organized as a response to our campaign – the open letter about the key problems of PLHIV in Serbia. With the councillors of the President we talked about those problems – we presented them from the perspective of PLHIV and of course some of our suggestions for solving them. We also talked about potential involvement of the President and the Cabinet in solving those problems, and thus improving healthcare situation for PLHIV in Serbia.
We have agreed to continue communication with the Cabinet until the key issues have been resolved, and that we will have the support of the Cabinet in our further actions.
The Q-club will continue working with all the relevant institutions on finding ways of overcoming the key problems in response to HIV.
The Ministry of Youth and Sport responded to the initiative of the Q-club – the open letter on key problems of PLHIV in Serbia, so they invited our representatives to a meeting. We met with the Head of the Department for Youth Cooperation, Zorica labudović on February the 6th 2012.
We discussed the ways this Ministry can help in solving of the key problems. Even though this Ministry of Youth and Sport has very little jurisdiction over the healthcare system, they demonstrated willingness to give the necessary support and help with our activities directed primarily at youth.
We, at the Q-club, have had a special programme for years targeting youth living with HIV and prevention of HIV among young people, so we hope that cooperation with the Ministry will grow trough projects directed at this population.
The Secretariat for Health Care has shown considerable understanding for the problems of PLHIV, and thanks to their immediate response to the campaign of the Q-club regarding the key problems of PLHIV, we have met with the deputy secretary, dr Aleksandar Stefoski today. Nada Mićić, Nenad Petković and Bratislav Prokić represented the Q-club.
On the meeting we have discussed various possibilities of cooperation on solving the key problems of PLHIV within the capacities of the City. We have agreed to consider the options of including the Q-club into ongoing and immediate activities. And we hope that this cooperation will produce concrete results which will directly improve the social position of people living with HIV in Belgrade.
The association of people affected with HIV, Q-Club, is pointing out the pressing problems within the healthcare system, which people living with HIV in Serbia face on daily bases. The Q-Club has sent an open letter pointing out the five most pressing problems people living with HIV face, to all the key stakeholders; the problems are: failure to recognize HIV as a chronic disease, insufficient inclusion of modern drugs for HIV treatment, irregular availability of diagnostic tests, neglecting of confidentiality of medical data and discrimination of people living with HIV when providing medical services.
“According to the official data, there are about 2,500 registered people living with HIV in Serbia, although we estimate the actual number is higher, and constantly rising.” said Nada Mićić, president of the association of people affected with HIV, Q-Club.
With adequate support of the state and by enforcing the determined strategies for prevention and treatment of people living with HIV, it is possible to reduce the incidence of infection and terminal outcomes. By applying the appropriate therapy the people living with HIV can increase their life span, and the quality of their life. “It is possible to live with HIV if the illness is under control” – added Nada Mićić.
A lot of people find out their HIV status when they get stricken by opportunistic infections, due to deteriorated immunity, which decreases their chances for successful treatment. Early detection of the virus, with timely testing, as well as adequate treatment enables a longer and better life for PLHIV. By enabling stable health for PLHIV we help preserve their ability to work and to actively participate in the society.
According to Nenad Petković, the legal representative ot the Association of people living with HIV, “The Q-Club is trying to motivate the key decision makers, all relevant institutions and social stakeholders to join us in solving these problems and contribute to equal social status of people living with HIV”. In this way, by providing adequate health services and employment of PLHIV, we can decrease social costs, but also significantly influence prevention and spreading of the disease.
You can read the open letter here (in Serbian)
Jelena Duković, PR agency Executive Group
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