Purchase of antiretroviral in Guatemala: towards sustainability and development

Also available in: Español

Guatemala is committed to sustainability and development in response to HIV by reducing purchase prices and making it easier for medicines to enter the country if they comply with the requirements of international regulatory agencies.

By: Sandra Ramírez

The National Strategic Plan 2017-2021 sustains the Guatemalan response to HIV and is based on five strategic axes: increase the availability of combined prevention programs; eradicate the transmission of HIV from mother to child; integrate medical care and social support for people, their families and their communities; promote a legal and social environment that favors human rights and gender equality and strengthen the public health sector to improve and sustain the national response.

For this strategy to become a reality, it is necessary to optimize resources, guarantee the supply of medicines and expand coverage. For this reason, the country recently issued the Governmental Agreement 104-2018 that seeks to guarantee the response to HIV and its sustainability, through the use of mechanisms that allow international purchases of medicines at low cost through international bodies and multi-country partnerships, such as COMISCA, PAHO/WHO, among others.

Since the beginning of the epidemic, Guatemala has recorded 38,217 cases of HIV (1984-2017), deaths or abandonment of treatments are unknown, as there is no monitoring system that collects this information and the estimates of UNAIDS indicated for 2016 that around 46 thousand people lived with HIV in that country. In this context, only 18,000 people receive antiretroviral (ARV) treatment.

Among the difficulties that have arisen for the acquisition of ARV drugs and in some cases has involved demands and safeguards of people with HIV towards the State of Guatemala, have been identified (1) the diversity of treatment schemes, which make more difficult to estimate needs and the transition between the provision of the Ministry of Health and the Guatemalan Social Security Institute; (2) the protection of intellectual property rights, expressed in patents or test data protections that limit the entry of generic drugs and (3) poor planning to guarantee supply in the care units.

The Minister of Health, Carlos Enrique Soto Menegazzo, announced the mechanisms that have been implemented in the two largest national hospitals in the country for the purchase of medicines through the Council of Health Ministers of Central America -COMISCA-, which has allowed a saving of more than Q26 million quetzals (four million dollars).

Soto said: “I seek to guarantee access to essential medicines and other basic products for public health, aimed at the objectives of sustainable development.”

This measure seeks to benefit the population with greater access to essential medicines, obtaining quality at a lower price and with the support of PAHO/WHO.

The National Laboratory will also be strengthened so that it has the capacity to supervise and guarantee all medicines that comply with quality and efficacy guarantees.

Other measures that must be taken in the short and medium term are: to expand nationwide the strategy of sex education in schools, increase national financial resources necessary for the response to HIV, increase HIV testing in community settings and support the adherence to medical care, including antiretroviral therapy.

For the Legal Network and its Observatory on Human Rights and PEMAR, the measure was accepted in response to the action for protection recently issued by the High Court of Justice ordering the MSPAS to guarantee the supply of medicines and protect the lives of patients. With these savings, the country will be able to acquire more medicines at better prices, which will allow to invest in prevention and to contribute to the goals set for 2030 seeking to eradicate HIV.