25 Jan 2017
The Global Fund Must Not Turn Its Back on Venezuela
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The Global Network of People Living with HIV (GNP+) wishes to express our grave concern and profound disappointment with the Global Fund’s recent decision to reject a humanitarian plea for financial and technical support made by the Venezuelan Network of Positive People (RGV+) on behalf of the thousands of HIV+ people who are suffering through a devastating food and health services crisis in Venezuela.
In a letter sent to Global Fund leadership in June of 2016, the Board of RGV+ outlined the status of the deteriorating medical system in Venezuela including ongoing treatment interruptions and stock-outs of ARVs (reportedly, atazanavir, raltegravir, ritonavir, nevirapine, efavirenz, rilpivirine, tenofovir, emtricitabine and abacavir). Further, the letter also goes on to outline the lack of access to essential medicines and medical supplies as well as the spectacle of dangerously contaminated surgery rooms, ill-equipped laboratories, water and electricity disruptions, long lines at supermarkets and widespread food insecurity.
With some of the highest HIV infection, teen pregnancy and STI rates on the continent, Venezuela is in the midst of a public health crisis that is imperiling the health, safety and wellbeing of people living with HIV. Due to constant treatment interruptions more and more people living with HIV are acquiring TB, or suffering and dying from life threatening skin rashes, eye diseases and other easily preventable opportunistic infections. Further, there is not enough ARVs to stem the tide of mother to child transmission of HIV and inflation has grown so high that in one highly publicized report condoms were being auctioned off for $755 USD a pack. Reports of the growing political and economic crisis that has enveloped Venezuela have been corroborated by the Venezuelan Society of Infectious Diseases, Human Rights Watch and a number of major international news sources.
Seven months after receiving RGV+’s desperate appeal, the Global Fund categorically rejected their request claiming that their “current policy framework does not allow the Global Fund to provide funding to Venezuela” without offering any other solution. The Global Fund’s eligibility criteria is determined principally by the World Bank’s country income classification system measured by gross national income (GNI) per capita. Countries, like Venezuela, that are currently classified as high income are ineligible for Global Fund support. However, in exceptional and in dire circumstances the Global Fund has in the past found a way to award emergency relief grants.
The use of GNI to determine a country’s income status paints an incomplete or illusory picture of a country’s social, economic, and political stability that obscures the widening inequalities that people living with HIV and key affected populations still face. Through the result of Development Continuum Working Group and Equitable Access Initiative, the Global Fund and other global partners fully acknowledged that simply using economic and disease burden indicators as metrics to determine investment is not enough.
Venezuela is in the midst of a political and economic crisis, people living with HIV, gay and bisexual people, sex workers, transgender people and drug users in Venezuela are experiencing distressingly high levels of poverty and food insecurity, lack of access to healthcare, widespread stigma, discrimination and violence as well as a dismal lack of social and legal protections. It is time that the Global Fund exercise their power to expand their flexibilities and intervene on behalf of the health, safety and wellbeing of people living in HIV in Venezuela. We must demand that the Global Fund live up to its mandate to not only invest money to end the global epidemics of HIV and TB but also to go into and save lives in places where they are needed the most. Now is not the time for the Global Fund to backtrack on their most principled and important commitments. Join us in the call to keep the Global Fund global!