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BUENOS AIRES (IPS) - There is a lack of continuity in medical treatment for the thousands of Argentines who are HIV- positive or have full-blown AIDS, a problem activists blame on the government's increasingly limited and unpredictable financial and political support for AIDS programmes. In this country of 36.6 million people, there are some 130,000 with HIV (human immunodeficiency virus), of whom some 20,000 have developed AIDS (acquired immunodeficiency syndrome), according to the Ministry of Health.

Seventy-five percent of those with HIV/AIDS should be receiving the necessary medications through Ministry of Health programmes, but the irregularities in delivery are a constant, report non- governmental organisations (NGOs). Each month, between five and 15 new patients arrive at the AIDS Foundation asking for help in filing legal claims that would obligate the state to provide them with antiretroviral drugs, Noem� Perelman, the foundation's president, told IPS.

These HIV/AIDS patients are attempting to ensure continuity of their combination retroviral treatment, also known as a drug "cocktail", which has been proven to be 95 percent effective worldwide - if the medications are supplied and consumed in a timely manner.

But the government's distribution of the pharmaceuticals tends to be interrupted or delayed on a regular basis, complain those who need the pharmaceuticals to keep their HIV levels in check.

One of the criticisms frequently heard is that the government is handing out generic drugs, which may not have the exact same formula as the expensive trademarked version of the medication, but contain the same active ingredients. Some doctors, however, question the effectiveness of the generics, though other experts assert that they produce the same results as the trademarked drugs manufactured by the patent- holding companies. Patients often complain about the side effects of the generic versions.

Another difficulty is the frequency of drug distribution, which is often just once weekly. This presents a problem for patients who are not able to get to the distribution site on the designated day due to their work schedule or because they do not have money to pay for transportation.

At times, the availability of the drugs may be interrupted for as long as 15 days. In that period, the concentration of HIV in the individual's blood can rise, and the body can develop resistance to the drugs, according to AIDS specialists.

Adding to the uncertainty in Argentina's HIV/AIDS arena was Mabel Bianco's resignation last week from her post as director of the National AIDS Programme. Among her reasons for leaving, she cited the government's "lack of political will and support" for her efforts.

"This lack of support prevents the sustainable development of our activities," Bianco told the fourth Argentine Congress on AIDS, held last week in the western province of Mendoza.

She underscored the scant official aid for existing prevention and research programmes, and also - though to a lesser degree - the irregularities in the provision of AIDS drugs to the patients.

When she was designated as head of the National AIDS Programme, Bianco was president of the Foundation for Women's Research, dedicated to sexual and reproductive health. With that background, she made a great deal of progress in HIV/AIDS prevention efforts aimed at the female population.

She was also chosen to represent Latin America on a panel of experts that drew up a special report that was presented at the special session of the United Nations General Assembly on AIDS earlier this year.

In Argentina, Bianco is at the helm of Project 'Lusida' (a play on the word 'lucid' and the acronym for AIDS in Spanish - SIDA), which was created in 1997 and is financed in equal parts by the World Bank and the Argentine government. The project's efforts focus on prevention, labour rights for HIV/AIDS patients, and the distribution of medications.

This year, the World Bank delivered 13 of the 14 million dollars it had promised, while the Argentine government has only provided six of its 14 million dollars.

The country's economic-financial crisis recently prompted the Fernando de la R�a administration to cut state spending, keeping it on par with monthly revenues, which means that Project Lusida may be suspended next year.

Bianco said that although the provision of AIDS drugs is guaranteed by law, several other activities aimed at preventing the spread of the disease must be carried out through joint efforts of the state, NGOs, hospitals and other community groups.

Perelman, of the AIDS Foundation, says Project Lusida never had received strong support from the Ministry of Health. "The epidemic increases and, in the same measure, the sensitivity and the motivation of the officials to deal with this problem decreases," commented the psychologist.

Pedro Cahn, a doctor specialising in infectious diseases and head of another foundation specialising in AIDS, expressed concern about Bianco's resignation, saying she served as a sort of guarantee of programme continuity.

"There are more and more patients who depend on the state because they have lost their jobs, and therefore no longer have medical coverage through private firms or through their trade unions," Cahn said.

He reported that some of his patients, in addition to suffering delays in the delivery of AIDS medications, often receive the pills by the handful, without even a labelled container. (END/IPS/LA/HE/TRA-SO LD/MV/MJ/01)


Copyright © 2001 -Inter Press Service, Publisher. All rights reserved to Inter Press Service. Reproduced with permission.Reproduction of this article (other than one copy for personal reference) must be cleared through the Inter Press Service, IPS-ONLINE, World Desk via Panisperna 207 00184 Rome, Italy. Email IPS visit Inter Press Service.

Information in this article was accurate in November 19, 2001. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.