To επίτευγμα είναι πολύ σημαντικό από μόνο του, αλλά επίσης μας υπενθυμίζει οτι η συστηματική, λογική και με σωστά επιχειρήματα διεκδίκηση μπορεί να επιτύχει αλλαγές πολιτικής.
Ηταν την Τετάρτη -29 φεβ 2012- που η κυβέρνηση ανήγγειλε τη δέσμευσή της στο να σταματήσει τη χρέωση της θεραπείας για την HIV λοίμωξη.
Η στιγμή είναι σημαντική για το ΝΑΤ (National AIDS Trust) αφού αγωνίζεται γι αυτό 8 χρόνια.
Εως τον Οκτώβριο του 2012, που θα ενεργοποιηθεί η απόφαση, μπορεί οι χωρίς νομιμοποιητικά έγγραφα κάτοικοι της Αγγλίας, να κληθούν να πληρώσουν για τη θεραπεία τους.
Η καμπάνια για την ελεύθερη πρόσβαση στη θεραπεία είναι πάντα μια μάχη για τη δημόσια υγεία.
ΑΚΟΜΗ ΚΑΙ ΑΠΟ ΟΙΚΟΝΟΜΙΚΗΣ ΠΛΕΥΡΑΣ, είναι συμφέρον.
Είναι πιό φθηνό να θεραπεύεις τους ανθρώπους πριν αρρωστήσουν και χρειαστούν νοσηλεία, ενώ εμποδίζοντας την πρόσβαση στη θεραπεία και συνεπώς αποτρέποντας και τον έλεγχο, διακινδυνεύουμε περαιτέρω λοιμώξεις και επομένως και αύξηση του κόστους..
Αν μπορέσει και το Ελληνικό Υπουργείο Υγείας... να το σκεφτεί αυτό μπορεί να σταματήσουν τα εμπόδια στη χορήγηση θεραπείας στους ανασφάλιστους ασθενείς με HIV λοίμωξη.
Στο κάτω-κάτω, δεν έπιασε καλοσύνη τους Εγγλέζους!
Το συμφέρον τους σκέφθηκαν..
The end of HIV charging is a brilliant outcome in its own right, but also a welcome reminder that rational, evidence-based advocacy can secure meaningful policy change.
Now that the decision is official, we can dig slightly below the surface of the newspaper headlines.
March 5, 2012
Sarah is Senior Policy and Campaigns Officer at NAT (National AIDS Trust).
NAT is the UK's HIV policy charity.
We champion the rights of people living with HIV and campaign for change.
Sarah works on policy issues around migration and asylum, access to healthcare, poverty and welfare.
The story was across the papers by Tuesday morning (28 February) but it wasn’t until 9.30pm on Wednesday night that the Government formally announced its “absolute commitment” to ending charging for HIV treatment.
Lord Fowler withdrew his amendment, on the assurance that the Government would bring about the change through regulations to be laid before the summer recess.
Photo: aldenchadwick (Flickr)
This was a very exciting moment for everyone at NAT, as we have been campaigning on this issue for eight years, and worked closely with Lord Fowler on his amendment. Now that the decision is official, we can dig slightly below the surface of the headlines.
Until the regulations come into effect in October 2012, some people who are not ‘ordinarily resident’ in the UK may be charged for HIV treatment, as they are for most NHS secondary care.
Those most affected are irregular and undocumented migrants, refused asylum seekers (except for those receiving section 4 or section 95 support), and short-term visitors to the UK.
Contrary to how some newspapers reported the change in policy, patients in these groups are not currently denied HIV treatment if they cannot pay. As HIV treatment is life saving it is always considered ‘immediately necessary’ – which means a doctor will give it without delay as needed.
It is then the job of the NHS trust to try and secure payment.
This proves very difficult as those migrants who are most likely to be affected by charging are also least able to pay a bill for treatment – many are destitute.
The official announcement also clarified that whereas the amendment laid by Lord Fowler had required six months residency in the UK to qualify for free HIV treatment, this requirement is not part of the Government’s promise.
Instead the Department of Health will simply amend the current list of exemptions so that HIV will no longer be singled out as the only chargeable STI.
The rules for HIV will then be the same as for all other STIs and infectious diseases.
This is both a simpler and stronger change than proposed by Lord Fowler’s original amendment, and the Government should be congratulated on the commitment it shows to public health.
The statement Baroness Northover read on to the Lords confirmed that public health concerns had informed the final decision.
This has always been a campaign fought on public health as much as human rights.
We have never been afraid to make a two-pronged economic case for providing treatment: that it is cheaper to treat people before they become so ill they need hospitalisation; and that by dissuading people from accessing treatment (and by extension, testing), you risk further transmission and associated costs.
It is hard to say why the evidence that charging for HIV treatment is a more costly policy than universal access resonated now when it hasn’t before.
Part of the explanation has to be the first randomised trial showing conclusively the preventive benefit of HIV treatment – a 96% reduction in transmissions among those on treatment.
Of course the timing - an amendment laid by Lord Fowler off the back of the Lords Committee inquiry into HIV in the United Kingdom - is also significant.
Whatever the trigger, we should note and make the most of this precedent, when evidence-based arguments for public health have triumphed over ill-defined and un-evidenced fears of ‘health tourism’.
These arguments will be needed again, most obviously later this year when the Government will consult again on overseas visitors and the possibility of extending charging to primary care.
The end of HIV charging is a brilliant outcome in its own right, but also a welcome reminder that rational, evidence-based advocacy can secure meaningful policy change