A Venezuelan woman had grown used to shortages. Then her HIV drugs ran out.
‘It is a nightmare,’ one doctor said
Adapted from a story by The Washington Post’s Anthony Faiola and Rachelle Krygier.
Carmen Hernández needed Viraday.
The Venezuelan woman had dropped eight pounds in four weeks. Her headaches were becoming all too frequent. The mother of five needed the drug to keep herself alive. Hernández was diagnosed with HIV in 2013, and Viraday — known as Atripla in the United States — could help. The drug’s powerful compounds act against enzymes that cause the HIV infection to spread.
But when Hernández visited a clinic in July, the doctor told her they were all out. Try again in August, he said.
“When they told me they ran out, I left, sat down on the street and cried,” Hernández said. “I couldn’t stop. People passed by and stared.”
“I’m scared of decaying,” she said.
Venezeula’s surging HIV/AIDS crisis
With the Venezuelan economy collapsing, many things are hard to find, including life-saving drugs. Doctors are struggling to cope with a surging HIV/AIDS crisis that experts fear could become the worst in Latin America in years.
In a country where a six-pack of condoms — which can prevent transmission — costs almost a full day’s minimum wage, the number of newly infected patients continues to climb. Food prices are skyrocketing, and HIV carriers require a good calorie intake for their weakened immune systems. Severe shortages of HIV drugs go back to at least April, doctors say.
“We used to have about one or two HIV patients a day; now we have four and five, up to 25 a week,” said María Eugenia Landaeta, head of infectious diseases at Caracas University Hospital, one of the capital’s largest medical centers. “We’ve had too many patients die because we can’t offer treatment.”
“It is,” she said, “a nightmare.”
According to statistics from the United Nations’ AIDS agency, based on information from Venezuela’s Health Ministry, the number of AIDS-related deaths in the country surged 25 percent to 2,500 between 2010 and 2016, even as they fell 12 percent on average across Latin America. Many Venezuelan medical experts believe the numbers could be even higher.
An imploding health system
Already living with the world’s highest inflation rate and an increasingly repressive government, Venezuelans are facing an imploding health system.
During the 14-year rule of President Hugo Chávez, a charismatic socialist who died in 2013, oil-rich Venezuela was praised by health experts for its HIV prevention programs and free treatment. But the national health system is now buckling as years of government mismanagement and corruption, coupled with lower oil prices, have plunged the economy into chaos.
Authorities import many drugs, including antiretrovirals, at discounted rates via the Pan American Health Organization. But the local currency is in free fall, putting those cut-rate drugs, as well as basic imported medical supplies such as needles and saline, increasingly out of reach.
Free HIV tests have been mostly unavailable since November. Pinched by costs, prevention programs offering free condoms ceased last year. Amid pill shortages, otherwise healthy carriers like Hernández are going weeks, sometimes months, without antiretroviral drugs.
The government of Nicolás Maduro, Chávez’s anointed successor, has routinely rejected offers of international humanitarian aid. Nonprofit groups say Venezuelan authorities have refused even small-scale help.
Jesús Aguais, founder of AID for AIDS International, said his nonprofit used to have a permit to bring up to $2 million worth of HIV drugs into Venezuela annually. Without citing a reason, the government abruptly refused to renew its license in 2014, he said.
“We send drugs to 42 countries,” said Aguais. “What is happening in Venezuela hasn’t happened anywhere else.”
A patient’s fate
Hernández returned to the clinic in August. When a doctor called her name, she rushed to the window.
“Viraday,” Hernández said.
No, they didn’t have it.
But they did have the generic.
The doctor told Hernández she was lucky. Only 500 monthly doses had arrived for 2,900 patients.
“What happens to the patients who come next week?” Hernández asked.
The doctor looked down, shaking her head.
