HIV positive: We can't wait

The Tomsk region is among the top ten regions for HIV incidence in Russia. There are 113 patients per 100 thousand population. According to the regional Rospotrebnadzor, the number of HIV-infected people is close to eight thousand. But there is no medicine to treat them now, and the situation is getting worse every day.

In 2017, the system for purchasing drugs for antiretroviral (ARV) therapy changed. Now procurement is carried out centrally by the Ministry of Health of the Russian Federation; in previous years, this was done by the regions.

In May, Russian Health Minister Veronika Skvortsova announced that centralized procurement had been completed and supplies of drugs to the regions should begin. The first tenders were concluded in February - around the same time, information about interruptions in the distribution of medicines began to come from different regions. The shortage of drugs in 20 Russian regions was also confirmed by Roszdravnadzor.

Now a problem with a shortage of drugs has appeared in Tomsk.

“My son Artem is 30 years old,” Svetlana tells TV2. “He took drugs for a long time, but went through 12-step rehabilitation and quit. I started working as a volunteer, helping other drug addicts. Registered with the AIDS Center in 2016. At that time he had 350 cells. Artem is a smart, educated boy. When he came to the center, he asked about therapy, but he was told that he didn’t need to take anything, that with this level of cells he could live for another 15-20 years.”

We are talking about the number of T-lymphocytes in the blood or immune status. The average CD4 cell count for an HIV-negative person ranges from 600 to 1900 cells/ml of blood. Six months later, the level of lymphocytes in Artem’s blood dropped to 300. He lost weight, his temperature began to rise, but the young man never received therapy.

“We were referred to a TB specialist. Artem underwent tests, which showed that there was no tuberculosis,” recalls Svetlana. — At the AIDS center we were prescribed prophylaxis, which was completely uncontrolled. He just came, they gave him pills and he took them. Over the next three months, he lost another 18 kilograms and developed psoriasis. He was lying down. As a result, the medications were simply canceled over the phone. In May we went to Anti-AIDS, where we were told that there were no test strips and were advised to come back in two weeks. We've arrived. And we were told in plain text that there are no medications and we cannot prescribe therapy.”

Svetlana’s neighbor advised her to do a tomography, which showed foci of tuberculosis. Artem was admitted to a diagnostic hospital in Timiryazevo.

We talked to him on the phone. Artem asked to calm down, and then said: “Mom, I have a drop of 200 cells.” I went to see the head doctor, and he explained to me that they have 200 people who have 5-10 cells, and that there is no medicine. But what should I do? My child is dying! And Chernov replies: “Hold on for two or three months, it’s possible that something will change.” I understand that my son will not be cured, but he can live 10-15 years. Why is the state depriving him of this chance? We wrote to Putin directly, but there was no answer. We were simply left to our fate, but no one is immune from this.

Photo: Telzir.ru

Svetlana cries and then apologizes for her tears. After much persuasion, they were prescribed therapy on July 3. The necessary medicines from the “first aid kit”, collected by patients, were sent by activist of the public movement “Patient Control” Yulia Vereshchagina

“In Tomsk, as in many regions of Russia, a catastrophic situation is developing,” says Yulia Vereshchagina. — In accordance with clinical recommendations, ARV therapy should be started as a priority to all HIV-infected people whose lymphocyte count is 350 cells or lower. If this is not done, then other diseases begin to progress - tuberculosis, pneumonia, fungal infections."

Now on the website Pereboi.ru (created to collect information from patients themselves about the lack of vital medications for the treatment of HIV, viral hepatitis and tuberculosis in Russia) there are also messages from patients from Tomsk.

“I have been receiving therapy since 2015. This year, interruptions began in February,” says TV2 Evgeniya. — The doctor offers two options to choose from: either change the medications, or not take the pills and take a “vacation” from them. Accordingly, you are just getting used to one scheme, as you have to get used to another, and some are changed several times. And there is no choice: either drink what they give, or take a “vacation”, which may not end, because no one knows when the drugs will arrive at the AIDS center.”

According to the head doctor of the AIDS Center, Alexander Chernov, there are not enough drugs at the moment. Therefore, ARV therapy is primarily provided to pregnant women, children and persons with severe clinical manifestations. There are 200 people on the waiting list with low immune status who, according to clinical indications, need therapy as soon as possible.

Photo: courtesy of Yulia Vereshchagina

According to unofficial data, there are more than 1,100 patients in the Tomsk region for whom, according to clinical recommendations, it is time to prescribe ARV therapy.

As Alexander Chernov emphasizes, the Tomsk region has repeatedly appealed to the Ministry of Health with a request to provide information on the timing and volume of supplies of antiretroviral drugs, but has not received a response. Currently, the application for drugs has been completed by 51%.

“Patient Control” appealed to the acting governor of the Tomsk region, Sergei Zhvachkin, and the head of Rozdravnadzor, Mikhail Murashko, with a request to take measures aimed at normalizing the situation regarding HIV treatment in the Tomsk region.

Now a similar situation of drug shortage is developing in the Altai Territory, Omsk, Kemerovo regions. In Novosibirsk, HIV-positive people went out to single pickets and flash mobs .

Photo: Margarita Loginova, http://tayga.info

According to United Nations program estimates, Russia ranks with the Central African Republic, Democratic Republic of the Congo, Indonesia, Nigeria and South Sudan in terms of the number of people infected and methods of combating HIV. Not only are the already high numbers of infected people constantly increasing in these countries, but they are also experiencing shortages of antiretroviral drugs.

At the same time, Russia does not officially recognize that there is an HIV epidemic in the country. In this case, international funds could come to the rescue (Global Fund, UNISEF, UNIAIDS and others).