The Cuban health services are taking a great step forward in their response to HIV bringing in the latest antiretroviral treatments and expanding therapeutic treatment to reach a further 5,000 people.
Cuba is maintaining the epidemic at a stable level with a 0.1 per cent prevalence, one of the lowest in Latin America, although it still has not managed to reduce the number of new incidences of the disease.
“We still have not managed to achieve the result we really want. We are aiming to bring down the annual curve of new infections such that it does not increase again, and to help people live better and longer,” said doctor Jorge Pérez, one of the country’s top authorities on the topic of HIV, during the XI National Scientific Convention of the AIDS Prevention Group, a national network of awareness-raising volunteers.
Improved HIV drugs
To this end, local authorities this year will begin implementing a package of changes to the antiretroviral treatment protocol. The undertaking aims to get very toxic drugs taken out of circulation, such as Indinavir and Nelfinavir, which include among their side effects lipodystrophy, the degeneration or loss of fatty tissue all over or on certain parts of the body.
More recent antiretroviral drugs, with less harmful side effects, will also be introduced. At the same time, the Cuban health authorities aim to provide antiretroviral treatment to more people living with HIV; from now on, medication must be prescribed to all those with a CD4 count below 500 cells/mm3, following the stance taken by other countries in Latin America and the rest of the world. Until recently, medical staff would wait until the count was down to 350 cells before writing the prescription.
With this move, antiretroviral treatment coverage could reach more than 15,000 people in 2015, an increase of around 5,000 people in comparison to those treated in 2013.
Starting HIV treatment earlier
Recalling Pérez’ words, the rate of new infections should begin to fall after a stable period or plateau of three or four years in the number of new cases detected; to achieve this it is essential to treat people earlier.
With these changes, expenditure on medical care for HIV patients and on prevention of the virus will rise to around USD 8 million per year.
This reform will be made possible thanks to a new promise of financial aid from the Global Fund to fight AIDS, Tuberculosis and Malaria, which will last until 2017.
It is possible that after this project the island will have to look for more support from international allies, or prepare to start producing these medications locally.
Low but rising epidemic in Cuba
In Cuba, where around 16,400 of the country’s 11.2 million inhabitants live with HIV, antiretroviral treatments are free, along with all other healthcare, despite the fact that the island has been in the midst of a severe economic crisis for more than 20 years.
According to the latest report from the Joint United Nations Programme on HIV/AIDS (UNAIDS), for the years studied, an upward trend was recorded in the Cuban archipelago, within the regional group which also includes the Dominican Republic, Haiti, Jamaica and Trinidad and Tobago, and accounts for 96 per cent of the HIV epidemic in the region.
This finding agrees with information published in The Gap Report, which indicates that there were more new diagnoses of HIV in Cuba in 2013 than in 2005, in contrast to the rest of the worst-affected nations in the Caribbean isles.
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This story was first published in Spanish by Corresponsales Clave