Subject: AIDS IN PANAMA
From: [email-masked]
Date: Thu, 22 Jan 1998 22:27:44 -0600 (CST)

20 January, 1998

IN PANAMA, PEOPLE  WITH AIDS ORGANIZE TO SEEK TREATMENT  ACCESS
                                                     
                                                         By Richard Stern

In the Central American country of  Panama, People Living with AIDS are
beginning to organize around the issue of access to treatment and are
entering into a dialogue with health  care officials.

There are 1,700 diagnosed cases of  AIDS in this Central American country of
just under three million people.  Of diagnosed cases, about 30 percent have
occurred in the gay community. About half of the patients  have died.   The
Panamian government provides only AZT to those patients who have government
sponsored health care  coverage, but only about 50 percent of the population
is insured.   At this point, many experts consider  that providing AZT as
"monotherapy" is contraindicated, because the resistance it can cause when
given alone  could interfere with the effectiveness of other medications if
they were to become available.

Like Costa Rica, its neighbor to the North, Panama is an example of a
country where the government clearly has the resources to provide the new
triple therapy medications, but is unwilling to do so because AIDS has never
been  a priority in the Central American region.

As an advocate for people living with AIDS in Costa Rica,  I recently had
the opportunity to spend time in Panama, meeting with people there who are
in process of forming a new  non-governmental organization, known as
PROBIDSIDA, which will focus on discrimination as well as access to the
newer AIDS  medications. 

Throughout  Panama City, gleaming skyscrapers and new shopping centers flash
in the sun and shadow over the Panama Canal zone. One gets the impression of
a prosperous, booming  country, although terrible slums  also exist.

Nobody in Panama has publicly come out as HIV+.  There is the fear of the
impact on family and in the  workplace.

In Costa Rica, with patient numbers  very similar to Panama,  a Supreme
Court decision last September,  forced the government, through the National
Health Care system,  to provide the newer medications to people living with
AIDS, and virtually all AIDS affected patients with severely compromised
immune systems are now receiving these medications.  However, in Costa Rica,
almost all patients are covered by the Health Care system, whereas in Panama,
50 percent are left with no health coverage whatsoever.

PROBIDSIDA  has initiated discussions with Doctors and other government
officials working in the AIDS  field, but so far the results have not been
encouraging.  I attended a meeting in which also focussed on the possibility
of planning a Court  challenge in the very near future if changes  are not
forthcoming.

It seems tragic that  in many developing countries, groups of patients have
to rediscover, painstakingly,  lessons already learned in other countries
about human rights and access to treatment, as if they were living on a
different planet.

The Panamian issue also draws attention to an issue of great importance in
many developing countries: the existence of a dual system in which only a
portion of the population is covered by the national health care system.
Even a victory for access to medications in Panama would leave half or more
of the AIDS affected  population no better off than before because they are
not covered by government health care benefits.

No one I  spoke to in Panama had received any support from  UNAIDS or the
OPS (Pan American Health  Organization) or even knew the functions of  these
funded Agencies.  UNAIDS  which has substantial   resources,  is responsible
for the  development of  programs focussed around access to treatment and
human rights issues affecting people living with  AIDS, but the impact of
its programs on a Central American level appears to be negligible.

PROBIDSIDA can be reached by contacting Norma de Quintero at
(507)-233-6238, or by  e-mail at  [email-masked].

Richard Stern
Associacion Triangulo Rosa
San José Costa Rica
506-234-2411