Monitoring The Right to Health in Venezuela Newsletter N. 11

J U N E . 2018

HEALTH

TA B L E O F C O N T E N T S ANALYSIS AND INTERPRETATION OF AGGREGATE RESULTS MEDICINE SHORTAGE INDEX FOR JUNE 2018

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AGGREGATE RESULTS NATIONWIDE: JUNE 2018.

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EVOLUTION AND BEHAVIOR OF THE MEDICINE SHORTAGE INDICATOR #CONVITEDENOUNCES: JUNE 2018: FATHER’S DAY? FATHERS AND CHILDREN SICK AND WITHOUT ACCESS TO MEDICATION. THE REEMERGENCE OF POLIO SHOWS A 29-YEAR STEP BACKWARDS IN HEALTH IN VENEZUELA

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GRAPHICAL REPRESENTATION OF THE RESULTS BY CITY AND MORBIDITY

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METROPOLITAN AREA OF CARACAS

BARQUISIMETO

10

MARACAIBO

12

MÉRIDA

14

NUEVA ESPARTA

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MONITORING THE RIGHT TO HEALTH IN VENEZUELA JUNE 2018

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ANALYSIS AND INTERPRETATION OF AGGREGATE RESULTS

MEDICINE SHORTAGE INDEX

FOR JUNE 2018

INDICATOR BEHAVIOR AND EVOLUTION The aggregate results of our measurements from January 2018 through June 2018 are broken 1

down below:

Table 1 shows the fluctuation of the shortage indicator for

On the other hand, the basket of medicines prescribed for

the four main causes of morbidity affecting the Venezuelan

the treatment of Acute Respiratory Infections (ARI) remains

population during the first half of 2018. It has been observed

the worst supplied, as it is was over 92% short during the first

that, over this period, the Shortage Index has always remained

semester of the year.

above 70%.

Regarding the General Shortage Index (GSI), the outlook is As can be seen in the table, the best supplied group of medicines

till absolutely bleak, for it shows a sustained trend to remain

during the first half of the year was that of antihypertensive

above 85% and 90%, which represents a lurking threat to the

medication, which fell below the General Shortage Index

health and lives of all Venezuelans. In practical terms, this

(GSI), peaking in January, at 87.5% and 89%,5% in the two

means that, on average, Venezuelans must visit between 8

measurements made in the first month of the year, and closing

and 9 pharmacies to find the treatment that they have been

at 76.6% and 74.1% during the two surveys made for the month

prescribed, if they are lucky.

of June, a phenomenon that seems to indicate a downward trend, which is not necessarily indicative of a substantial drop in the shortage rate.

1.To obtain historical information on all the measurements taken since the beginning of the project, consult our newsletters No. 1 to No. 9, available at https:// conviteblog.wordpress.com/

MONITORING THE RIGHT TO HEALTH IN VENEZUELA JUNE 2018

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AGGREGATE RESULTS NATIONWIDE: J U N E 2 0 1 8

During the month of June 2018, the best supplied cities were

Merida (the case of antihypertensive medication being the

Maracaibo and Porlamar, whereas Caracas and Barquisimeto

most significantly different vis-à-vis the situation nationwide).

were the worst supplied. Plainly speaking, it was practically

Nueva Esparta showed a slight reduction in the rate for

impossible for Venezuelans during the month of June to find

morbidities such as diabetes and hypertension. Maracaibo, is

drugs to treat acute respiratory infections. Caracas celebrated

still relatively the best supplied

its anniversary month amidst a tragedy for those who fall with diarrhea. Barquisimeto depicted the national scenario, as did

EVOLUTION AND BEHAVIOR OF THE MEDICINE SHORTAGE INDICATOR

Graphic Nº 1: Behavior and Evolution of the Medicine Shortage Index by Morbidity. January-June 2018.

MONITORING THE RIGHT TO HEALTH IN VENEZUELA JUNE 2018

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#CONVITEDENOUNCES: JUNE 2018: FATHER’S DAY? FATHERS AND CHILDREN SICK AND WITHOUT ACCESS TO MEDICATION. THE REEMERGENCE OF POLIO SHOWS A 29-YEAR STEP BACKWARDS IN HEALTH IN VENEZUELA.

June 2018 closed:

1 With a shortage of over 76% in medicines to treat the four main causes of morbidity affecting the population. This is how it is broken down:

a. Diabetes: 84.0% b. Hypertension: 74.1% c. Acute Respiratory Infections (ARI): 93.3% d. Diarrhea: 86.7%

2 Pan American Health Organization (PAHO) representative Clarissa Etienne visited the country. During her visit, the

representative of the United Nations agency participated in a meeting with a group of health sector organizations , to

address

the

humanitarian

recurring interruption in drinking water supply,

solid waste collection and electricity services at the

2

but no decision was communicated as to the measures needed

4 The

emergency.

national level is having a direct impact on the health of Venezuelans, especially in the form of an upsurge of gastrointestinal, respiratory and dermatological diseases.

However, despite the refusal to recognize the existence of the complex humanitarian emergency, it was learned that, during a meeting with the Ministry of Health, an agreement was subscribed to guarantee the provision of 3

medicines .

5 There is a simultaneous resurgence and expansion of at least seven epidemics in the country: measles, diphtheria, 5

malaria, tuberculosis, scabies , Chagas disease and dengue fever. An additional epidemic must be added to

3 The shortage of medicines, vaccines, reagents and the

the foregoing list: polio, which had been eradicated in

high costs of access to medical treatment promote the

the country 30 years ago, with a reported first confirmed

spread of endemics and epidemics while hindering

case. On this alarming situation, it should be noted that:

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patient recovery and translating into patient deaths.

2. Including Acción Solidaria (Solidary Action), Asociación de Pacientes Acromegálicos de Venezuela (Venezuelan Association of Acromegalic Patients), Asociación Venezolana de Servicios de Salud y Orientación Cristiana (Venezuelan Association of Christian Health Services and Guidance), Cáritas de Venezuela, Coalición de Organizaciones por el Derecho a la Salud y a la Vida (Coalition of Organizations for the Right to Health and Life), Prepara Familia –from Hospital J. M. de Los Ríos-, Red Defendamos la Epidemiología (the Defend the Epidemiology Network) and Sociedad Venezolana Gente Positiva (‘Positive People’ Venezuelan Society).

3. EFE. Venezuela Subscribed an Agreement wih the PAHO to Guarantee Medication (2018). Available at http://www.el-nacional.com/noticias/politica/venezuela-suscribioacuerdo-con-ops-para-garantizar-medicamentos_239963 4. Available at: http://www.observatoriodeconflictos.org.ve/destacado/conflictividad-social-en-venezuela-primer-semestre-de-2018 5. GDA. LA NACIÓN. ARGENTINA (2018). Another Dramatic Face of the Venezuelan Crisis: Spreading Epidemics. Available at: http://www.el-nacional.com/noticias/ sociedad/otra-dramatica-cara-crisis-venezolana-las-epidemias-expanden_239380

MONITORING THE RIGHT TO HEALTH IN VENEZUELA JUNE 2018

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Unfortunately, without vaccines and in the absence of the proper and complete immunization schedule required, cases will continue to appear and people will die. These will be absolutely preventable deaths.

MEASLES • iPosters with the message ‘Knock and Wait. Do Not Pass.

6 Measles!!!’ reminds us of the existence of the epidemic, one that unfolds under the cold, indolent gaze of a State for which the health of its citizens is a pending issue.

POLIOMYELITIS

• So far in 2018, 1,558 cases have been reported in Venezuela.

Amacuro.

• Venezuela is the only country to report polio cases in the last 20 years.

• 1 confirmed and 3 suspected cases are known to exist in Delta

• It is a disease for which there is no antiviral treatment. It can only • Measles cases have been reported in 21 of the country’s 24 states.7 • Thirty-three (33) measles-related deaths have been reported in indigenous communities in the State of Delta Amacuro.

be prevented by vaccination; therefore, about 2.5 million children in the country are at risk due to the fact that they have not been immunized.

• This enteric virus is acquired through the digestive tract, contaminated water, or food prepared under poor hygiene

• A PAHO report warns that Venezuela accounts for 84% of measles cases among 11 countries in the region that reported the disease.

conditions; this means that the collapse of the drinking water supply

• Between January and May 2018 alone, 1,427 measles cases were reported in Venezuela.reportados en el continente están en Venezuela.

Complex Humanitarian Emergency, find themselves forced to eat

• This means that 65% of the reported cases of the disease in the continent are in Venezuela.

system in Venezuela has increased the chances of acquiring the virus. If we add the number of entire families that, as a result of the directly from the garbage, the picture becomes increasingly dark, for the sectors that are the most vulnerable sectors to this disease are those living in conditions of extreme poverty.

DIPHTHERIA • In the first half of 2018 alone, 352 diphtheria cases were reported.

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• Diphtheria cases have been reported in 9 of the country’s 24 states.

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• Between January and April, at least 40 deaths from diphtheria were registered in Venezuela. No official data for the month of June have been made available.

• Venezuela is home to 70% of the continent’s diphtheria cases.

• The Pan American Health Organization recognizes the existence of the complex humanitarian emergency and urges 10

Venezuela to take appropriate steps to halt the spread of measles and diphtheria , while acknowledging that the country is 11

going through a socio-political and economic situation that has upset basic health indicators.

6. El Tiempo Latino. Epidemics Are Spreading in Venezuela: A Country Ravaged by a Humanitarian

9 AFP. Venezuela Recorded 40 Deaths for Diphtheria Over a Four-Month Period in 2018.

Crisis. (2018). Available at: http://eltiempolatino.com/news/2018/jun/10/las-epidemias-se-expand

(2018). Available at: http://www.el-nacional.com/noticias/salud/venezuela-tuvo-muertes-por-

en-en-venezuela-un-pais-dev/

difteria-cuatro-meses-2018_237241

7. Prodavinci. Ten Facts About the Health Situation in Venezuela, according to the PAHO. (2018).

10. AFP. The PAHO Urges Venezuela to Put a Halt to the Spread of Measles and Diphtheria.

Available at: https://prodavinci.com/10-datos-sobre-la-situacion-de-salud-en-venezuela-segun-la-ops/

(2018). Available at: https://www.panorama.com.ve/ciudad/OPS-urge-a-Venezuela-a-frenar-

8. AFP. OPS: “Venezuela Recorded 40 Deaths for Diphtheria Between January and April 2018”.

avance-de-sarampion-y-difteria-20180622-0080.html

(2018) Available at: http://www.eluniversal.com/estilo-de-vida/10477/ops-venezuela-registro-40-

11. The PAHO Calls For an Urgen Plan to Curb Measles and Diphtheria in Venezuela (2018).

fallecimientos-por-difteria-entre-enero-y-abril-de-2018

Available

at:

https://notiespartano.com/2018/06/21/ops-solicita-un-plan-urgente-para-

reducir-sarampion-y-difteria-en-venezuela/

MONITORING THE RIGHT TO HEALTH IN VENEZUELA JUNE 2018

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6 Protests and Conflict in Demand of the Right to Health 12

The health sector is in an emergency state.

7 The Venezuelan government, through the Minister of Health, criminalizes and rejects the organizations that

defend the right to health, a fact that became evident

a. In

the first semester of 2018, 583 protests were

when the now former minister decided to attack the

documented to have taken place in demand of the

President of Codevida for having evidenced exposed

right to health. During this six-month period, the

the complex humanitarian emergency and for having

chronically ill and their families have taken to the

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demanded respect for the right to health and life :

streets to demand the implementation of a humanist health system that defends and guarantees the right to health and life.

b. In

like manner, health workers held 838 protests.

Together, they add up to approximately 1,421 protests, accounting for 27% of all protests recorded.

This evidences the severity of the crisis that the health sector is enduring in Venezuela.

The Minister of Health described Codevida’s director as a “scoundrel and hired for a fee”. Health Minister Luis López described the NGO Codevida as “Roche’s little cartel” when he insinuated that the president of the non-governmental organization, Francisco Valencia, is allegedly making turbulent business with the pharmaceutical industry. “I say to this man from Codevida, a Roche employee: you may be suffering from some kind of illness, but if you open up your mouth and take a political stance and step into the political world, what answer do you expect? You are a scoundrel, a Roche’s employee. We, the minister and the president, are not buying the drugs that Roche wants to sell us at any price and we are looking for them in India. Since we are not looking for the drugs that work for you for money, you take the patients to the ministry, you shameless”.

12. Available at: http://www.observatoriodeconflictos.org.ve/destacado/conflictividad-social-en-venezuela-primer-semestre-de-2018 13. Available at: https://www.venepress.com/article/Ministro_de_Salud_califico_a_director_de_Codevida_de_sinvergueza_y_asalariado1528744474073

MONITORING THE RIGHT TO HEALTH IN VENEZUELA JUNE 2018

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G R A P H I C D E P I C T I O N O F R E S U LT S

BY C I T Y A N D M O R B I D I T Y

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METROPOLITAN AREA OF CARACAS DIABETES

Graphic Nยบ 2: Behavior and Evolution of the Medicine Shortage Index for Diabetes. MAC, June 2018.

HYPERTENSION

Graphic Nยบ 3: Behavior and Evolution of the Medicine Shortage Index for Hypertension. MAC, June 2018.

14. This is a graphic depiction of the behavior and evolution of the shortage indicator by morbidity and city for every measurement conducted between September 2017 and January 2018.

MONITORING THE RIGHT TO HEALTH IN VENEZUELA JUNE 2018

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ACUTE RESPIRATORY INFECTIONS (ARI)

Graphic Nยบ 4: Behavior and Evolution of the Medicine Shortage Index for ARI. MAC, June 2018.

DIARRHEA

Graphic Nยบ 5: Behavior and Evolution of the Medicine Shortage Index for Diarrhea. MAC, June 2018.

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BARQUISIMETO: DIABETES

Graphic Nยบ 6 : Behavior and Evolution of the Medicine Shortage Index for Diabetes. Barquisimeto, June 2018

HYPERTENSION

Graphic Nยบ 7: Behavior and Evolution of the Medicine Shortage Index for Hypertension. Barquisimeto, June 2018

MONITORING THE RIGHT TO HEALTH IN VENEZUELA JUNE 2018

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ACUTE RESPIRATORY INFECTIONS (ARI)

Graphic Nยบ 8: Behavior and Evolution of the Medicine Shortage Index for ARI. Barquisimeto, June 2018.

DIARRHEA

Graphic Nยบ 9: Behavior and Evolution of the Medicine Shortage Index for Diarrhea. Barquisimeto, June 2018.

MONITORING THE RIGHT TO HEALTH IN VENEZUELA JUNE 2018

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MARACIBO: DIABETES

Graphic Nยบ 10: Behavior and Evolution of the Medicine Shortage Index for Diabetes. Maracaibo, June 2018.

HYPERTENSION

Graphic Nยบ 11: Behavior and Evolution of the Medicine Shortage Index for Hypertension. Maracaibo, June 2018.

MONITORING THE RIGHT TO HEALTH IN VENEZUELA JUNE 2018

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ACUTE RESPIRATORY INFECTIONS (ARI)

Graphic Nยบ 12: Behavior and Evolution of the Medicine Shortage Index for ARI. Maracaibo, June 2018

DIARRHEA

Graphic Nยบ 13: Behavior and Evolution of the Medicine Shortage Index for Diarrhea. Maracaibo, June 2018

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MÉRIDA: DIABETES

Graphic Nº 14: Behavior and Evolution of the Medicine Shortage Index for Diabetes. Mérida, June 2018.

HYPERTENSION

Graphic Nº 15: Behavior and Evolution of the Medicine Shortage Index for Hypertension. Mérida, June 2018.

MONITORING THE RIGHT TO HEALTH IN VENEZUELA JUNE 2018

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ACUTE RESPIRATORY INFECTIONS (ARI)

Graphic Nº 16: Behavior and Evolution of the Medicine Shortage Index for ARI. Mérida, June 2018.

DIARRHEA

Graphic Nº 17: Behavior and Evolution of the Medicine Shortage Index for Diarrhea. Mérida, June 2018.

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NUEVA ESPARTA: DIABETES

Graphic Nยบ 18: Behavior and Evolution of the Medicine Shortage Index for Diabetes. Nueva Esparta, June 2018.

HYPERTENSION

Graphic Nยบ 19: Behavior and Evolution of the Medicine Shortage Index for Hypertension. Nueva Esparta, June 2018.

MONITORING THE RIGHT TO HEALTH IN VENEZUELA JUNE 2018

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ACUTE RESPIRATORY INFECTIONS (ARI)

Graphic Nยบ 20: Behavior and Evolution of the Medicine Shortage Index for ARI. Nueva Esparta, June 2018.

DIARRHEA

Graphic Nยบ 21: Behavior and Evolution of the Medicine Shortage Index for Diarrhea. Nueva Esparta, June 2018.

MONITORING THE RIGHT TO HEALTH IN VENEZUELA JUNE 2018

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