Taiwan has recently been hit by rabies, but due to a lack of funding, the government has not been able to purchase an adequate amount of vaccine. Cuts to HIV/AIDS medication funding have been suggested as one solution to the lack of money available for rabies vaccines because the proportion of funds for national disease prevention that go toward HIV/AIDS medication is so high.
With an increase in the number of people with HIV and yearly increases in HIV/AIDS-related expenses, the government’s funding strategy has been to continue negotiations to lower the costs of drugs and limit the number of drug combinations available for people with the disease.
For drug companies, lowering costs means a drop in profits which could have repercussions on investment in development and quality control. This could slow down the development of new drugs, while also lowering the chances of those drugs coming into Taiwan.
For people with HIV, restricting drug alternatives means that their options are limited if the initial drug combination is not effective, which is wasteful. Bad experiences with certain drug combinations for patients could make them afraid to receive additional medical treatment.
And reducing HIV/AIDS treatment costs by negotiating prices downward is obviously not an effective means to lower the number of new infections.
Due to the design of Taiwan’s medical system and because HIV is a communicable disease, the Centers for Disease Control (CDC) has been responsible for management of the disease for a long time. However, given that the vast majority of people with the disease now survive for a long time and because the number of newly infected people continues to rise, the government should rethink which of its departments are responsible for HIV/AIDS-related costs.
The government should also get the National Health Insurance Administration and the Centers for Disease Control (CDC) to work together and help make sure that people living with HIV/AIDS receive good treatment at the various stages of their illness. It should also allow people whose conditions are stable to re-enter the National Health Insurance system. This would stop HIV-positive people from being kicked around different parts of the medical care system.
HIV infections are increasing among young people, many of whom are students. However, the majority of parents think that: “My child will never catch a disease like that.”
This leads parents to look upon sex education as unnecessary. Therefore, HIV prevention policies should not only be focused on sex education among the young, but also on educating parents, enabling them to face up to the severe trend of HIV infections. Only by doing this can HIV prevention be effective.
The increasing number of HIV infections among young Taiwanese will have repercussions on the labor force. Ensuring that HIV-positive people can continue to receive steady drug treatments should be a major, long-term goal of the health agencies’ policy. In addition, well-thought-out policies rely on listening to the concerns of everyone involved.
The newly established Ministry of Health and Welfare has promised to create a healthy Taiwan. This promise must not remain a slogan. The ministry must come up with national policies that benefit people living with HIV/AIDS. Such an approach is necessary to remove the scapegoat of drug costs whenever public budget allocations are inadequate.
Ivory Lin is secretary-general of the Persons with HIV/AIDS Rights Advocacy Association of Taiwan.
Translated by Drew Cameron
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