The complaint came from a patient and was later confirmed with three organisations in the field: although the law establishes that "anti-retroviral therapy is dispensed for a minimum period of 90 days", in reality this doesn’t happen in some health units - a situation that the doctors and activists who Lusa spoke with say is not new and was already happening before the pandemic.
Asked by Lusa, two hospitals confirmed that they are not guaranteeing medication for three months.
In response to Lusa, the Central Lisbon University Hospital Center (CHULC) – which monitors the largest number of HIV patients in the country, around 5,900 – began by stressing that “whenever possible, depending on the availability of stock, antiretroviral drugs are administered for a period of three months”.
However, he admits, "in circumstances where the availability of stock does not allow it, the prescription is made for a shorter period".
Based on knowledge of the field, Luís Mendão, president of the Group of Treatment Activists – GAT, told Lusa that CHULC (which includes, among others, Curry Cabral, São José and Capuchos hospitals) “never gave” medication for the period established by law.
CHULC highlighted that it tries to "safeguard (always) that there are no interruptions in supply to any user" and recalls that it dispenses "antiretroviral therapy from four of its pharmacies, in addition to ensuring the delivery of medications in close proximity to community pharmacies in the area of the patient's residence”.
The objective of the law adopted in 2015 was precisely to guarantee “an adequate follow-up of the response to treatment” and to prevent “the use of unnecessary medical appointments or clinically unjustified visits to hospital institutions”.
Order No. 13447-B/2015, of 18 November, also says that situations in which the doctor following the patient decides that the medication should not be dispensed for 90 days "will have to be exceptional, and the hospital, in cases where such a situation occurs for reasons attributable to the National Health Service and after the patient's agreement, ensure that the medication is placed at the address provided by the user”.
The Centro Hospitalar Universitário do Algarve (CHUA) also confirmed to Lusa that “the majority” of the 1,957 users with HIV receive “medication for two months” and that only “in some identified cases” the medication is made available for three months.
“CHUA has the drug delivery proximity program in place, which provides for the patient to be able to receive the medication at their local pharmacy or even at their own home,” the unit reports.
The Garcia de Orta Hospital (HGO) – which Luís Mendão referred to Lusa as one of the units that allegedly would not comply with what the law establishes – guaranteed that “it is ensuring medication for patients with HIV/AIDS for three months and, in some cases, up to six months”, for example to “migrant patients working abroad”.
The HGO (located in Almada) - which monitors about 2,000 people with HIV - guarantees that there is no "therapeutic interruption in any of the patients" and adds that it "promotes delivery in close proximity (community pharmacy or home)" for "patients with difficulty access to the hospital”.
This situation of non-compliance with the law was confirmed by two more organizations in the field (in addition to the GAT): the Portuguese League Against AIDS and Abraço.
“We have one patient or another who reports this to us. At that time, we tried to immediately mediate with the hospital, namely by realising if it is punctual and if it will be resolved without jeopardizing the treatment”, reports Cristina Sousa, president of the Abraço association.
Eugénia Saraiva, president of the Portuguese League Against AIDS, reports that they have already received calls from users about the medication.
“So that there are no breaks, there are certain hospital pharmacies that have decreased from three to one month”, she reports. “It's boring for those who have to go to the hospital”, she admits, adding that the League has been making deliveries to users.
“There have been, but always have been, restructurings at the level of medication, but we have no complaints about disruptions and medication has been assured”, she highlighted.
Recognizing that the law is not being complied with, Eugénia Saraiva underlines that, even so, “no patient was without medication”.
Contacted by Lusa, Isabel Aldir, who until recently was the leader of the national strategy for HIV/AIDS, confirmed that she had information that these situations happened “punctually in the past”. However, the reality at the hospital where she works, Egas Moniz (Lisbon), “has not been like that”, she pointed out.
The infectious disease physician considers the situation “worrying, as [the medication for three months] is a guarantee”.
This is because, she explains, unlike other diseases, in which the person who does not take the medication harms himself above all, "in the case of HIV, a person who does not take the medication correctly is indirectly harming society, because, by not having the medication under control can transmit the disease”.