HIV testing at a family doctor and medicines for HIV patients at pharmacies. What the new law changes for people living with HIV

[ad_1]

On February 3, a law came into force that changes the key principles of HIV testing and simplifies the access of HIV patients to medicines. The legislation in the field of combating HIV infection has not changed for more than 12 years. During this time, thanks to the government, public associations and international organizations, the death rate from AIDS has decreased by 4 times. HIV testing has become available and free, and ARV therapy (drugs for people with HIV) can be obtained free of charge. Over the past five years, changes have also occurred in the health care system in general – thanks to the medical reform. However, established medical practice and current legislative documents that regulate the diagnosis and treatment of HIV infection are largely outdated. Therefore, the field has long needed an update of the legislation. Work on the new version of the law went on for more than a year. The new version of the law was registered symbolically on December 1, 2021 – on this day every year the world community celebrates AIDS Day. After the registration of the draft law, I initiated a wide discussion and consultations among the medical community, patient organizations, representatives of the Health Care Committee, and with the Ministry of Health. During the work on the drafting of the law between the first and second readings, a working group was created to which representatives of international organizations could join in order to share the experience of other countries. , we managed to put it in the session hall for a second reading vote only at the end of 2022. The finally adopted law entered into force on February 3, 2023. Read also: What to do if you are diagnosed with HIV – explained in the Central Hospital What changes can patients and medical workers expect? First of all, the state monopoly on registration and dispensation of persons in whom the virus has been detected is abolished. The range of entities that can test for HIV and register HIV-positive persons in a single national electronic register and keep their dispensary records is also expanding. Previously, only municipal or certain state medical institutions could do this. From now on, it can be medical institutions of any form of ownership (private medical institutions, medical centers of charitable organizations, doctors of public health institutions). Such an innovation has two positive factors at once. First, it will prevent a monopoly on HIV treatment only in health facilities owned by the state or local authorities. And therefore, it will create healthy competition among market participants for these medical services, and, as a result, will increase their quality, reduce stigma and disdain for patients living with HIV. The National Health Service will finance any medical institutions that express a desire to provide medical services to HIV-positive patients to the extent that HIV-positive persons expressed a desire to receive medical services in these institutions. Second, it will reduce the burden on state and communal hospitals in large cities. Currently, people with HIV are literally “tied” exclusively to the medical institution in which they are registered at the dispensary according to registration. With the beginning of a full-scale invasion, this norm showed its inability and ineffectiveness. In order to receive ARV therapy, internally displaced persons must either move and register in the city of temporary stay (and, in case of returning home, go through the same procedure again), or travel to their hometown for medication every month. Not to mention long queues in such medical facilities. A new opportunity created by the law makers is to obtain the necessary medicines by electronic prescription at the nearest pharmacy. For the first time in the entire history of the fight against HIV, the dispensing of ART has been simplified and from now on this therapy will be dispensed in pharmacies by prescription, just like other medicines. This will also have a positive effect on the general statistics of the spread of HIV infection. After all, some people with HIV-positive status interrupt ART treatment precisely because of regular difficulties associated with obtaining drugs – logistical and time costs. From now on, people with HIV will be able to receive antiretroviral therapy (medicines that suppress the reproduction of the virus in the human body, this allows the patient to control the disease) in pharmacy chains in the order determined by the Ministry of Health. This will greatly expand access to medicines. In the new version of the law, the role of the primary medical unit is strengthened. Rapid tests for HIV are included in the mandatory (not to be confused with forced) package of tests from a family doctor. Such testing is paid for by the state. However, earlier the initiative of conducting the test belonged exclusively to the patient. From now on, a family doctor must rule out HIV infection in each of his patients who signed a Declaration for medical care with him. Usually, the family doctor recommended an HIV test based on the patient’s previous history and interview. The practice of “selective testing” led to the fact that some people who are carriers of HIV did not know their positive HIV status for years, because they are not representatives of risk groups or did not have the motivation to take the test. The new legislation stipulates that the family doctor must offer the patient a free HIV test. The patient, of course, has the right either to refuse or to protest and use the opportunity to exclude HIV (know about his HIV status) completely at the expense of the state. This practice of maximal coverage of the population with HIV testing is one of the main tasks of overcoming epidemics. After all, a person who has HIV and does not know about it continues to spread the infection. Thanks to the introduction of a new testing algorithm at the initiative of a family doctor, another important goal will be achieved – reducing the number of cases of transmission of HIV infection from mother to newborn child. Timely testing and prompt appointment of treatment with ARV drugs reduces the probability of transmission of the virus to the newborn. From now on, the law expands the article on state guarantees in providing citizens with antiretroviral drugs for the prevention and treatment of HIV infection. Pre-contact and post-contact HIV prevention, medicines for the prevention and treatment of co-infections, in particular, tuberculosis and hepatitis, will be free of charge for patients. In addition, medical products for monitoring (controlling) the effectiveness of HIV treatment are added to the list free of charge. The new edition of the law also regulates the legal field of persons and entities participating in the HIV testing process. In particular, the concepts of “self-testing” and “assisted testing”, which are widely used in practice, but remained a “gray zone” in the legal field. Due to the lack of a clear and unambiguous definition of these definitions, there was discretion in their interpretation. The term pre-contact (DCP/PrEP) and post-contact prevention of HIV infection is introduced. In order to increase the availability of testing, free testing of persons is now allowed at the legislative level, regardless of the legality of their stay in the territory of Ukraine. The cases and procedure of direct blood transfusion have been regulated. Instead of the outdated norms concerning the sanitary-epidemiological service, the law was supplemented with the modern term “public health institution” in connection with the creation of the public health system. Thanks to the changes included in the new law, it can be said that modern practices in the diagnosis and treatment of HIV infection will become the foundation of not just combating the spread of HIV in Ukraine, but the beginning of the end of the existence of this epidemic. This is evidenced by the practice of the countries of the European Union, Israel, Britain, and the United States, in which, thanks to similar adopted changes, it was possible to achieve complete control over the spread of the virus and reduce the HIV epidemic to zero. Read also: TEST: what you know about HIV/AIDS, its symptoms and ways of transmission Lada Bulak, People’s Deputy from the “Servant of the People” party, specially for UP.Zhyttia Publications in the “View” column are not editorial articles and reflect exclusively the point of view the author

[ad_2]

Original Source Link