Improving Drug Prescription to HIV-positive People

By Momchil Baev

For several months there has been an advocacy campaign to optimize the normative procedure for the prescription of antiretroviral therapy for HIV-positive patients in Bulgaria. Single Step Foundation joined the initiative by sending a statement to Dr. Tonka Varleva, Director of the HIV / AIDS Prevention and Control Program. The initiative was initiated by Youth LGBT Organization Deystvie and was supported by all community-based organizations. The National Patient Organization has also expressed its formal support.

The Foundation was involved in the initiative in relation to the development of monitoring and HIV treatment policies globally, which requires an update of our regulatory framework, too. Our request is for a change of "Ordinance No 34 of 25 November 2005 on the procedure for payment from the Republican budget for the treatment of Bulgarian citizens for diseases not covered by the compulsory health insurance", which currently regulates the prescription of the medication on a monthly basis, as this can happen once every three months.

We support the change in the prescription regimen of drugs for patients with HIV infection in patients with optimal 1-year viral suppression from one to three months, as well as the resulting need to provide the necessary amounts of medication in hospital pharmacies. We believe that this will optimize the workings of the HIV treatment sectors on the one hand, and on the other hand it will facilitate the lives and treatment of patients who are now required to visit the departments every month to receive a prescription. This is particularly uncomfortable for workers and for residents of different towns that need to travel.

As an organization that works for the LGBTI community, we support the argument that patient care should be complex, not only providing access to quality health care, but also making every effort to ensure maximum comfort during treatment. Through this change, patients who have been proven to adhere to their therapy and who have achieved viral suppression will be able to visit treatment centers once every three months, which will relieve the already overcrowded medical establishments on the one hand and reduce patients’ inconvenience on the other.

The idea is supported by all doctors from the immunodeficiency departments, and they have sent their written opinion to Dr. Varleva. This is a sign that doctors and patients are advocating together for a positive change in Ordinance 34, which is a guarantee for success.

Currently, an order is issued by the Minister of Health to form a task force to work on the document. Single Step Foundation has expressed its desire for a representative to be included in the task force together with other experts and community representatives. The involvement of all stakeholders in this process will guarantee transparency and the fact that target groups are personally involved in the decision-making processes for their own health.