InterPress News Service (IPS) - August 23, 1998
Estrella Gutierrez

In fact, in its effort to shield AIDS patients from discrimination, it has not stopped short of threatening the defence minister with a jail sentence. This week the Supreme Court handed down two verdicts protecting the constitutional rights of people living with the Acquired Immune Deficiency Syndrome (AIDS), in which it once again signalled the state's obligation to care for the sick.

The Court ordered the Health Ministry to provide comprehensive medical treatment to a group of claimants suffering from AIDS - a ruling that identified the ministry for the first time as responsible for protecting the health and lives of AIDS patients.

Another verdict ordered "the compulsory and peremptory execution" of a January ruling in favour of four members of the military who tested positive for the Human Immuno-deficiency Virus (HIV). That ruling obligated the Defence Ministry to provide the patients with confidential care and pensions.

The Court emphatically warned Defence Minister Tito Rincon that failure to comply with any aspect of the unappealable verdict could earn him a jail sentence of up to 15 months.

The director-general of the non-governmental Citizen Action Against AIDS (ACCSI), lawyer Edgar Carrasco, told IPS that besides the far-reaching nature of the decisions, another positive aspect was the speed with which the Court has been ruling on the cases.

The 15 Supreme Court magistrates have heard seven appeals brought by AIDS patients this year, in addition to upholding the verdict on the four members of the military, who appealed to it after failing to receive the medical attention and pensions ordered by the January ruling.

The appeals, all of which were filed with legal assistance from ACCSI, were aimed at compelling the Venezuelan Social Security Institute to provide them with comprehensive health care, including the costly combination anti-retroviral therapy.

But Carrasco said the novelty of the ruling issued by Supreme Court Magistrate Hildegar Rondon was that it involved the Health Ministry and established that even patients not affiliated with the Social Security Institute had the right to receive comprehensive health care, no matter what the cost.

The Supreme Court rejected the government's arguments that it lacked the resources to provide all AIDS patients with the triple cocktail shown to be effective in preventing the reproduction of HIV.

In the verdict, which decided in favour of an appeal lodged by 23 HIV-positive individuals, Rondon ruled that AIDS was a public health problem, and pointed out that the state was bound by the constitution to protect citizens' right to health.

Carrasco said ACCSI was preparing a new case on behalf of 80 patients not affiliated with the Social Security Institute because they did not have a job in the formal sector or for other reasons.

So far this year ACCSI has provided assistance in close to 300 cases, 90 percent of which have been based on complaints of discriminatory treatment.

The new ruling holds the government responsible, through the Health Ministry, for extending the right to treatment with all necessary drugs, exams and other coverage to each and every AIDS patient.

The unappealable sentence stipulates that the Health Ministry must demand that the relevant entities immediately provide the resources indispensable for complying with the verdict, because it involves the essential right to preservation of health and life.

But attorneys representing the Health Ministry argued that the annual cost for AIDS patients amounted to at least 12,000 dollars which, multiplied by the 7,020 people whom official statistics recognise as HIV-positive in this country of 23 million, brought the amount needed to around 82 million dollars.

That total is a far cry from the 4.4 million dollars allotted to the Health Ministry by the 1998 budget for implementing AIDS prevention programmes and providing patients with care and medicine.

Venezuela's public health system is in a state of collapse, and until the long-awaited reforms arrive, the state has been maintaining fragmentary care through social security centres which cater to affiliated workers.

Red tape, corruption and structural adjustments have limited the health budget to less than 1.5 percent of Gross Domestic Product, and several large hospitals are functioning without basic materials like gauze and cotton.

After AIDS patients won five appeals, the Social Security Institute set up a system to ensure an inventory of medicine and the provision of care in line with orders handed down by the courts, Carrasco noted.

He added that it was the growing organisation and activism of AIDS patients that led to the setting of legal precedents in their favour.

A Committee of Appellants for legal verdicts in favour of free healthcare and medicine found that from the moment medicine was prescribed in the Social Security Institute, 15 bureaucratic steps were taken before the product reached the patient.

Special records, a data system and centralised care have now been set up for AIDS patients, which have benefited patients and cut costs for the state. According to several Supreme Court rulings, healthcare must be confidential and non-degrading, and job applicants cannot be made to take an AIDS test.

Magistrate Rondon stipulated measures to ensure that AIDS would be considered a public health problem, and to eliminate the stigmas and prejudices surrounding the disease.

Many aspects of the ruling which cracked down on the Health Ministry recognised the doctrine set in January by the verdict in favour of the four members of the military who were discharged when found to be HIV-positive.

That decision established that HIV-positive individuals or full- blown AIDS patients had the right to work, privacy, non- discrimination, dignity and psychological and economic attention as well as health care.

"The statistics reveal that this is a virus to which any person, without distinction, is exposed, given the variety of forms of transmission," wrote Rondon.

Carrasco said the consultations that reached ACCSI pointed to an alarming rise in the number of HIV-positive women, in line with the global spread of the disease.

The latest U.N. report on AIDS indicates that one of every 100 adults worldwide lives with HIV. Each day, 16,000 people are infected: 40 percent of them are women and half are between 15 and 24 years of age. (END/IPS/tra-so/eg/ff/sw/98)

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