Latin America and the Caribbean
Of all developing and transitional regions, Latin America and the Caribbean has by far the most comprehensive ARV treatment coverage, with 62% of those in need receiving drugs. More than a third of those being treated live in Brazil, which is a world leader in providing ARVs free to its population, achieved mainly through in-country production of cheap generic ARVs. Progress in other countries varies widely
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Cuba
Cuba set up its National Commission on AIDS in 1983, three years before its first case was diagnosed. It has since had a 'strong-arm' approach to dealing with HIV, quarantining those diagnosed, having strict partner tracing programmes, as well as having compulsory 8 week education programmes for those diagnosed and providing ARVs for all pregnant women. Just a handful of children have ever been born HIV+ on the island. Cuba consequently has one of the lowest prevalence rates in the world, at 0.1%. At the end of 2003, there were 3,300 people living with HIV.
No ARVs were available in Cuba up until 2001 because of the US trade embargo. However, in 2001, Cuban laboratories began making generic ARVs and now Cuba is one of only a few developing countries producing their own supplies of the drugs to all people living with HIV who need treatment. Latest available data records 1,500-2,000 people receiving ARVs in Cuba, which is more than the number thought by UNAIDS/WHO to be in immediate need. The island's mortality rate from AIDS has now dropped to as low as 7% of patients with AIDS. Because of it success in providing ARVs for its own population, Cuba is now looking to export generic drugs to other developing countries.
((((Note from Llandy: This is a move that has been blocked as much as possible by the US Pharma companies which hold a lot of "patents" on anti-retroviral drugs and wish to have a monopoly on exporting them to developing nations such as Africa for higher prices than Cuba))))
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United States of America
The first AIDS drugs were developed in 1987, four years after HIV was first identified. Since the mid-1990s, when combination therapy was introduced, US AIDS deaths have dropped about 70%. In 2003, the number of people living with AIDS in the USA was 384,906.
Most people in the US access their care and treatment through privately bought health insurance, as there is no country-wide state provision of healthcare. However, not all people can afford insurance. Instead they use Medicaid or Medicare, programs that pay for medical assistance for certain individuals and families with low incomes and resources. These programs provide medical long-term care assistance to people who meet certain eligibility criteria.
Since 1987, AIDS Drug Assistance Programs (ADAPs), which are federally and state-funded and state-run, have made treatments available primarily to low-income HIV patients who do not qualify for Medicaid. Currently, ADAPs buy around 20 percent of the HIV drugs prescribed in the United States, enough for 92,000 people. So far, 11 states have been forced to close ADAP enrolment for new patients. Others have tightened income-eligibility criteria. In April 2004, 1,263 people nationwide were waiting to access any kind of treatment through ADAPs. There are, even in America, people who die for want of AIDS drugs.
