International AIDS Society Newsletter, no. 21

AIDS and Globalization:
The Argentinean Crisis
Pedro Cahn, MD, PhD and Kurt Frieder,
Fundacion Hue'sped, Angel Peluffo 3932, 1202 Buenos Aires, Argentina

Argentina is going through the worst crisis
in its history. Practically every governmentrun system in Argentina is failing. Complete
institutional breakdown has resulted from a
decade of government adherence to a fixed
currency exchange rate of one peso to one US
dollar. At last a clear link has been shown
between the economic programs of the last
decade, a policy strongly endorsed by international financial organizations like the IMF
and the World Bank, and the decline of the
nation as a whole.
The consequences of years of inefficient
government have been far-reaching. The
country's people face corruption within the
judicial and political system, and other key
public areas. The unemployment rate has
reached a staggering 23% of the total labor
force with almost 49% of the population living below the poverty line. Argentina's foreign debt stands at more than 160 billion US
dollars making it one of the highest per capita foreign debts in the world today. This
debt has crippled the nation, destroying any
chance of economic growth and costing the
people of Argentina dearly. A century ago,
this country was earmarked to become the
world's sixth strongest economic power. It is
scarcely believable how different the situation
is and how much the welfare of the people
has suffered as a result of ill engineered, overzealous plans.

In spite of a farcical economic backdrop,
Argentina is still showing fair health indicators by Latin-American standards. However,
the future looks grim unless urgent and drastic steps are taken. Approximately 11 million
people (30% of the total population) exclusively depend on an overcrowded public hospital system. Whilst these services are provided free-of-charge, some patients cannot
even raise the fare to travel to the nearest
hospital. In line with the experiences of
many other nations, HIV/AIDS is rapidly
taking hold in the poorer and more socially
deprived sectors of the population. Many of
the patients that are being covered by the
public health system, live since long ago
below the poverty line. They are unemployed
or, due to their very low incomes can't afford
to cover even their most elemental subsistence requirements.
For the first time since HAART was
accomplished in 1996, the economic and political crisis that formally erupted in December
2001 may threaten the - by law - guaranteed
free access to it. Argentina is one of the few
Latin-American countries that are being
proudly presented as an example of equity in
access. The potential interruption of supply of
ARV is today's main cause of anguish to the
20,000 patients that are being covered by the
health system although, until now, medicines
have been available for their treatments.

The National AIDS Program has already
been axed following the resignation of its
former director in November last year, just a
few weeks before the financial crisis was
exposed. Following the collapse of the former
government, it took around two months for
the new national health administration to
appoint a replacement for the director of the
crucially important National AIDS Program.
Many of the 15,000 PLWHA covered by the
Federal Program (the remaining 5,000 are
covered by Social Security and private insurance), are concerned about the uncertainty of
receiving regular and timely medical supplies. The stress caused by medical problems,
coupled with acute deterioration in living
standards and growing poverty presents a real
risk that some people may decide to abandon
or suspend their treatments. This is a grave
concern for the community involved in the
multi-dimensional struggle against AIDS.
Even for those patients being treated by
the social security health system and through
private health insurance, are worried about
the future. The social security system is
struggling to make ends meet owing to
diminishing contributions from a low income
workforce, and escalating unemployment.
Private health insurance companies are witnessing similar problems owing to a dwindling number of clients able to afford the
high monthly payments. With all health care

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