Monitoring The Right To Health in Venezuela Newsletter Nro 9

NEWSLETTER

HEALTH

TA B L E O F C O N T E N T S

ANALYSIS AND INTERPRETATION OF AGGREGATE RESULTS OF MEDICINE SHORTAGE INDEX MEASUREMENTS FOR APRIL 2018

3

BEHAVIOR AND EVOLUTION OF THE INDICATOR

3

AGGREGATE RESULTS NATIONWIDE – APRIL 2018

5

EVOLUTION AND BEHAVIOR OF THE SHORTAGE INDICATOR

8

GRAPHICAL REPRESENTATION OF RESULTS

BY CITY AND MORBIDITY CAUSE

9

DIABETES

HIGH BLOOD PRESSURE

10

ACUTE RESPIRATORY INFECTIONS (ARIS)

11

DIARRHEA

12

CO N VITE XH E A LTH. A PRIL 2018: THE E X ACERBATION OF THE COM PLE X H U M A NITA RI A N EM ERGENCY POS ES A H E A LTH TH R E AT A ND PU TS TH E LI V ES OF V ENE ZU EL A NS AT S ERIO US RIS K.

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MONITORING THE RIGHT TO HEALTH IN VENEZUELA APRIL 2018

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ANALYSIS AND INTERPRETATION OF AGGREGATE RESULTS OF THE FIRST TWO MEDICINE SHORTAGE INDEX MEASUREMENTS

FOR APRIL 2018 Within the framework of the

1

Monitoring the Right

make up the basic basket of active ingredients prescribed

to Health in Venezuela: An Approximation Based on

for the four leading causes of morbidity affecting the

Medicine Shortages, Preventable Deaths and Hospital

Venezuelan population, namely: high blood pressure,

Infrastructure

project, Convite, A.C. has conducted a

diabetes, diarrhea and acute respiratory infections (ARIs).

total of 16 measurements (September I and II; October I

In Venezuela, a country ravaged by a complex humanitarian

and II; November I and II; December I and II; January I and

emergency, access to medicines to treat the four leading

II, February I and II, March I and II, and April I and II) to

causes of morbidity weighing on the population remains

determine the existence and availability of medicines that

severely restricted.

BEHAVIOR AND EVOLUTION OF THE SHORTAGE INDICATOR The aggregate results of the 16 measurements conducted so far are broken down below:

MORBIDITY

general

Upon an analysis of the behavior of the Medicine

the second week of September. This means that 8out

Shortage Index based on the results obtained from each

of the 10 pharmacies visited had no prescription drugs

measurement conducted to date, the following may be

available to treat the condition, and people with diabetes

observed:

have no way of keeping the disease under control to lead a good quality of life.

-

As for the basket of medicines prescribed for

diabetes, the shortage indicator has remained below

-

90 percent, but above 80 percent, with the exception

although the shortage indicator in 2 of the 16

of the first measurement, which was conducted during

measurementshas been below 80 percent, the situation

As

regards

antihypertensive

medication,

1. Survey Chronological Details: The survey consisted of two monthly measurements made between April 11-13, 2018, and April 21-23, 2018, which were the second and fourth weeks of the month, respectively, in order to detect variations that could be measured and circulated regarding medicine supply protocols in pharmaceutical establishments. For further information on the technical data sheet of the survey and other methodological details, please refer to Newsletter No.1, September 2017, available at: https://tinyurl.com/IEM-1-Bolein.

MONITORING THE RIGHT TO HEALTH IN VENEZUELA APRIL 2018

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is more or less similar: it peaked during the second week

-

As far as diarrhea is concerned, in 7 of the 16

of September and it has remained between 85 percent

measurements conducted to date, the shortage indicator

and 78 percent in subsequent measurements. This

has been above 90 percent, while in the remaining nine

means NO antihypertensive medication was availablein

it gets as high as 80 percent. With diarrhea as one of the

8 out of 10 pharmacies in the sample.

main causes of morbidity in children under five years of age 2,it is truly alarming that 8 out of 10 pharmacies have

-

Theshortage indicator for the basic basket of

no type of antidiarrheal treatment to offer.

medicines for acute respiratory infections (ARIs), which, as we have warned in previous newsletters, has been the worst supplied throughout the survey, has remained above 93 percent in all measurements.

Confronted with such chilling and alarming figures, it is not only necessary but imperative that actions betaken to compel the Venezuelan State to recognize both the existence of a humanitarian emergency and its own inability to respond and address the situation.More importantly,the time has come to demand that the State —that “abstract” person responsible for guaranteeing the lives of its citizens—agree to set up mechanisms, before another Venezuelan dies,for the reception of the humanitarian aid that we require to save the lives of those at a latent risk of dying.

2. Rodríguez, Eva, Arias Gómez, Armando, Sifontes, Sonia, Luna, Héctor, Gaiti, Jorge, EPIDEMIOLOGY. Venezuelan Archives of Puericulture and Pediatrics [online] 2010, 73 (January-March) : [Query Date: May 19, 2018]. Available Online At:<http://www.redalyc.org/articulo. oa?id=367937039007> ISSN

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AGGREGATE RESULTS NATIONWIDE: A P R I L 2 0 1 8

CITIES

The table above shows how five of the capital cities in the country are suffering the ravages of the #ComplexHumanitarianCrisis as much as any other city in the inland region.

LIVING WITH HYPERTENSION May 17 is World Hypertension Day. Within the framework of this commemoration, a de facto categorization has been created in Venezuela according to whichthere are two types of hypertensive patients in the country: 1) Those whofind medicines, but cannot afford to buy them, and 2) Those who can afford to buy them, but cannot find them.

People with high blood pressure move between these two seas of desolation, amidst a complex humanitarian emergency that continues to materialize in the form of a systematic and widespread violation of the most basic fundamental rights, including the right to life, the right to food, the right to health and the right to free movement.

This situation has already cost the lives of a significant number of Venezuelans, and the lives ofmany others â&#x20AC;&#x201D; who are struggling to win the battle to which they have MAY 17 - World Hypertension Day. MONITORING THE RIGHT TO HEALTH IN VENEZUELA APRIL 2018

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been forcibly subjected by a State that simply doesn’t

Atenolol,

Nifedipine,

Amlodipine,

and

Losartan

care #TheStateDoesn’tCareabout the suffering, hunger

Potassium. Enalapril has been thebest stocked since

and death of its citizens— are at a constant risk.

the beginning of the project. However, the fact that the general shortage indicator has remained dangerously

In October 2017, Julio Acosta Martínez, president of the

close to 100 percentacross the survey period, always

Venezuelan Society of Cardiology, warned that 7 million

fluctuating between 78 percent and 92 percent, is a

hypertensive Venezuelans were not getting adequate

matter of serious concern, because it means that in

medical care or treatment. He also warned that, owing to

7and 9out of 10 pharmacies visited during the course

poor health services and food and medicine shortages,

of the project there was NO ANTIHYPERTENSIVE

the occurrence of the disease would increase not only

MEDICATION AVAILABLE.

3

in the elderly, but also in young people . Based on this information, about 30 percent, i.e. 3out of 10, of Venezuelans have high blood pressure.

Venezuela commemorates World Hypertension Day in

BITTER SUGAR Regarding the basket of medicines to treat diabetes, the

the red and worse. For example, Venezuelan hypertensive

shortage indicator increased in Aprilas compared against

patients currently fail to comply with or interrupt or

the month of March. The shortage of hypoglycemic

modify their dosage of prescribed medication due

drugs was 85.1 percent in April, which reveals an increase

to two determining factors: high costs and scarcity.

Hypertensive patients are at risk of heart attack and stroke, a risk that is potentially increased due to the poor quality of health services, the shortage of food available

of 2 percentvs. the previous month. In the meantime, theshortage trend continues to consolidate, dangerously approaching 100 percent.

for human consumption, and the lack of medicines.

The almost total lack of hypoglycemic agents should be Doctors from the Venezuelan Society of Cardiology predict that the risk of heart failure will increase by 50 percent, and that the probability of heart attack will

cause for alarm for our health authorities, especially in a context where the deliberate shortage of food forces

be 25 percent; to cap it all, emotional factors such as

citizens to eat a diet (of hunger) based on the consumption,

depression, angst, anxiety and stress are known to cause

in some cases exclusively, of carbohydrates in the form of

sudden deathand heart attacks.

flours, vegetables and tubers, which, in the long run, are

As part of our Monitoring the Right to Health in Venezuela project, we collect data on the Medication Shortage Index during the second and fourth weeks

processed into sugars and increase the risk of diabetes.

Alarming practices such as replacing whole portions of food with inexpensive, available fruits such as mango

of each month in order to monitor the availability of

—which are high in sugar—, and consuming excessive

six (6) active ingredients included in the basic basket

amounts of tubers, increase the average Venezuelan’s

of antihypertensive drugs, namelyEnalapril, Valsartan,

risk of developing diabetes.

3. FRANQUIS (2017).Hipertensosexpuestos a infartosporfalta de medicinas (Hypertensive Patients At Risk of Heart Attach Due to Shortage of Medicines) . Available Online At: http://www.el-nacional.com/noticias/salud/hipertensos-expuestos-infartos-por-falta-medicinas_207119

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As early as 2016, Dr. Imperia Brajkovich, president of

it’s going to keep rising because people are eating poorly,

the Venezuelan Society of Endocrinology, warned that

mostly tubers, which is the cheapest thing they can find”,

“we see between three and four new diabetes cases on

and Metformin, an essential drug according to the World

a daily basis in every hospital; when consulted, these

Health Organization (WHO), “cannot be found and is very

patients are all found to be poorly controlled because

expensive: 30 tablets cost over 1 million Bolívares” 6.

theylack access to insulin, oral hypoglycemic agents, blood pressure lowering agents or antibiotics or they

Jeiver Ollarve, a young man who was barely 21 years old,

cannot afford to buy them, even if the find them, because

the beloved son of Doralis, whose story we documented

4

they are too expensive” .

as part of our Monitoring the Right to Health project, died in March 2017. Having been diagnosed with type-1

She also warned that diabetes, if not treated properly

diabetes, he was unable to comply with his treatment, one

and promptly, causes kidney, eye and heart damage and

that was primarily insulin-based; hetoured pharmacies,

leads to death. Diabetics who are also hypertensive are

clinics, hospitals and outpatient clinics, but he couldn’t

nine times more likely to have a heart attack or suffer

make it. Jeiver was a victim of the shortage of medicines.

5

heart failure .

Jeiverdidn’t getthe medication that would have allowed him to lead a normal and healthy life despite his condition.

The outlook gets darker if we add the following

That’s why from Convite we denounce that Jeiver

variable to the equation: by 2018, diabetes became the

#WasKilledByTheState.

third leading cause of death in Venezuela. Dr. Maritza Durán, president of the Venezuelan Society of Internal Medicine, expressed her concern that diabetes cases have risen from 8 percent to 13.1 percent; this means that 13 out of every 100 Venezuelans over the age of 20 have diabetes, according to a study on cardiometabolic health conducted by Evescam (Venezuelan Survey of Cardiometabolic Health) between 2014 and 2017. “And

4. Entre tres y cuatrocasosnuevos de diabetes se ven a diario en cadahospital (BetweenThree and Four New Diabetes Cases are Seen Daily in Each Hospital). Available Online At:http://www.panorama.com.ve/bellezaysalud/Entre-tres-y-cuatro-casos-nuevos-de-diabetes-se-ven-adiario-en-cada-hospital-20180502-0091.html 5. La diabetes pasó a ser la tercera causa de muerte en Venezuela (2016)(Diabetes BecametheThirdLeading Cause of Death in Venezuela (2016). Available Online At: http://www.el-nacional.com/noticias/sociedad/diabetes-paso-ser-tercera-causa-muerte-venezuela_16212 6. Laguna (2018).Aumentan casos de diabetes en Venezuela (Diabetes Cases OnTheRise in Venezuela). Available Online at:https://www. el-carabobeno.com/aumentan-casos-de-diabetes-en-venezuela/

MONITORING THE RIGHT TO HEALTH IN VENEZUELA APRIL 2018

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EVOLUTION AND BEHAVIOR OF THE

S H O R TAGE I N D I C ATO R

CHART NO. 1: BEHAVIOR AND EVOLUTION OF THE MEDICINE SHORTAGE INDEX BY MORBIDITY: SEPTEMBER 2017 – MARCH

Chart No. 1 shows that the General Shortage Index has

The shortage of drugs to treat acute respiratory

ranged between 85 percent and 93 percent for prescription

infections (ARIs), which are the worst stocked, with was

drugs to treat the four main causes of morbidity affecting

between 93 percent to 95 percent in the month of April and is

the Venezuelan population, recording its highest level at

above the Overall Shortage Index, is still absolutely bleak and

the beginning of the survey. In April, it was again below 90

frightening.

percent, which isa slight reduction as compared against the previous four measurements. In this connection, the

A shortage ofdrugs to treat diarrheal syndromes

following remarks are in order:

above 80 percent, which is the current indicator, should be a wake-up call for the country’s health authorities, particularly

The group of antihypertensive medication are the

in light of the spreadof intestinal infections and diarrheal

best stocked throughout the survey. However, this “best

diseases caused by the poor quality of the water intended for

stocked” is by no means a favorable sign because, as we

human consumption, and of the increase in the number of

have already noted in the first part of this newsletter, 3 out of

citizens who have no choice but to eat a “diet” based on waste

10 Venezuelans are hypertensive.

directly from garbage containers or dumps.

Given the increase in the number of diabetes

patients, mainly due to the deficiencies in the intake of food, the picture is almost a carbon copy of what we have already discussed in the case of high blood pressure, which is frightening.

MONITORING THE RIGHT TO HEALTH IN VENEZUELA APRIL 2018

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GRAPHICAL REPRESENTATION OF RESULTS

BY C I T Y A N D M O R B I D I T Y C AU S E DIABETES

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Chart No. 2: Behavior and Evolution of the Medicine Shortage Index for Diabetes Medication, by City. September 2017 â&#x20AC;&#x201C; April 2018.

The General Shortage Index (GSI) for type-2 diabetes

Maracaibo is still the city with the best supply of

mellitus has ranged almost evenly throughout the study

diabetes medication, with a stable shortage indicator

from 83 percent to 91 percent, peaking at 90.7 percent

of below 80 percent. Barquisimeto, on the other hand,

during the first data collection in the second week of

is the city with the worst supply of hypoglycemic

September 2017.

agents, where the lowest that the GSI has been is 90 percent during the first measurement.

7. This is a graphical depiction of the behavior and evolution of the shortage indicator by morbidity and city for every measurement conducted between September 2017 and April 2018.

MONITORING THE RIGHT TO HEALTH IN VENEZUELA APRIL 2018

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HIGH BLOOD PRESSURE

Chart No.3: Behavior and Evolution of the Medicine Shortage Index for Antihypertensive Medication, by City.

September 2017 â&#x20AC;&#x201C; April 2018.

It appears that the group ofdrugs prescribed to

Caracas and Barquisimeto, where the indicator was

regulate high blood pressure remains the best supplied

88.2 percent and 86.4 percent, respectively, are the

of the four (4) drug groups monitored. However, as

cities with the worst supply of high-blood pressure

we have already noted, NO ANTIHYPERTENSIVE

medication.

MEDICATION COULD BE FOUND in 7 out of 10 of the establishments we visitedin the month of April and, when some was found, its price exceeded by far the purchase power of most hypertensive patients.

MONITORING THE RIGHT TO HEALTH IN VENEZUELA APRIL 2018

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ACU TE RESPIR ATORY INFEC TIONS

(ARIS)

Chart No.4: Behavior and Evolution of the Medicine Shortage Index for Medication to treat Acute Infections of the Respiratory Tract, by City. September 2017 â&#x20AC;&#x201C; April 2018.

The group of medicines to treat acute respiratory

The city with the best stock of drugs to treat ARIshas

infections (ARIs) remains the worst stocked in the five

been Maracaibo, where the indicator has been

cities surveyed. TheGeneral Shortage Index for drugs

below 90 percent in thirteen (13) of the sixteen (16)

prescribed to treat this health condition has ranged

measurements taken to date, its lowest being 85.1

between 93 percent and 98 percent along the 8-month

percent during the second measurement of the month

measurement period.

of April of 2018, which was the last chronological month of the survey.

MONITORING THE RIGHT TO HEALTH IN VENEZUELA APRIL 2018

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DIARRHEA

Chart No.5: Behavior and Evolution of the Medicine Shortage Index for Diarrhea Medication, by City. September 2017 â&#x20AC;&#x201C; April 2018.

The group of medicines prescribed for diarrheal diseases has been the second worst supplied in the 16 measurements taken up to the month of April, with a shortage indicator of between 85 percent and 95 percent; the best it has been was 85.5 percent in the second April measurement.

MONITORING THE RIGHT TO HEALTH IN VENEZUELA APRIL 2018

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CONVITEXHEALTH: APRIL 2018: THE EXACERBATION OF THE COMPLEX HUMANITARIAN EMERGENCY POSES A HEALTH THREAT AND PUTS THE LIVES OF VENEZUELANS AT SERIOUS RISK. In April, the right to health picture looked like this:

1.

A shortage of more than 85 percent of drugs to treat the four leading causes of morbidity affecting the population.

a. Diabetes: 85.1 percent. b. Hypertension: 78.2 percent. c. Acute Respiratory Infections (IRAs): 93.8 percent. d. Diarrhea: 85.5 percent.

2.

People with Leishmaniasis are forced to travel to Brazil in search for treatment. For a year now, the “Rosario Vera Zurita” Hospital in Santa Elena de Uairén, which is the main healthcare center in the Gran Sabana municipality, has had a complete shortage of Glucantime, a drug prescribed to treat the disease; it should be noted that Leishmaniasis is a tropical disease whose spread increases as a result of the deforestation in mining areas. There are no reliable records of people affected by the parasite, as patients, as soon as they suspect that they have been infected, go right away to the healthcare centers on the Brazilian side of the border, which also do those with malaria. In the face of urgency, they prefer not to waste time 8.

a

9

In this regard, it is important to note that :

i. Outbreaks

of Leishmaniasis increase before and

during the rainy season, specifically between May and June. In other words, the probability of occurrence increases significantly in May.

ii. In Venezuela, the three types of Leishmaniasis are usually treated through ascheme consisting of twenty (20) vials of Glucantime, a pentavalent antimonial distributed exclusively by the Ministry of Health. At present, there is no information as to the availability thereof. The “Rosario Vera Zurita” Hospital in Santa Elena de Uairén has not been stocked with Glucantime for more than a year now.

8. Morillo (2018) ) Enfermos con Leishmaniasis viajan a Brasil a buscar la cura. Documento on line disponible en http://elpitazo.ml/reportajes/ enfermos-con-leishmaniasis-viajan-a-brasil-a-buscar-la-cura/ 9. Gascón (2018). Leishmaniasis ¡Mosca con el Jején!. Documento on line disponible en http://elpitazo.ml/reportajes/infografia-leishmaniasis-moscajejen/

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iii.

There is a second treatment alternative, developed at the Universidad de Los Andes, known as Ulamina; its

c

On April 24, the World Health Organization stated its concern about the significant increase in malaria cases

production, however, is currently halted.

iv.

in Venezuela, noting that malaria cases are growing at a very alarming rate due to the drastic reduction in 13

Serological tests are a tool for diagnosis of the disease; however, they pose a challenge because, as we have already reported in previous newsletters, there shortage of reagents in the country to perform

anti-malarial campaigns across the country .

d

serological tests is almost total.

3.

of Monagas, Aurora Navas, reported that during the first quarter of 2018, 3,200 cases of malaria had been confirmed in that state. The lack of medicines to

The Ministry of the People’s Power for Health has

provide timely treatment to the affected population is

sponsored a National Surgical Plan, which is merely

the common culprit.

a surgery program of dubious effectiveness. Eliana Briceño, 31, underwent sterilization on April 21stas part of the surgery program run by the Ministry of

5.

People with kidney disease and transplanted patients continue to struggle in an effort to cope with the

Health; however, the wound from hersurgerywas not

indolence of the State, which does not seem to care

properly closed and part of her small intestine came

about:

10

out through the incision .

4.

On April 12, the Single Health Authority in the state

The re-emergence of eradicated diseases, such as

a

The collapse of the hemodialysis unit in Valle de La Pascua. Since Wednesday, April 25, all eight

malaria —which marks Venezuela’s sharp decline in

hemodialysis machines that are used to treat patients

the right to health—, is on the rise, and there seems to be no realistic chance of combating them, at least not

from eight municipalities in the state of Guárico are

in theforeseeable future. Eighteen malaria deaths have

out of order 14 .

11

been reported in the state of Anzoátegui .

a b

To the outbreak of malaria and diphtheria reported by Convite, A.C. in previous newsletters, we must add that

b

The fact that five (5) people with kidney disease died in April in the state of Nueva Esparta alone. A victim

of measles, hepatitis, dengue, and Chagasdisease at

of the shortage of medical supplies, Asdrúbal Lindo

the close of April.

was the fifth renal patient to die in the state of Nueva Esparta: he had been treated for 20 days in the Dialysis

The fact that 3,000 children are at risk of dying in the 12

state of Lara for lack of treatment is alarming .

Unit of the ‘Luis Ortega’ Hospital,but they had to use a catheter that was not the one prescribed for his treatment because the one thathe needed was not 15

available .

10.Altuve (2008). Mujer ingresó a El Algodonal tras quedar mal operada en el Plan Quirúrgico Nacional(After a BadSurgeryundertheNationalSurgical Plan, A WomanWasAdmittedtothe El Agodonal Center). Available Online At: http://elpitazo.ml/ultimas-noticias/video-mujer-ingreso-algodonal-tras-quedar-mal-operada-plan-quirurgico-nacional/11.Pellicani (2018). Se elevó a 18 el número de víctimas fatales por paludismo en Anzoátegui. Documento on line disponible en http://elpitazo.ml/ultimas-noticias/se-elevo-a-18-el-numero-de-victimas-fatales-porpaludismo-en-anzoategui/ 11.Pellicani (2018). Se elevó a 18 el número de víctimas fatales por paludismo en Anzoátegui.(The Number of Malaria Deaths in Anzoátegui Rose to 18). Available Online At:http://elpitazo. ml/ultimas-noticias/se-elevo-a-18-el-numero-de-victimas-fatales-por-paludismo-en-anzoategui/ 12.http://www.el-nacional.com/noticias/salud/alrededor-3000-ninos-lara-tienen-tratamiento-contra-paludismo_233477 13.http://efectococuyo.com/salud/oms-venezuela-registra-el-mayor-incremento-de-casos-de-malaria-en-el-mundo/ 14.Guerra (2018) Pacientes de hemodiálisis denuncian colapso de unidad de diálisis de Valle de La Pascua (sic).(Hemodialysis Patients Denounce the Collapse of the Dialysis Unit in Valle de La Pascua). Available Online At: http://elpitazo.ml/ultimas-noticias/pacientes-hemodialisis-denuncian-colapso-unidad-dialisis-valle-pascua/ 15.Miquilena (2018) Seis pacientes renales murieron en menos de dos meses en Margarita.(Six Kidney Patients Died in Less than Two Months in Margarita). Available Online At:http:// elpitazo.ml/ultimas-noticias/seis-pacientes-renales-murieron-en-menos-de-dos-meses-en-margarita/

MONITORING THE RIGHT TO HEALTH IN VENEZUELA APRIL 2018

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6.

Bioanalysts report a 100 percent shortage of supplies

required, Venezuelans are facing the risk of enduring

of Bioanalysts claims that public laboratories even

the outbreak of epidemics within a period of no more

lack the material that they needed to perform “a simple

than five years.

16

laboratories operate with a 70 percent shortage .

8

On April 25, a 9-month-old baby diagnosed with AH1N1 Influenza died at the J.M. de Los Ríos Hospital. The

On April 6, the national government announced that it

expiry date of the last units of Oseltamivir that are left

would launch the National Immunization Plan. However,

in the hospital, which was once a reference in pediatric

on April 26, people from the Efecto Cocuyo web portal

medicine across the country, reads 2011 and 2015

toured three healthcare centers and three maternity

.This is evidence that we are not prepared to deal with

hospitals in the municipality of Libertador: none had all

a potential outbreak of that type of influenza in the

the vaccines announced by the Government, not even

mainpediatric hospital in Venezuela where, in addition

the BCG vaccine that must be administered to babies a

to the child who died, two confirmed cases of this type

17

few days after birth to protect them from tuberculosis .

a

If vaccination schedules are not implemented as

in public laboratories. The president of the Association

hematology test “; on their part, privately-owned

7.

b

18

of influenza have been reported.

9.

In

the

current

complex

humanitarian

Today in Venezuela our children grow up under the latent

emergency situation, it is important to differentiate

threat of acquiring some kind of autoimmune disease,

between two terms that are being used very lightly

since the vaccines that they need to be administered in

but are totally different: humanitarian intervention

order to protect their immune system are not available.

and humanitarian cooperation, and to emphasize that human rights organizations are clearly in favor of the

16.http://elpitazo.ml/ultimas-noticias/video-%E2%80%8Bbioanalistas-venezuela-denuncian-paro-tecnico-laboratoriospublicos-100%E2%80%8B/ 17. SLEINAN (2018) Ni en maternidades ni en sanidades de Caracas se consiguen las 9 vacunas del Plan Nacional. (Not Even in Maternity Hospitals nor in the Ministry of the People’s Power for Health and Social Assistance’ Centers Can You Find the Nine Vaccines of the National Immunization Plan). Available Online At:http://efectococuyo.com/principales/ ni-en-maternidades-ni-en-sanidades-de-caracas-se-consiguen-las-9-vacunas-del-plan-nacional/ 18. SLEINAN (2018) J.M. de los Ríos no tiene cómo tratar casos de AH1N1 por falta de medicamentos. (Cases of AH1N1 Influenza in the J.M. de Los Ríos Hospital Cannot Be Treated for Lack of Medicines). http://efectococuyo.com/ salud/j-m-de-los-rios-no-tiene-como-tratar-casos-de-ah1n1-por-falta-de-medicamentos/

MONITORING THE RIGHT TO HEALTH IN VENEZUELA APRIL 2018

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9.

In the current complex humanitarian emergency situation, it is important to differentiate between two terms that are being used very lightly but are totally different: humanitarian intervention and humanitarian cooperation, and to emphasize that human rights organizations are clearly in favor of the Government requesting and accepting humanitarian cooperation. Some basic differences between the two concepts include:

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MONITORING THE RIGHT TO HEALTH IN VENEZUELA APRIL 2018

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