Monitoring The Right To Health in Venezuela Newsletter Nro 2

CONVITE - Newsletter Nยบ 2. October, 2017.

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XLaSalud XLaSalud

Newsletter Nro 2 October, 2017

CONVITE - Newsletter NÂş 2. October, 2017.

MEDICINE SHORTAGE INDEX (MSI)

Convite, A.C. has conducted two surveys (September I – II) to measure the availability or otherwise of the basic basket of active principles associated with high-blood pressure, diabetes, diarrhea and acute respiratory tract infections (ARTIs). The findings have demonstrated that there is a severe shortage of said active principles, and that the trend is that it could reach 100%.

Overall, the figures obtained from this research work are similar to the global medicine shortage indexes released by non-governmental agencies and pharmaceutical chambers.

A 90% SHORTAGE

AGGREGATE RESULTS NATIONWIDE Results from the first survey are broken down as follows: TABLE 1- Aggregate Results Nationwide (September I - II)

MORBIDITY

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2nd Week, September

4th Week, September

(I)

(II)

High-Blood Pressure

94,0%

80,9%

Diabetes

91,7%

87,6%

Diarrhea

96,8%

87,2%

ARTIs

95,3%

94,8%

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CONVITE - Newsletter Nº 2. October, 2017.

GRAPHIC 1 - Shortage Indicators, based on Morbidity and Location, September I BARQUISIMETO

NUEVA ESPARTA

Diabetes 87.7% High-Blood Pressure 85.8% ARTIs 92.1% Diarrhea 92.1%

Diabetes 91.7% High-Blood Pressure 88.9% ARTIs 96.4% Diarrhea 95.8%

MARACAIBO

METROPOLITAN AREA OF CARACAS

Diabetes 96.1% High-Blood Pressure 97.5% ARTIs 95.8% Diarrhea 99.0%

Diabetes 91.1% High-Blood Pressure 97.5% ARTIs 95.8% Diarrhea 99.0%

MÉRIDA Diabetes 78.2% High-Blood Pressure 73.1% ARTIs 97.1% Diarrhea 76.9%

At the aggregate level (nationwide), during the first week, the highest shortage index was observed for ailments such as diarrhea, followed by infections of the respiratory tract and high-blood pressure, with diabetes being the least affected.

During the survey’s second week, a substantial reduction of almost 13% was observed in the shortage index for high-blood pressure drugs,

TOTAL Diabetes 91.7%

High-Blood Pressure 94.0%

ARTIs 95.3%

Diarrhea 96.8%

which went from 94.0% to 80.9%, followed by those for diarrhea, which ranked third during the last week but which decreased between the first and second measurements by 9.6%. On the other hand, the shortage index for drugs to treat diabetes dropped from 91.7% in the survey’s first week, to 87.6% in the survey’s last week. The shortage reduction was marginal for drugs to treat diarrhea.

GRAPHIC 2 - Shortage Indicators, based on Morbidity and Location, September II BARQUISIMETO

NUEVA ESPARTA

Diabetes 90.1% High-Blood Pressure 92.0% IRA 93.5% Diarrhea 88.9%

Diabetes 96.6% High-Blood Pressure 89.1% ARTIs 98.7% Diarrhea 97.7%

MARACAIBO

METROPOLITAN AREA OF CARACAS

Diabetes 75.3% High-Blood Pressure 54.8% ARTIs 87.5% Diarrhea 59.1%

Diabetes 90.8% High-Blood Pressure 88.5% ARTIs 97.8% Diarrhea 98.9%

MÉRIDA Diabetes 96.3% High-Blood Pressure 85.8% ARTIs 99.1% Diarrhea 88.9%

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TOTAL Diabetes 87.6%

High-Blood Pressure 80.9%

ARTIs 94.8% Diarrhea 87.2%

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CONVITE - Newsletter Nº 2. October, 2017.

METROPOLITAN AREA OF CARACAS

The Metropolitan Area of Caracas showed alarmingly high shortage indexes, all approaching 100%, exceeding aggregate levels nationwide.

,

g Team

onitorin Local M MAC.

MORBIDITY

2nd Week, September

4th Week, September

(I)

(II)

High-Blood Pressure Diabetes Diarrhea ARTIs

97,5% 91,9% 99,0% 95,8%

88,5% 90,8% 98,9% 97,8%

“1 out of 3 adults have high-blood pressure”.1

During the first week of the month of September, the Metropolitan Area of Caracas showed alarmingly high shortage indexes, all approaching 100%, exceeding aggregate levels nationwide.

The most alarming finding pertains to the shortage index for diarrhea medication, and it is likely that only 1 out of 100 hundred persons would have the chance for access thereto.

In the case of high-blood pressure drugs, supply improves during the second week, with a 9%-reduction from 97.5% to 88.5%; the same applies to medication for diabetes, albeit less significantly.

The opposite is true for drugs to treat infections of the respiratory tract, with a shortage index increase of about 2%, approaching 100%, while that for diarrhea medication remained almost unaltered.

The MSI showed a trend towards full-blown shortage for the four morbidity items, with dire consequences for those whose lives depend on said drugs.

1. World Health Organization (2012). World Health Statistics Report.

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CONVITE - Newsletter Nº 2. October, 2017.

BARQUISIMETO

Barquisimeto ranks slightly better than Caracas. However, figures are still alarming, with a trend towards 100% shortage.

m,

Tea itoring n o M l Loca imeto.

Barquis

2nd Week, September

4th Week, September

(I)

(II)

MORBIDITY High-Blood Pressure Diabetes Diarrhea ARTIs

85,8% 87,7% 92,1% 92,1%

92% 90,1% 88,9% 93,5%

There are three (3) active ingredients to treat Type II Diabetes: Metformin, Gliclazide and Glibenclamide, in six (6) different dosages.

In Barquisimeto, drugs associated with high-blood pressure were, during the survey’s first week, the least difficult to find overall, with an 85.5% shortage index. However, during the last week of the survey, said index rose to 92%. Medication for diabetes, diarrhea and acute infections of the respiratory tract did not escape the upward trend, as reflected by the indicators. Overall, Barquisimeto’s outlook is representative on the average.

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It should be noted that during the two weeks of the survey of the four morbidity items, Barquisimeto ranked slightly better than Caracas.

However, the results are still alarming, with a trend towards 100% shortage.

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CONVITE - Newsletter NÂş 2. October, 2017.

MARACAIBO

Regarding drugs to treat high-blood pressure and diarrhea, the shortage index remained below 60% during the 4th week of September as measured in the survey.

am,

g Te onitorin Local M . ibo Maraca

MORBIDITY High-Blood Pressure Diabetes Diarrhea ARTIs

2nd Week, September

4th Week, September

(I)

(II)

97,5% 96,1% 99,0 % 95,8%

54,8% 75,3% 59,1% 87,5%

Being it a border state, shortage indexes tend to be below average.

Results for the city of Maracaibo during the first week of the survey are highly alarming. Indexes, both for diarrhea and high-blood pressure, are at almost 100%-shortage levels, which mean that it is likely that those in the region who suffer from said ailments will not be able to find their medication. The outlook is less discouraging as far as diabetes and infections of the respiratory tract are concerned; however, the situation is far from positive and reflects the widespread shortage facing the country. These figures are striking, to say the least, because one would have expected Zulia, being a border state, to show lower figures as compared against other cities in the survey.

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The situation improves significantly in Maracaibo during the last week of the survey. Indexes drop even below aggregate levels, improving in comparison with Caracas and Barquisimeto.

The shortage index for drugs to treat high-blood pressure falls by almost half, i.e. nearly 43%, from 97.5% to 54.8%. The same applies to medication for diarrhea, albeit less so, with a 39.9% reduction, even considering that the shortage for diarrhea medication was of 99% during the survey’s first week. Shortage indexes also shrink for diabetes drugs, from 96.1% to 75.3%. Finally, shortage indicators for drugs associated with respiratory tract infections also fall, but to a lesser extent.

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CONVITE - Newsletter Nº 2. October, 2017.

MÉRIDA

In September, it was almost impossible for Merida’s inhabitants to find medication to treat respiratory tract infections.

g onitorin Local M .

Mérida

Team,

MORBIDITY Hipertensión arterial Diabetes Diarrea IRA`s

2nd Week, September

4th Week, September

(I)

(II)

73,1% 78,2% 76,9% 97,1%

85,8% 96,3% 88,9% 99,1% Infections of the respiratory tract are the 4th cause of death in Venezuela.2

A comparative analysis of the city of Mérida reveals that the shortage indexes worsen noticeably between the first week of the survey and the last week thereof. For the first week, the MSI remained below 80%, at least for the four morbidity items under study: that for high-blood pressure was 73.1%, which is the lowest, followed by diarrhea and diabetes, with 76.9% and 78.2%, respectively.

In all cases, shortage indicators showed an increase during the last week of the survey, being the one pertaining to acute infections of the respiratory tract simply horrifying.

In conclusion, during the month of September, it was almost impossible for Merida’s inhabitants to find medication to treat respiratory tract infections.

2 World Health Organization (2012). Venezuela (Bolivarian Republic of): WHO Statistical Profile.

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CONVITE - Newsletter NÂş 2. October, 2017.

PORLAMAR

In Porlamar, figures are devastating by their extent and worsening trend.

g onitorin M l a c o L ar.

Porlam

Team,

MORBIDITY High-Blood Pressure Diabetes Diarrhea ARTIs

2nd Week, September

4th Week, September

(I)

(II)

88,9% 91,7% 95,8% 96,4%

Comparatively, the situation between the first week of the survey and the last week thereof worsened, showing alarming figures. The shortage index for 3 of the 4 morbidity items under study is in excess of 90%, and it deteriorates over time.

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89,1% 95,8% 97,7% 98,7% As in MĂŠrida, it was almost impossible for people in Nueva Esparta to find drugs to treat infections of the respiratory tract.

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CONVITE - Newsletter Nº 2. October, 2017.

TECHNICAL DATA SHEET Period and Frequency of Data Collection: Two measurements were conducted in September between the 13th and the 14th and between the 26th and the 29th, which are the first and fourth week of the month, respectively, in order to detect variations that could be measured and circulated regarding medicine supply protocols in pharmaceutical establishments.

Statistical Unit: Pharmacies, defined as operating establishments with all permits and meeting all legal requisites to sell drugs.

Scope of the Survey based on the Description of Affected Age Groups: The medicine shortage index deals with the 4 most recurring ailments in Venezuela: diabetes, high-blood pressure, acute infections of the respiratory tract, and diarrhea. Diabetes and high-blood pressure mainly affect senior citizens; as for diarrhea, it primarily affects children and is one of the causes of child mortality in developing countries, according to the WHO. Finally, acute infections of the respiratory tract (AIRTs) affect all age groups to the same extent, from childhood to old age.

Geographical Area: Five capital cities: the Metropolitan Area of Caracas, Barquisimeto, Mérida, Maracaibo and Porlamar.

Number of Establishments Surveyed Nationwide: 155, distributed as follows: a) MAC: 40 establishments. b) Barquisimeto: 27 establishments. c) Maracaibo: 31 establishments. d) Mérida: 27 establishments. e) Porlamar: 30 establishments.

Local 24-Member Teams distributed as follows: a) MAC: 1 Coordinator; 4 Local Monitors.s b) Barquisimeto: 1 Coordinator; 4 Local Monitors. c) Maracaibo: 1 Coordinator; 4 Local Monitors. d) Mérida: 1 Coordinator; 4 Local Monitors. e) Porlamar: 1 Coordinator; 4 Local Monitors.

Data Collection Method: Variable, depending on the geographical area. In the Metropolitan Area of Caracas, verification of availability is made via the web pages of commercial chains selling pharmaceutical products. In the remaining areas, a direct qualified-informant interview is conducted.

Sample Design: Stratified sampling with proportional affixation.

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XLaSalud

XLaSalud With support of:

@conviteac

@conviteac

Convite Asociaciรณn Civil

https://conviteblog.wordpress.com/