Designated treatment hubs and primary HIV care facilities are advised to “observe client-centered approach in the provision of antiretroviral (ARV) drugs to PLHIVs amid the imposition of Enhanced Community Quarantine and declaration of the entire Philippines under a state of calamity over Covid-19.”
DOH recognizes that “this current situation poses challenges in accessing life-saving medications… which may result in treatment interruption”, so it is mandating treatment facilities to “exhaust all possible methods to ensure reliable access to PLHIVs to treatment without having to risk increased exposure to Covid-19 when accessing their medicines.”
For the DOH, various methods recommended are:
- Use of available courier service for pick-up and delivery of ARVs. Cost of service may be shouldered by the treatment facility, the client, community-based organizations (CBOs), or PhilHealth’s OHAT package
- Hub-designated ARV access points (e.g. local government units or CBOs)
- Use of LGU vehicles for delivery of ARVs at agreed meeting points
- Use of electronic or SMS appointment information as proof of entry of PLHIVs in areas under community quarantine during extreme instances where visit to the primary treatment facility is inevitable
The DOH also emphasized the provisions of the Guidelines on Service Delivery of PLHIV Affected by the Community Quarantine, including the catering of affected PLHIVs by other treatment facilities for their ARV refills and for other services.
There is still confusion re access to treatment, however.
For instance, some facilities are reportedly requiring PLHIVs not under their care to bring their HIV confirmatory test results and their ARV booklets (that list down their ARV intake); but these requirements are with the primary hubs, not with the PLHIVs.
In the end, the DOH is giving hubs leeway on implementation, stating that “treatment facilities shall ensure mechanisms are in place for the close coordination and communication between treatment facilities, partner organizations/support groups, and PLHIVs.”
Meaning: PLHIVs ought to still coordinate with their respective hubs if these have efforts at all re access to treatment, care and support during the quarantine period.
Some hubs reiterate the policy on co-sharing of responsibility – e.g. In a Facebook post, Dr. Jeffrey Garcia stated: “To all the patients from DOH-RITM ARG and other treatment hubs/primary HIV Clinics: You may temporarily have your ARV refill and medical consultations at a hub nearest to you.”
However, Garcia himself eventually noted that “there were incidents where PLHIVs/patients were not allowed to pass through the borders to have their ARV refill despite showing their IDs and cards” while “some cannot go the nearest hubs due to public transportation suspension.”
“I hope the DOH will address this soon”, just as he is asking other government agencies (e.g. Department of Social Welfare and Development, Armed Forces of the Philippines and local government units) to “please help our patients.”
Garcia added: “For now, you may seek assistance from your local government units/barangay officials.”
This, obviously, introduces other issues to PLHIVs – e.g. the need to unnecessarily disclose their HIV status so that other agencies will help them.
There are hubs that have been stepping up – e.g. Ospital ng Biñan – HIV/AIDS Core Team is conducting emergency ARV refill stations.
CBO The Red Whistle, meanwhile, partnered with MapBeks to create the Oplan #ARVayanihan map so those who want – or are able – to access other treatment hubs while the quarantine is in effect.
In a Facebook post, Benedict Bernabe – who helms the group – stated that “because of road closures at borders between towns, cities, and municipalities, the paralyzation of the public transport system, the unreliability of courier services, the lack of viable documents that can be accepted at checkpoints, some PLHIVs are worrying about their supply of ARVs.” So the group created a map containing “ALL the DOH-designated treatment hubs across the country. This will give you the nearest treatment hub where you are located.”
The map also contains 1-km and 2-km area markers for PLHIV to check if the treatment hubs are within walking distance if there’s no transportation available.