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Section: Nicaragua
Published: 2004


On more than one occasion we have insisted that  the bureaucratic procedures implemented by CCM's  or by  the Global Fund itself,  must yield to quicker mechanisms that would enable access to anti-retrovirals  medicines in as little time as possible.

However, in Nicaragua the purchase of antiretrovirals financed by the Global Fund is an extremely slow procedure, which results directly in the increase of the number of people who continue to die because they are not provided with medicines in a timely manner due to negligence and bureacracy. 

The Global Fund Project in Nicaragua was approved in January 2003 (more than a year ago). At that time, PLWA were injected with new hope as they could now finally visualize a future in the horizon. Sadly, many have already died without ever receiving the long-awaited for medicines.

What happens to financing offered by the Global Fund to save lives?

Over the course of a number of telephone conversations with NICASALUD, the Principal Recipient in Nicaragua for Global Fund financing, we have discovered that the disbursement for the purchase of antiretroviral medicines has not yet been made, although the contract was signed almost six months ago. (Nicaragua has already received some money from the Global Fund which was assigned destined to Malaria programs, but none  has been disbursed for   the purchase of antiretrovirals.)

The Global Fund headquarters in Geneva  confirmed that the funds for the antiretrovirals had not been sent. They informed us that last week they had received the report from Nicaragua , and that after it was verified (which would take approximately a week) the funds would be  sent.

Another situation that will delay even further the delivery of the medicines, is that according to  NICASALUD, the organization identified as the possible distributor  (IDA), would initiate the purchase procedure only after the contracts are signed and they receive a 50% advance of the total costs. In addition, the purchase procedure takes between 8 to 16 weeks for ARV's  to be delivered to the country (some medicines take 8 weeks to be delivered, others 12 and some up to 16).

Due to the above, if the Global Fund, the National AIDS Program, NICASALUD, the agency purchasing the medicines and any other institution involved follow the “normal” procedure, the ARV's would not be available for PLWA until June or July at the earliest.

How many PLWA have died in Nicaragua since 1996 when antiretrovirals were made available to the general public in other countries? How many PLWA have died since the AIDS Legislation (Law #238) was approved guaranteeing the right to treatment in 1996? How many more have died since January 2003 when the Global Fund project for the country was signed? How many more have died since the contract was signed? How many more PLWA will die in Nicaragua before the medicines are purchased? How many more before the medicines are effectively distributed to the hospitals in that country? Must we continue to count unnecessary deaths? 

We hope these words do not prompt a list of excuses as to why the purchase and delivery of these medicines has been delayed. We are not interested in excuses, what we are interested in is sensitizing those who have the lives of these peoples in their hands so that they understand the value of each human being and expedite these procedures as if it were for the  benefit of their own family. We hope that  bureaucratic procedures do not continue to result in totally needless deaths.

Richard Stern y Guillermo Murillo

Agua Buena Human Rights Association

February 23, 2004

Tel/Fax 506-2280-3548

This article is available in Spanish. Please contact the authors. 


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