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Responses to Information Requests (RIRs) cite publicly accessible information available at the time of publication and within time constraints. A list of references and additional sources consulted are included in each RIR. Sources cited are considered the most current information available as of the date of the RIR.            

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22 May 2008

MEX102842.E

Mexico: The availability and accessibility of medication to treat individuals who are HIV positive; whether the individual has to be employed in order to access HIV medication
Research Directorate, Immigration and Refugee Board of Canada, Ottawa

In 29 April 2008 correspondence, the Director of the National Centre for the Prevention and Control of HIV/AIDS (Centro Nacional para la Prevención y el Control del VIH/SIDA, CENSIDA) in Mexico City indicated that in 2004, the government of Mexico instituted a policy of universal free access to antiretroviral medication for individuals with HIV. In particular, the CENSIDA Director stated that people who cannot work (or who do not have a job or access to medical insurance) can go to specialized health centres such as the Ambulatory Centres for the Prevention and Treatment of AIDS and Sexually Transmitted Infections (Centros Ambulatorios de Prevención y Atención en SIDA e Infecciones de Transmisión Sexual ITS, CAPASITS) in order to access these medicines (Mexico 29 Apr. 2008). The Director provided the website address of a list of CAPASITS that provide free medicines in a number of states in Mexico: <http://www.salud.gob.mx/conasida/capasits.htm>.

This information is partially corroborated by a March 2008 report by the National Resource Centre of the United States-based AIDS Education & Training Centers (AETC). In particular, the AETC website notes the following:

Nearly all HIV medications available in the United States are now available to Mexican citizens in Mexico through a range of public and private programs. Access to HIV medications in Mexico has expanded greatly in recent years.

...

Each state has an HIV/AIDS director responsible for coordinating treatment and prevention programs. You or your patient can contact this person to determine the availability of HIV diagnostic tests and HIV medications in the state to which your patient is returning. Patients are treated either in general hospitals or in CAPASITS (HIV specialty clinics: "Centro Ambulatorio de Prevención y Atención en SIDA e ITS"). The CAPASITS network was introduced in Mexico in 2005 and is still expanding. As of 2008, it comprised nearly 60 centers around the country. (AETC Mar. 2008)

In Mexico's 2008 report to the United Nations General Assembly Special Session (UNGASS) regarding its progress on HIV/AIDS, CENSIDA reported the following:

[translation]

At the end of 2003, Mexico achieved universal coverage of antiretroviral treatment for all people who need it. Nevertheless, it is difficult to reach 100 percent coverage of antiretroviral treatment, even when the resources exist to provide it, for various reasons, which range from lack of timely detection of HIV/AIDS to the rejection of or non-adherence to treatment. Moreover, there have been shortages of antiretroviral medication in public sector institutions (mainly in the [Mexican Institute for Social Security - Instituto Mexicano del Seguro Social] IMSS), which affect universal access to treatment for people who are already part of that program. (Mexico 31 Jan. 2008, 51)

In July 2006, an article about HIV/AIDS in Mexico published in the journal Science corroborated the preceding information, indicating that Mexico initiated its policy of universal access to antiretroviral drugs in 2003 (Science 28 July 2006). However, the Science article also provides commentary from Carlos del Rio, the former head of AIDS policy in Mexico, indicating that "although antiretroviral drugs may be widely available, many people who need them do not know they are infected, and pharmacies often run out of drugs." (ibid., 478). Furthermore, del Rio indicated that difficulties in training clinicians have negatively impacted the quality of treatment (ibid.). According to Nuar Luna, a "prominent AIDS activist," the "biggest challenge Mexico faces is unequal access to quality care," claiming that the "good services are for the rich ones, and the bad services are for the poor" (ibid., 479).

This Response was prepared after researching publicly accessible information currently available to the Research Directorate within time constraints. This Response is not, and does not purport to be, conclusive as to the merit of any particular claim for refugee protection. Please find below the list of additional sources consulted in researching this Information Request.

References

AIDS Education and Training Centers (AETC). March 2008. "Recommendations for Providers Assisting HIV Patients Returning to Mexico." <http://www.aetcborderhealth.org/aidsetc?page=rep-ummxtx-bg> [Accessed 1 May 2008]

Mexico. 29 April 2008. Centro Nacional para la Prevención y Control del VIH/SIDA (CENSIDA). Correspondence received from the Director.

_____. 31 January 2008. Centro Nacional para la Prevención y Control del VIH/SIDA (CENSIDA). Informe UNGASS México 2008. <http://data.unaids.org/pub/Report/2008/mexico_2008_country_progress_ report_sp_es.pdf> [Accessed 1 May 2008]

Science. 28 July 2006. Vol. 313. Jon Cohen. "Mexico: Land of Extremes - Prevention and Care Range from Bold to Bleak." <http://www.scienceonline.org/cgi/reprint/sci;313/5786/477b.pdf > [Accessed 1 May 2008]

Additional Sources Consulted

Internet source, including: Government of Mexico websites, Joint United Nations Programme on HIV/AIDS (UNAIDS), Organization of American States (OAS), Pan American Health Organization (PAHO), United States Agency for International Development (USAID), World Health Organization (WHO).

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