From: ww@nyxfer.UUCP
Newsgroups: soc.culture.caribbean
Date: 06 Jan 93 23:09 PST
Subject: Cuba's Evolving AIDS Policy
Nf-ID: #N:RTVZwB4w165w@nyxfer.uucp:1782762288:000:6283
Nf-From: nyxfer.uucp!ww    Jan  6 23:09:00 1993


Subject: Cuba's Evolving AIDS Policy
From: nyxfer!ww (Workers World Service)


Via NY Transfer News Collective * All the News that Doesn't Fit


CUBA'S EVOLVING AIDS POLICY

By Brenda Sandburg
San Francisco

Two HIV-positive gay men from Cuba are on an historic two-month
U.S. tour talking about Cuba's AIDS policy. The trip by Dr. Juan
Carlos de la Concepcion and Raul Llanos is unprecedented. Cuba
has long been vilified for its public health policy around AIDS;
this is the first time any HIV-positive person from Cuba has been
able to speak in the U.S. The reason for this is the criminal
U.S. blockade of Cuba, which has made it difficult for Cubans to
come to this country to talk about their revolution and its
gains.

Concepcion and Llanos tell of how Cuba's AIDS policy has evolved,
and how despite the U.S. blockade Cuba has made great strides.
They spoke to 55 people at a San Francisco Workers World forum
Jan. 3.

Concepcion and Llanos will also be speaking in Los Angeles, San
Jose and Santa Cruz, Calif., New York, Washington and
Philadelphia.

Karen Wald, a North American journalist who has lived in Cuba for
the last 11 years, and her daughter Sierra Thai-Binh helped
translate the Jan. 3 meeting. Wald, a producer of the documentary
"Living with AIDS in Cuba," is one of the main organizers
facilitating the U.S. tour.

THE SANATORIUM ISSUE

Concepcion and Llanos entered Cuba's first AIDS sanatorium in
1986. Concepcion is a doctor and Llanos is an accountant and
computer expert who computerized Cuba's sanatorium system. They
told the San Francisco meeting that "to understand the reality of
the sanatoriums, you have to understand the reality of Cuba."

Concepcion explained that health care is a constitutional right
in Cuba, free for every citizen. AIDS is not considered a
political problem in Cuba, but a medical problem. The sanatorium
system was created to limit the spread of AIDS.

Cuba's national program to combat AIDS also includes testing
large sectors of the population, testing all blood donations, and
epidemiological surveys of all those who test positive. This
program "has allowed Cuba to almost completely eliminate
pediatric AIDS," said Concepcion. "It has allowed Cuba to contain
the spread of AIDS and to provide thorough and comprehensive
medical treatment."

Llanos noted that as of Dec. 7, a total of 863 people had tested
positive for the HIV virus--a relatively small increase each year
since 1986 when 99 people tested positive. Of these people, 249,
or 28.9 percent, were women; 614--71.1 percent--were men. Of the
men, 363 were homosexual or bisexual. Thus, gay men make up a
minority of people with AIDS in Cuba, so the social context for
public health policy is different from that in the U.S.

To date, 84 people have died, 159 are classified as having AIDS
and 620 are HIV positive.

Llanos also noted that only nine people contracted HIV through
blood transfusions--seven prior to 1986. At that time, Cuba
stopped all importation of blood and blood derivatives from
countries that had an incidence of AIDS. Cuba developed its own
AIDS antibody diagnostic test kit in 1985.

Concepcion acknowledged that he was not happy about having to go
to the sanatorium. But he said the sanatorium of 1986 was very
different from the current system that now includes 11
sanatoriums.

"The year I went into the sanatorium we had little hope of being
back on the street. Now everyone goes in and out," he said.
Fifteen days after he went in, a pass system was created, which
allowed people to go out with a chaperone about once a month.
Shortly thereafter, this was expanded to every weekend.

In 1989, the sanatorium policy underwent "a complete revolution,"
Concepcion said. Many people in the sanatorium began to work, and
a system of "garante" (acting responsibly) was launched.

Under the garante system, a multidisciplinary panel of doctors,
psychologists, sociologists and nurses meet with patients on an
individual basis six months after they have entered the
sanatorium and received AIDS education. They determine if an
individual is "garante"--responsible to be out of the sanatorium
without a chaperone. People who are non-garante are chaperoned.

The sanatorium system "has one thing against it, which is it
limits the free movement of people," Concepcion asserted. He said
this too will change, for in the coming months Cuba will give
those in the sanatorium the option of going home.

"The sanatorium will become what we have always dreamed it would
be--a specialized center where someone with HIV can get
specialized medical attention and learn how to live with AIDS,
and have the option of living in the sanatorium or not."

Despite its limitations, the speakers said the sanatorium takes
care of all their medical needs. People with HIV also receive the
same salaries they had before they went into the sanatorium
whether they work or not.

Llanos was asked whether the U.S. government's blockade of Cuba
has affected the sanatoriums. He said that while the rest of the
country suffers from a scarcity of electricity, fuel,
transportation and food, the sanatoriums do not lack these
things.

However, the sanatoriums are beginning to have problems obtaining
some medicines. He also noted that Cuba has to pay three times
the price for AZT it should pay.

Concepcion said Cuba has not been able to obtain ddI or ddC, the
two other drugs that have been approved by the U.S. Food and Drug
Administration for the treatment of AIDS. ddI is manufactured by
Bristol-Myers Squibb. ddC is manufactured by Hoffmann-La Roche.
Cuba is trying to develop its own medicines, primarily
interferons that can interfere with HIV reproduction.

                             -30-

(Copyright Workers World Service: Permission to reprint granted
if source is cited. For more info contact Workers World, 46 W. 21
St., New York, NY 10010; via e-mail: ww%nyxfer@igc.apc.org or
workers@igc.apc.org or workers@mcimail.com.)

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