Get drugs, the daily odyssey that exacerbates the Venezuelan shortage

Maduro government policies have compounded the shortage and the exodus of doctors

CARACAS – "There are no blockages, drugs have not entered

Venezuela

because you stole money from the people. "The denunciation of the president in charge,

Juan Guaidó

, contains some of the answers to the big question amidst the challenge with humanitarian aid as a protagonist. One question (why are there no medicines in Venezuela?) To which its citizens have responded with force over the years: corruption, mismanagement, lack of foreign exchange caused by the control of the changes, the closing of 'pharmaceutical factories, smuggling and triangulation, military management, continued failure of health ministers …

The loop closes with the tactics of the ostrich, so Bolivarian: by not recognizing the reality, his diagnosis and remedies are always wrong. This is the key to the 85% shortage in the country that has the largest reserves of crude oil: it finds only 1.5 out of ten drugs sought. A process that, only time and research, will be able to quantify the victims who have caused and already count in the thousands, according to NGOs and local experts.

Corruption The army landed at the Ministry of Health in 2007, with the appointment of Colonel Jesús Mantilla. "She launched the repackaging plan of more than 50 public hospitals and, ten years later, supposed work, some of which had not even started yet, ranging from infrastructure to equipment and reagents," he said. he explained. the same practice of corruption in other sectors of the economy, "said Feliciano Reyna, founder of Codevida, a plan that has forgotten the sick and professionals: Venezuela lost 50% of its doctors and 30% of its nurses.

Change control. Venezuelan pharmaceutical companies do not manufacture raw materials that are imported, processed and processed into medicines. The dependence on imports is absolute and, therefore, also the system put in place by the government to allocate foreign currency to importers. A mechanism contaminated by corruption that, according to Jorge Giordani, economic vice president of Hugo Chávez, would have resulted in embezzlement of 400 000 million dollars. Since the "supreme commander" established in 2003 the control of foreign exchange on the Venezuelan economy, the manufacturer buys the dollars to the State with its bolivars and makes the payment of the imports; the famous Cadivi replaced later by the Cencoex. When the State approves the operation, the laboratory can import the raw material. The order is managed, the rates are paid and the government issues the corresponding payments in less than one month.

Economic crisis In 2012, the state began to accumulate failures with airlines, merchants, businessmen as well as foreign pharmaceutical companies, to which it accords the same treatment as the others. The debt of domestic companies as well as transnationals to their overseas suppliers is increasing with this very fundamental sector until reaching the figure of 5700 million dollars. Lack of supplies enters pharmacies and hospitals.

Regulated prices Article 8 of the Price Regulation Act includes "molecules" (active ingredients) in the group of frozen price products. Thus, a box of eight tablets of the famous omeprazole gastric protector cost two cents, the same as the 30 tablets of Glucofage against diabetes. Government taxes put the industry on the ropes and before the losses (the manufacture of these drugs is more expensive than their selling price) minimizes the manufacture of these remedies.

The shortage is triggered. In 2014, 60% were achieved and in 2016, 85%, both in common use drugs and in high cost treatments.

Without funding. In September 2016, all payments abroad were stopped. If the raw material is not paid, how can one make drugs?

Red alarm in chronic patients. In 2016, the state reduced the list of priority drugs to buy and excluded more complex chronic conditions: bad cancer, multiple sclerosis, psychiatric disorders, arthritis, hemophilia, transplant, dialysis, HIV, palliative treatment … "Frenazo por full of arrival products," recalls Reyna.

Pharmaceutical closure. The debts and the defaults weigh heavily on the industry: of the 56 existing pharmaceutical factories, only 15 remain, after the expropriation and the closure by contamination of SM Pharma.

Cuban solution The government has awarded drug offers to the military, which is close to the government and is buying expensive international goods. Prices are multiplying in pharmacies, which is so palpable scarcity. From smuggling to the border, which included drugs at ridiculous prices, we go to triangulation: it is sold at a very low price abroad and it is bought much more expensive.

Consequences. The sick and the hospitals, which undergo the same process of supply, become the big losers of the Bolivarian hurricane. The direct victims of the disaster are 140,000 cancer patients, more than 300,000 with cardiac diseases, 300,000 chronic patients, such as Parkinson's disease and hemophilia, and 79,000 with HIV. They stop receiving treatment since 2016 or receive it intermittently, with all that it entails for worsening their health. The "diet" is so serious that some have been forced to resort to veterinary drugs.

Infectious diseases

• The crisis in Venezuela is accelerating the resurgence of malaria, Chagas disease, dengue, Zika and other dangerous infectious diseases, and threatens to derail twenty years of progress in public health, warned experts in a study published in the journal The Lancet Infectious Diseases.
• The researchers say that it is possible that epidemics spread beyond Venezuela's borders, which could cause a regional health emergency.