The Health Ministry will reduce funding for AIDS prevention in the Ethiopian community in January 2015, Haaretz has learned.
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Eleven nurses have already been dismissed from hospital AIDS centers, along with social workers and community coordinators. Condoms will no longer be distributed to HIV carriers and payment for travel expenses to AIDS centers for patients will also be discontinued.
Ruth Weinstein, head of the Health Ministry’s department for health education and promotion, wrote in a letter last month to hospital AIDS center directors informing them of the cuts. “Unfortunately, due to a significant cut in budget of the department for health promotion, we cannot continue to fund the services we have funded until now,” she wrote.
The treatment project for HIV carriers and people stricken with AIDS was launched in 1997 to reduce infection in the Ethiopian-Jewish community, many of whose members were uninformed about the disease. The instances of infection and death were particularly numerous in that community at the time.
The health care system had great difficulty establishing a treatment program due to issues of language, culture and poverty among patients as well, as well as lack of acceptance of diagnosis and treatment.
Today, a treatment program exists in eight AIDS centers in hospitals (which treat any HIV carrier or AIDS patient). Within the network is a dedicated unit that deals with Ethiopian Jews, who make up less than 2 percent of Israel’s population yet account for about half of the country’s 6,000 carriers of the virus.
The unit for treatment of patients of Ethiopian origin includes three to four professionals in each hospital, including doctors, nurses, social workers and community coordinators.
The community coordinators are Ethiopian-Jewish women who have been trained as liaisons between the community and the patients, and their job is to locate potential carriers and follow up assistance to patients. An assessment written in September at the request of the ministry’s health promotion department called the coordinators “a critical resource that is irreplaceable in the foreseeable future.”
Treatment programs worked
According to the Israel AIDS Taskforce, there has been a significant improvement over the years in Ethiopian Jews’ readiness to get treated for the virus, which means their response to treatment has improved greatly as well.
The taskforce says the response rate in the community to treatment now stands at 90 percent, as opposed to 20–30 percent in the past.
“This is a very important system. The way it works today, we are dealing very well with patients and achieving therapeutic success. But damage to this system would be critical,” said Dr. Michal Hovers, chairwoman of the Society for AIDS Medicine and director of the Infectious Diseases Unit at Meir Hospital, Kfar Sava.
“There are a lot of patients who do not speak the language or whose socioeconomic status is not high. Some won’t come if they do not get reimbursed for transportation,” she added.
Considering the challenges facing the community over language, culture and socioeconomic conditions, Hovers said it would be all too easy for its members to miss out on prevention, diagnosis and, when necessary, treatment. Sometimes all it takes is to cancel transportation reimbursement, she noted.
“This is a disease in which changes and advancements in treatment are very rapid, and therefore it’s very important to maintain ongoing communication between patients and specialists,” she said. “The feeling is that the Health Ministry is cutting where it’s the easiest and quickest; the people who were dismissed were women who did not have tenure. Transportation reimbursements are also a negligible amount for the ministry. Patients only have to come every few months for check-ups and it’s an outlay that’s difficult for most of them.”
The Israel AIDS Taskforce said in response, “The dismissal of the coordinators, nurses and social workers is a mortal blow to the struggle to prevent the spread of the virus, and could lead to the loss of years of successful work, which reduced the infection rates from HIV among members of the Ethiopian community.
"The dismissals of the nurses, coordinators and social workers, and cutting funding of preventive measures and travel reimbursements for people who cannot afford these expenses, will compromise the health of community members who live with the virus, and could add more to the circle of people living with HIV.”
The Health Ministry confirmed that the funding had been cut but added that “the health minister is working to have the funding restored.”