The Scottish Medicine Consortium (SMC) decided on the 10th of April that National Health Service (NHS) will fund the purchase of Pre-exposure prophylaxis (PrEP), a drug which reduces the chances of an individual contracting HIV by more than 90 percent, at a cost of 450 pounds per month for each person.
Deborah Gold, National Aids Trust (NAT)'s chief executive, declared that this prevention "turn Scotland into a model internationally of how to do HIV prevention well", in contrast with "delays in other three UK nations". But in contrast above all with other countries which still restrict the entry, residence and stay of foreigners who are HIV-positive (such as China and Australia for the long-term period stay, or Singapore and Russia even for the short period stay).
Health as a human right
Ross Clark on "The Spectator" asked: "How can NHS Scotland afford to fund an HIV drug?" However, beyond the money, it must be considered that health is a human right. Also for people who live in close contact with an Hiv Positive person.
Mervyn Susser, the renowned South African doctor and activist, defined health as a positive right, contrary to other negative rights in which society cannot interfere: in the case of health, the society aims to confer a benefit by promoting it.
The key is the equality, that means equal access to appropriate services - Susser said. Of course, equality is an ideal: "Unavoidable impairment bars some individuals" Susser specified. Yet, it must be pursued.
British National Health Service
The question of Susser is how. In a 1993 essay, he pinpointed three broad approaches: 1) centralised state-financed system, such as in Cuba; 2) centrally financed but local administered state system, such as British National Health Service; 3) a national comprehensive insurance system, such as in Costa Rica.
According to him, "the British National Health Service achieved equity between social classes in service but failed to achieve in health states (as measured by mortality). Deficiencies in commitment to public health services contributed largely to this failure."
Something from 1993 has changed. It still remains the problem of how a State can afford equality with health service.
The right to life
The answer would be to consider the right of health as a part of the right to life. A resolution of the Constitutional Court of Ecuador, in 2004, related to the National prevention and treatment of HIV affirmed that "the State must take precaution to safeguard the right to health and that the right to health also forms part of the right to life. (...) By not providing an immediate, diligent and effective solution, the Ministry of Public Health caused serious damage to the quality of life of those suffering from HIV/AIDS".
According to this definition, Paul Hunt, professor and member of the Human Rights Center, doesn't agree with Susser that health is only a positive right. "The right includes freedoms - stated Hunt in 2006 - such as the right to be free from discrimination and involuntary medical treatment".
As a conclusion, a person should be able to decide if take or take not the drugs.
Not in all country
Unfortunately, it is difficult to think about the public financing of this drug against HIV in all countries.
American anthropologist and physician Paul Farmer wrote in 2001 about AIDS: "Efforts to treat AIDS and multidrug-resistant tuberculosis in areas such as Africa and Haiti, which lack a health care infrastructure, are dismissed as "unsustainable" or "not the appropriate technology".
"Excellence without equity - concluded Farmer - looms as the chief human rights dilemma of health care in the 21st century".
