Advice for Stranded Travellers

posted: 21/04/2010

Some people with HIV, stranded by the air travel chaos following the Icelandic volcano’s ash cloud, are running out of HIV medications. Here’s what to do.

It is very important to provide as much documentation as possible in order to limit the cost to you.

Stuck in the UK?
People with HIV stuck in the United Kingdom who are running out of HIV medication can approach HIV clinics in the UK for medication, but may be charged at the discretion of the clinic. Whether an individual is charged will depend on their country of residence.Find a clinic using NAM's database of services.

If you are from a country in the European Economic Area (European Union plus Liechtenstein, Switzerland, Norway and Iceland) you will not be charged, if you produce your European Health Insurance card. If you cannot produce your card, you will be charged and issued with a receipt, and you can claim the cost when you return home. If you do not have this card, you can obtain one from your country's embassy in the United Kingdom, usually within 24 hours.

If you are stuck in the UK but from a country outside the EEA that has a reciprocal health agreement with the United Kingdom, you will not be charged if you can show your passport. Countries with reciprocal agreements 

If your stuck in the UK and your country of residence does NOT have a reciprocal health agreement with the UK, you will be charged.

Examples of help and BHIVA's advice

In London a number of National Health Service HIV clinics are issuing medication. At the Chelsea and Westminster Hospital for example, individuals needing medication can obtain an appointment with an HIV doctor and will receive a prescription for two weeks’ worth of medication.

Policies may vary at other clinics, and British HIV Association chairman Dr Ian Williams is writing to all HIV doctors in the UK to ask them to be flexible if approached by patients who are not registered at their clinic.

In addition to the cost of drugs, some clinics may charge a fee for the consultation with a doctor.

Stuck outside the UK?
People with HIV from the UK who are stranded overseas can approach local HIV clinics or support organisations for help. You can search for organisations and clinics by country here.

What you pay will depend on the country where you are stuck. If you have the European Health Insurance card, you can use this throughout the European Economic Area to obtain whatever is freely available through the local health system. You will have to pay any local costs that would be normally met by local residents from their own pockets or health insurance, such as co-payments on medicines.

A similar situation applies for countries with reciprocal health agreements. You can check the list and find out what is freely available here  and find general advice for British citizens on health care abroad here.

Get an email/fax from your clinic

Your clinic in the UK should be able to provide a letter, by email or fax, to the foreign hospital detailing what treatment you are receiving and what drugs you need - in particular the correct dosages. Many HIV doctors may be away this week, attending the British HIV Association annual conference in Manchester. If you do not have contact details for other staff at your HIV clinic, you can find them here.

An NHS prescription is not valid overseas and you may need to obtain an appointment with a doctor in order to get a foreign prescription, but this will not be the case in all countries. In some countries it you can buy anti-retrovirals from a pharmacy without a prescription.

Source

Treatment Booklet Updated

posted: 18/03/2010

The latest issue of NAM’s booklet, anti-HIV drugs, is just out. It tells you about each of the drugs currently licensed for HIV treatment in the UK.
 

All the booklets in this series are free to people living with HIV in the UK, or can be ordered through the aidsmap online bookshop for £1.

You can read it online, or download the booklet as a pdf.

Colour HIV drugs chart - new edition

The new edition of their full colour HIV drugs chart (February 2010 edition) is also now available to download as a pdf.

Clinics and HIV support groups
If you work in a clinic or support group in the UK, you can order these booklets for free for your clients and patients. Get in touch with Rose for details on 020 7840 0060 or by emailing her.

For the experts - HIV Treatment Directory
The new edition of the HIV Treatments Directory (28th edition) is also now available.
 

A complete reference guide to HIV treatment and medical aspects of HIV, with A to Z listings and an intuitive layout. Comprehensive information, and details of published research covering topics including:
• starting and changing treatment
• A to Z of antiretroviral drugs
• women's health issues
• drug resistance
• drug interactions and pharmacokinetics
• HIV and genetics
• side-effects
• the immune system and HIV
• prevention of mother-to-child transmission
Plus a full-colour drug chart and CD-ROM.
 

To order your copy, please visit NAM's webshop 
 

People's price

It costs professionals a few pence under £65 but people with HIV can buy it for £12.95 – it’s free but this is the cost of special delivery for this large, heavy book.

The Treatments Directory is excellent but has much more information than most people with HIV want. George House Trust has a copy you can use in our reception area.

HIV Drugs Patent Pool

posted: 18/12/2009

An international agreement to pool drug patents for HIV treatments has just been launched, putting even more pressure on drug companies to give up their monopoly rights to HIV drugs. The idea is to make low cost treatment far more widely available in poorer countries.
 

Unitaid, an international drug purchasing facility, voted for the pool in Geneva this week. It was welcomed by campaigners and the British government, which has strongly backed the idea.
 

Campaigners say millions of lives could be saved by drug companies giving up their patent rights to allow anti-HIV drugs to be produced cheaply by generic manufacturers. It would also allow different companies' drugs to be combined in simple-to-take multi-drug combination pills for people in the developing world.
 

The rich multi-national patent-holding drug companies would get a royalty in exchange while keeping their exclusive 20-year patent rights in wealthy countries.
 

'Victory' for developing world
"The Unitaid decision is a huge victory for those in need of HIV treatment around the world," Diarmaid McDonald, the co-ordinator of the umbrella group Stop Aids, said. "It will help to break down the patent barriers which stop people getting the drugs they need to stay alive. Unitaid and the UK government should be commended for their leadership on this." McDonald said the focus "now shifts to the big drug companies", adding: "It will test the sincerity of their rhetoric on helping the most vulnerable in our world."
 

People Campaigning

A grass roots campaign is asking people to email the ten leading drug multi-nationals with HIV patents to ask them to take the patent pool plunge.

Drug companies divided
"Companies like Gilead and Merck showed real leadership within the industry by speaking positively of the patent pool – they must now go beyond words and contribute their patents to the pool. The pressure will be on others within the industry to follow or to explain why they are willing to turn their backs on an initiative with such huge potential to save lives."
 

A small number of companies have so far shown a willingness to discuss flexibility over their patents, but the British firm GlaxoSmithKline (GSK) – a leading manufacturer of HIV drugs – is not interested.
Andrew Witty, GSK’s chief executive, said this summer that he had reservations and believed the company's price cuts and other initiatives would produce better results.
 

GSK under more pressure
McDonald said there had been meetings with GSK, but stressed that the company was a long way from committing to any involvement. "They have come up with lengthy questions and hesitations and concerns about the patent pool and have been less than co-operative in how they have engaged with the Unitaid task force," he added. "The pressure is going to increase on GSK to justify their rationale for walking away from an initiative which could save millions of lives."

Treatment at the crossroads
The international development minister, Mike Foster, applauded the board's decision. "The international community is at a crossroads in meeting the demand for HIV treatment," he said. "Last year, 2.7 million people were newly infected with HIV and 2 million people died from Aids – the need to make effective HIV medicines affordable for developing countries has never been greater. The Unitaid patent pool could be a key means of addressing the treatment crisis."
 

The UK is a founder member of Unitaid, along with Chile, Brazil, Norway and France. Much of its funding comes from a tax on airlines.
 

Michelle Childs, the policy director at Médecins Sans Frontières, the volunteer doctors organisation that pioneered the use of HIV drugs in the developing world, said the pool would be judged by its outcome. "We've been encouraged by the positive responses from a number of companies to our campaign in support of the pool," she said.
 

"Now that the pool has been given a green light, patent holders need to move from expressions of general support to firm and formal license commitments. We urge them to do so. This needs to happen fast as the clock is ticking for millions of patients."
 

Source

Unitaid report

Guidelines to protect expert HIV advice

posted: 10/11/2009

Expert independent HIV advice to the government should be on a firmer foundation from Christmas. Faith in how the government treats all the scientific advice it asks for and is given, including HIV advice, was rocked when the Home Secretary, Alan Johnson, sacked the chair of the independent Advisory Council on the Misuse of Drugs.

Scientists, HIV experts and others asked themselves - what is the point of advising the government with the best scientific views, if that advice can be treated with contempt and the government also then shoots the messenger?

Guidelines by Christmas
Now the science minister, Lord Drayson, has committed the government to producing guidelines by Christmas to ensure the independence of its scientific advisers. The move comes after ministers faced days of criticism from senior scientists, MPs and commentators, over the sacking of the independent chair for drugs advice, David Nutt.
 

A bit of sacking background

Home Secretary Alan Johson sacked Professor Nutt after he overrruled the Advisory Council for the Misuse of Drugs' advice and made cannabis crimes more serious by moving cannabis from grade C to grade B. Nutt is an academic professor who writes articles in academic journals and gives lectures. Johnson stamped his foot like a toddler when Nutt carried on giving the same advice in an article and lecture, and sacked him, claiming academic articles and lectures are 'campaigning' against government policy. Most people can see this for what it was - a professor doing his job and asserting the truth of independent scientific advice. This sacking was not Johnson's finest political moment - perhaps he felt threatened because his explanation for rejecting the panel's scientific advice was so weak.   

"What's happened is that the dismissal of Prof Nutt and the circumstances around that has upset, rightly, the scientific community and led to a lot of concern," said Drayson. "The government understands the importance of independent academic advice."
 

He said the events of the past few days had brought the concerns of scientists and their relationship with government to the top of the agenda. "If I had been consulted by the home secretary [before he sacked David Nutt], I would have had an opportunity to have said to him that there is a rumbling concern within the academic community with regards to the independence of scientific advice."
 

Smoothing ruffled scientific feathers

Science minister Drayson was in Japan last week when Professor Nutt was sacked, and returned to the UK on Tuesday. He has spent the past few days in meetings with cabinet colleagues, government science advisers and members of the scientific community in an attempt to find out why he was not consulted about the sacking, and how the government can undo the collapse in confidence it has caused in providing government with scientific advice.
 

The science minister's first response, leaked in an email earlier this week, was to say he was "pretty appalled" by the decision. But he later said that both the home secretary and the prime minister had assured him they understood the importance of independent scientific advice and academic freedom.
To remedy the situation, Drayson said he would take forward the guidelines now issued by senior scientists to keep scientific advice free from political interference.
 

Science advice guidelines

More than 20 academics drafted the guidelines, which they said "would enhance confidence in the scientific advisory system and help government to secure essential advice". Signatories included the former chief of the Medical Research Council Colin Blakemore, former government chief scientist Robert May, the president of the Royal Society Martin Rees and the director of the Science Museum Chris Rapley. In addition, there are chairs and other members of independent scientific advisory committees and the heads of several academic and research bodies.
 

Dealing with disagreement with government
The guidelines argued that "disagreement with government policy and the public articulation and discussion of relevant evidence and issues by members of advisory committees cannot be grounds for criticism or dismissal." When scientific advice is rejected, the experts said, the reasons should be explained explicitly and publicly.
 

Drayson welcomed this. "I think what's important now is that some good comes out of this. That means me working inside government to make sure that these points are understood, come out and very clearly reassure people. These principles that have been set out are a very helpful foundation."
 

Other proposals to safeguard advice
Among the ideas he will examine are the publication of all scientific advice, regardless of whether the government decides to follow it, and setting up an independent press office for science advisory committees to communicate their ideas directly to the public.
 

The minister will work with the signatories of the guidelines and the science advisory network in government, under chief scientist John Beddington, to come up with a clear set of "rules of engagement" by Christmas. "This incident has highlighted that people are not as clear as they need to be and that lack of clarity is on both sides."
 

Government decides but must explain
He said scientists also had to change some of their views of government. "A small number of scientists have gone on the record in the past few days and said the government has to take scientific advice. Well, with respect, it doesn't. Government has to get the best possible scientific advice it can and then government needs to reflect carefully on that advice, then it is the role of ministers to make the decisions. What they have to do is explain why they have made those decisions. And, if it differs from the advice they've been given, to explain why."
 

Protecting HIV advice
The department of health is advised on national HIV policy by the Expert Advisory Group on AIDS (EAGA), made up of some the country’s top HIV experts in community, health and social care organisations. It’s an advisory non-departmental public body which is non-statutory. The Advisory Council on the Misuse of Drugs has a stronger position – it was set up by Parliament, so it cannot be abolished.
 

EAGA was established in 1985 with the following terms of reference: "To provide advice on such matters relating to HIV/AIDS as may be referred to it by the Chief Medical Officers of the Health Departments of the United Kingdom".

It publishes on the EAGA web-pages its agendas and meeting minutes and other material, such as recent advice on PEP (post-exposure prophylaxis - treatment with HIV drugs for one month, starting immediately after exposure to HIV, in order to prevent HIV infection).
 

More about the Draft Scientific Advice Guidelines
 

Source 
 

Foil for Injectors

posted: 28/09/2009

'Harm Reduction' is the name given to anything that reduces health risks. For years injecting drug users have been provided with clean needles and syringes and this has helped keep the number of people with HIV from injecting drug use in Manchester and the rest of NW England low. Just 2% of HIV infections in the region came through injecting drugs, 118 people. This is far less than in Scotland and many other countries in Europe.

Now there are moves to provide aluminium foil as an alternative - the foil is used for smoking heroin and this is safer than sharing and using needles and syringes.

Drug treatment experts say that inhaling heroin instead of injecting reduces a user's risk of contracting HIV and Hepatitis C. A drug user heats a blob of heroin on the foil and smokes the fumes - which is called "chasing the dragon".

drugs paraphernalia and police

The Advisory Council on the Misuse of Drugs (ACMD) is examining whether the law should be changed to allow Britain's 300,000 problem drug users to receive foil as a way of protecting their health. Since last year, the ACMD's 31 members, who advise the Home Office, have been considering whether section 9A of the Misuse of Drugs act, governing "paraphernalia" or equipment used in the consumption of illicit substances, should be amended to allow the UK's network of needle exchanges to supply foil. At present, it prohibits the supply of "articles to be used for the preparation or consumption of illicit drugs".

Foil ban criticised

Critics say the ban endangers users' health because most drug workers are too afraid of being prosecuted to risk giving out something that many see as a sensible harm-reduction measure. An estimated 100 of England's 1,300 needle exchanges already defy the law by providing foil. Some have even had tacit support in the form of "letters of comfort" from their local police force, such as Avon and Somerset, which emphasises that it does not see the pursuit of section 9A as a priority.

The ACMD's technical committee has held two private evidence-gathering sessions on the subject with with Jamie Bridge of the International Harm Reduction Association, which backs legalisation, and drugs treatment researchers Neil Hunt and Rachael Pizzey. It is due to hear on 29 October from veteran Dutch drugs worker John-Peter Kools, who has issued foil in the Netherlands. Both Holland and Spain issue foil through needle exchanges without any major problems.

The full ACMD is to debate the issue in November and is expected to suggest setting up a pilot study on the effects of foil provision. It hopes to advise ministers of its views soon – possibly before the end of the year – on whether the law should be changed. Bridge said: "Smoking drugs is by no means safe, but is a great deal safer than injecting drugs – which is particularly associated with overdose, blood-borne viruses, drug-related litter, greater dependency, abscesses and vein damage.

police edging closer to foil acceptance

"The law has unintentionally put us in a strange position whereby we can give someone clean needles to inject with, but we face arrest for giving them aluminium foil to smoke with. Providing foil in this way is such a common-sense approach – with huge potential benefits and little opposition or potential costs – that we hope the law will change soon." Significantly, the Association of Chief Police Officers, which represents the country's most senior officers, is neutral on whether the law should be amended. But it would support a change if the ACMD recommended such a move on public health grounds, sources told the Observer.

Harry Shapiro of Drugscope, which represents 800 drug projects, said: "It's important to do everything possible to discourage Britain's 300,000 problem drug users from injecting their drugs, and we should allow injecting heroin users to be provided with foil as part of a harm-reduction programme. As the law now stands users' health is being compromised and it would be better if section 9A was repealed."

But James Brokenshire, the Conservative shadow home affairs minister, said: "I'm cautious about these sort of moves, which progress harm reduction rather than focus on getting people drug-free. In recent years there has been insufficient focus on getting people off drugs and too much on just maintaining people on drugs through methadone and other measures.

"I would need to be swayed that there are clear and compelling public health arguments to make such a change [in the law]. I want to promote abstinence-based rehabilitation. There needs to be a greater emphasis in getting people off their drug habit rather than maintaining their addiction."

Paul Hayes, the chief executive of the NHS's National Treatment Agency, which funds drug treatment, said: "Any way of using heroin is dangerous and likely to lead to addiction. However, injecting the drug is far more dangerous than other means of ingestion, such as smoking. Currently, the provision of foil is not legal. The NTA cannot advise drug treatment services to follow a course of action which is illegal and could have adverse consequences for provider services."
 

Source

Legalise It - former Chief Constable Tom Lloyd writes about legalising all recreational drugs instead of continuing the failing 'war on drugs'