Informal market plays a role in distributing antiretrovirals but exposes clients to risks

The informal market in antiretrovirals (ARVs) in Chile is poorly documented but is perceived to be growing and exposes clients and vendors to several risks, according to a paper presented by Christian Morales of the Montreal University, Canada, and the Chilean Drugs Access Initiative.

Morales said the informal market takes many forms. One is that individuals go to Spain or Argentina and buy drugs there, some of which they use themselves and some of which they sell to raise money to buy more drugs and so continue the cycle.

The other main way the informal market works is that some people get free drugs but choose to sell them to raise money to buy food; they choose a higher quality of life for a shorter period of time, over a longer poorer-quality life.

The informal market constitutes major public health challenges, reported Morales and colleagues. Clients are exposed to ARVs from doubtful sources, which may be of sub-optimal quality. Discontinuity of supply may cause resistances. Patients don’t receive adequate counselling and are exposed to stress.

Vendors selling their own ARVs undermine their health and may also develop resistances.

Morales told the conference that Chile treats 81% of people who need treatment in a mixed public and private health system. The researchers recommend the universal provision of ARVs.

C Morales, A Brousselle, and the Chilean Drug Access Initiative ANRS Study Group. Chile’s Informal Market for Antiretrovirals (ARV). Features, Challenges and Lessons for Optimal Regulation. XIV International AIDS Conference, Barcelona, 7-12 July. Abstract ThOrE1423