Sunday, June 13, 2004

The Seattle Times: Nation & World: AIDS patients, families in Mexico recycling unused drugs

The Seattle Times: Nation & World: AIDS patients, families in Mexico recycling unused drugs

Sunday, June 13, 2004, 12:00 A.M. Pacific

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AIDS patients, families in Mexico recycling unused drugs

The Associated Press

MEXICO CITY - Jose Clemente, who restores artworks in Mexico's capital, has never met Daphne Rivera, a Brooklyn health educator. But medicines donated by Rivera are keeping Clemente alive.

From Mexico to Mauritania, India to Iran, patients in poor countries have to piece together drug cocktails helping to prolong their lives using HIV and AIDS pills donated in the United States.

Americans give away their pills after they switch medications or while taking physician-encouraged drug holidays. Others are donated by friends and family members of U.S. patients who die.

U.S. authorities won't take back unused drugs once they have been prescribed because of fears about tampering. Giving away leftover pills to individual Americans is against U.S. law, but medicine can be donated to designated nonprofit groups for shipping out of the country as humanitarian aid.

Clemente found out he had HIV, the virus that causes AIDS, in 1994, and has received donated U.S. pills for four years. Every two months, medications sent from New York through Dallas arrive in the 36-year-old's apartment on Mexico City's western outskirts.

"I have many things I still want to do with my life," he said. "My medication is giving me the time I need to do them."

New York-based Aid of AIDS and other U.S. nonprofit groups pair American patients willing to donate with people in need.

"It's easy to give away pills you aren't using. But for the person getting them, it's really life or death," said Rivera, 34, who was diagnosed with HIV in 1992 and has donated drugs to Aid for AIDS for the past eight years.

Aid for AIDS doles out recycled medications to 350 patients in 16 countries in Latin America, the Caribbean, Africa and the Middle East.

"Donations from 20 to 30 people can provide one year's worth of medicine for one patient," said George Fesser, the group's director of recycling. "Relying on leftover medication, we don't have a consistent stream. We have little trickles, and it's up to us to create the proper drug regimens for the proper patient."

About 85 percent of the medications Aid for AIDS receives are unopened, and health professionals check those that have been opened for problems before shipping them overseas, Fesser said.

Dr. James Fitzgerald, an AIDS specialist for the Washington-based Pan American Health Organization, said his group works with several organizations that deal in donated drugs, but they have never received a report of those pills doing harm.

"Both (nonprofit groups) and the patients themselves are very careful," Fitzgerald said.

In Geneva, the World Health Organization produces guidelines for donated drugs, but also has not documented any cases of secondhand AIDS medications hurting patients.

The situation in Mexico is better than in most of the developing world. President Vicente Fox has promised to provide free treatment and drugs to all Mexicans with HIV and AIDS. But even here, thousands have fallen through the cracks.

Gerardo Garcia, a caterer in the northern city of Monterrey, has been taking recycled U.S. medications since learning he had HIV in 1996.

"The government of Mexico has medications for some patients, but the corruption, the bureaucracy, they are killers here," the 42-year-old said. "You go to a clinic, and they say, 'Go figure, we've run out of your medication.' "

Not everyone taking donated medications gets them from established nonprofits, however. Thousands of Mexican patients — especially those closest to the U.S. border — rely on individuals or groups who don't bother to register with the Mexican government because they don't want to face the bureaucracy, or because they have a specific person or support group they want to support.

Bypassing official channels, they pack thousands of dollars worth of donated medications into their cars or suitcases and drive or fly them into Mexico. Carrying pills across the border without a prescription is prohibited, but customs agents who don't confiscate the hidden medicines simply force the driver to pay a fine or import duties.

Some health authorities argue that smuggling does more harm than good because it can start patients on medication regimens they can't finish. The next time they start taking available drugs, their body has formed a tolerance.

Those slipping prescription drugs across the border shrug off such concerns.

"You try telling someone who has their pills today not to take them because tomorrow they may not have any," said Emilio Velasquez, who carried AIDS drugs from San Diego into Tijuana for 14 years. "You have to make sure everyone is getting medication now, or they might not be around to worry about the future."

Rene Garcia, a 62-year-old radiologist, said he flew from Mexico City to San Francisco regularly for a decade, returning with suitcases full of AIDS drugs donated by U.S. hospitals.

"If they opened my bags, and found the medicines, I left them with customs because I couldn't afford to pay the taxes," said Garcia, who has the AIDS virus. "But most of the time they didn't find them."


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