Israeli doctors say refugees HIV treatment is discriminatory and 'worse than no third world'

Refugees with HIV in Israel are subject to serious healthcare discrimination compared with citizens and can often only access outdated treatment with potentially severe side effects, according to a report this week.  

Doctors told Haaretz that some refugees are receiving drugs that have not been administered to Israeli patients for decades and leading to painful side effects for the patients. 

"It's not just a difference between life and death. It's a difference between life and death in agony," said Doctor Itzik Levy to Haaretz, director of the AIDS clinic at Sheba Medical Center, Tel Hashomer.

"The treatments currently given to undocumented carriers are ones that are no longer used - not even in third world countries."

One of the drugs a significant proportion of undocumented carriers are using is Zidovudine (AZT). 

According to the British HIV Association's guidelines for treatment, it should "be considered in certain specific circumstances" and can cause "myelosuppression [reducing bone marrow] and anaemia". 

While Israeli carriers are treated upon diagnosis, an undocumented carrier who tests positive for the disease will only be monitored and treated after their immune system activity falls below a certain threshold.

They are entitled to a test that monitors their immune system activity only once a year, while Israeli patients are entitled to quarterly tests. 

In 2016, Israel's health ministry launched a national programme to treat undocumented HIV carriers, with more than 500 passing through the scheme and 350 still receiving treatment. Before this, undocumented carriers received no treatment. 

An undocumented HIV carrier who spoke to Haaretz said: "My body does not react well to the pills.

"They cause me pains, exhaustion, and an accelerated heartbeat. When I take them I am afraid to leave the house and I simply prefer to forgo that on certain days."

The HIV-positive patient was an undocumented migrant who travelled to Israel from Ethiopia around 25 years ago. 

She said the medications she needed were not included in the health ministry's programme but was told they could be bought privately.

"I don't know which medication I will be receiving in another month or two. Sometimes I just switch treatment," she said. 

A statement from the Israeli health ministry said: "The use of medications other than those stipulated in the guidelines would raise the cost of the programme by several million more shekels or would bring about a significant decrease in the number of patients who can benefit from the programme."