As Kommersant has learned, the bill developed by the Ministry of Health, which obliges regions to provide antiretroviral therapy to all HIV-infected persons and to provide them with other medical services, did not find support from the Ministry of Economy and of the Ministry of Finance. The bill was drafted according to the instructions of Russian Prime Minister Dmitry Medvedev and should have come into effect in January 2020, but that is unlikely to happen.
In late January, the public examination term of the bill developed by the Ministry of Health, which amends the 323-ФЗ "On the principles of protection of public health in the Russian Federation," has been completed. The amendments enshrined in the article on territorial state programs guarantee the right to medical care for registered citizens not only in the place of residence but also at the place of stay. As noted in the explanatory note, these changes are relevant, in particular, to diseases that are not part of the basic program of state guarantees, including HIV infection and AIDS. "The adoption of the bill will allow full realization of the rights of citizens, including those infected with HIV, to receive free medical care regardless of registration at the place of residence," the document noted. The bill was drafted according to the instructions of the Russian head of government, Dmitry Medvedev, dated December 23, 2017. The statement proposes to "deepen the issue of medical care and supply of medicines to HIV-infected citizens who are not registered in the place of hospitalization ".
Previously, Kommersant reported complaints about problems with getting medical care and medicines for HIV patients who do not have a permanent record, especially in Moscow and the territory of Krasnodar.
"By law, we are required to send such patient to the paid services department or advise him to go for treatment at the place of registration.
But for safety reasons, sometimes you have to go to various tricks and treat the patient in the region where he is at the time of detection of the disease, otherwise he will simply hide from the doctors, explained the head of one of the region's medical institutions of Krasnodar on condition of anonymity. legal field.
Note that HIV service NGOs have welcomed the appearance of the law. In particular, Denis Kamaldinov, chair of the council of the public organization Humanitarian Project (Novosibirsk), called the initiative of the Ministry of Health positive and important and recalled that in Novosibirsk district, people infected with temporary registration can receive medical assistance thanks to decisions of authorities. In addition, the policy of providing medical care to HIV patients, regardless of whether or not they are registered, is conducted by St. Petersburg and the Leningrad Region. "Citizens of the Russian Federation have the right to free observation, examination and treatment if they have a passport, medical policy and SNILS," the St. Petersburg health committee said.
Unregistered people often represent socially unprotected segments of the population and refusal to treat them can aggravate the situation with HIV incidence, the agency added.
According to a government source, "the project was not supported by the Russian Ministry of Finance and the Ministry of Economy of Russia," which "now creates the main difficulty in working on the document": "We have to decide on the future destination of the project ". The Ministry of Economy "Kommersant" reported that the agency "agreed" on the Ministry of Health project in October 2018, pointing out "the possible difficulties of its implementation associated with determining the number of temporarily resident citizens, which should be taken into account when forming territorial programs of state guarantees ". The programs are approved for a period of three years, "and the terms of permanence of the citizens can not exceed a calendar year", noted in the Ministry of Economy. They also stated that a mechanism is needed "to avoid duplication in the formation of programs, since the registration at the place of stay is carried out without the removal of the citizen from the register at the place of residence. At the Ministry of Finance, the "Kommersant" issues were referred to the Ministry of Health, and Kommersant's request that work on the bill was "in progress" was met.
It should be noted that the published bill of the Ministry of Health has criticized lawyers specializing in protecting the rights of people with HIV.
"By proposing a positive initiative, the author of the bill deliberately proposes a discriminatory rule that prevents an HIV-infected person from registering without access to treatment," says the lawyer, head of the Open Medical Club Anna Kryukova. place of residence. "When a law is literally interpreted, citizens of Russia who, due to a number of circumstances, have no permanent and temporary record, can be denied access to outpatient observation and treatment," said lawyer Alexander Ezdakov. recalled, "groups of people affected by HIV can be socially private": "Not everyone can receive temporary registration."
Kommersant interviewed local health ministries and AIDS centers in various regions. Somewhere, it has been observed that unregistered people can only be provided with a counseling service and, in the absence of registration, "patients are encouraged to receive such a record." Anna Kuznetsova, chief medical officer of the Khabarovsk Region AIDS Center, said that "people without a particular place of residence may be registered at a rehabilitation center": "If a person has no registration at admission, it is issued at the address of the medical institution ". A similar situation has been reported in particular in Kazan, Saratov and Belgorod.
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