Abstract
BackgroundUndocumented migrants in Israel, mostly originating from HIV endemic countries, are not covered by Israel’s universal healthcare coverage. We initiated a Public-Private Partnership (PPP) to handle this public health and humanitarian challenge. The PPP venture included the Ministry of Health (MoH), pharmaceutical companies, pharmacies, and specialized HIV clinics, the Israeli HIV Medical Society (from the Israel Medical Association), and non-governmental organizations. This study describes the national policy process in conceptualizing and implementing access to HIV services for undocumented migrants through a PPP, and analyzes the preliminary results.MethodsThis case study describes the process of creating a temporary Public-Private Partnership to provide HIV care for undocumented migrants based on institutional records of the Department of Tuberculosis and AIDS (DTA) and memories and reflections from partners.This case was analyzed according to the OECD-DAC criteria for development assistance (relevance, effectiveness, efficiency, sustainability and impact). Demographic and serological data of patients referred between 2014 to 2018 were collected to monitor progress. and analyze preliminary medical and biological outcomes. Ethical approval was obtained from the Ministry of Health.ResultsCreating a policy to extend HIV care to undocumented migrants was a 15 year process that confronted several challenges within Israeli and international discourse, particularly concerning governmental response to the migration crisis. The use of a PPP model involving numerous stakeholders provided a solid, local feasibility demonstration that extending HIV care as a matter of policy would have positive implications for public health in Israel. During the first 2 years of the program (2014–2015), the MoH funded medical follow-up and the pharmaceutical companies provided antiretroviral treatment (ART) free of charge for only 100 patients at any given time, in addition to ART provided by the MoH for pregnant women. Since 2016, the MoH has fully covered this service and integrated it within the Israeli health system; this constitutes the major success of the PPP program. As of December 2018, the national program has monitored 350 patients and treated 316 (90.3%). The most prevalent disease present upon referral was Tuberculosis.ConclusionsTo our knowledge, this study documents the first example of a successful PPP with government partnership in a high-income country to address undocumented migrants’ lack of access to health services in general and HIV care in particular. In light of the intensification of North-South migration, this Israeli case study could be useful for other countries facing similar challenges. It also has lessons within Israel, as the country grapples with other health problems among uninsured communities.
Highlights
Migration remains a controversial topic, and health issues of migrants are often used as a pretext for discrimination [1]
To our knowledge, this study documents the first example of a successful Private Partnership (PPP) with government partnership in a high-income country to address undocumented migrants’ lack of access to health services in general and HIV care in particular
This paper offers a case study of how government office initiated a partnership in a PPP in Israel which increased access to antiretroviral treatment (ART) for HIV-positive undocumented migrants
Summary
Migration remains a controversial topic, and health issues of migrants are often used as a pretext for discrimination [1]. This is true regarding HIV/AIDS, a disease which is itself highly stigmatized. The Global Fund to Fight AIDS, Tuberculosis and Malaria (TGF), financed by high income countries, was created to improve access to prevention and treatment for HIV, Tuberculosis (TB) and Malaria in high-endemic, lowincome countries [3]. Undocumented migrants in Israel, mostly originating from HIV endemic countries, are not covered by Israel’s universal healthcare coverage. This study describes the national policy process in conceptualizing and implementing access to HIV services for undocumented migrants through a PPP, and analyzes the preliminary results
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
