Access to medication for children
(10/07-2007) The Norwegian Helsinki Committee is concerned about children's rights in Kosovo, particularly the access to medicine. As part of its human rights monitoring work in Kosovo, the NHC visited the Roma, Ashkali, and Egyptian (RAE) community in Fushë Kosovë / Kosovo Polje in March 2007. One case in particular raised several concerns.
In this case, three-year-old Fisnik (not his real name) was diagnosed with diabetes when he was 1½ years old. He has since required regular insulin injections as well as twice monthly tests to determine the appropriate insulin dosage. The family—father, mother, and three children—are unemployed and receive the state-allocated social assistance available to them, which is 65 Euro a month. The two tests per month cost 25 Euro a piece, and the insulin about 9 Euro a week, which means that the child's treatment alone is more than their total social assistance allowance.
The Ministry of Health has a list of state-funded and state provided medications. Insulin is included on that list. When the family requested that the insulin be provided free-of-charge, however, the Fushë Kosovë / Kosovo Polje municipal health center informed them that they do not have enough medications to provide everyone with insulin, so they cannot cover Fisnik’s needs.
In subsequent interviews with the municipal health center it appears that although patients who require insulin injections should be covered by the state health care system, the central Ministry of Health authorities do not provide sufficient insulin to service their entire community. In fact, municipal authorities only receive about one-third of the required vials of medication to service their patient population. Consequently, there is concern that an ad hoc practice of distribution of insulin has taken shape, with authorities informally determining that the best way to address the shortage is to give all patients “a little bit” of the supply.
The Norwegian Helsinki Committee is concerned about the ad hoc nature of such a practice and the risk of arbitrariness in decision-making resulting from such a policy as well as the medical soundness of such a solution. According to the Convention on the Rights of the Child, the best interest of the child must be applied as a primary concern in all actions concerning children. In the case of shortage of Insulin, the prioritization of children before adults should be considered. The Committee also has concerns that the central authorities have failed to respond to the municipality’s concerns, forcing them to construct such informal policies for addressing the needs of their patients. Furthermore, it appears that because of the limited supply of insulin some patients have had to approach private clinics to buy the necessary dosage—an option that is not only more costly, but that risks placing individuals at the mercy of private clinic policies.
The Norwegian Helsinki Committee will continue to work with the Ombudsperson Institution, domestic and international NGOs, and representatives of the United Nations and the Organization for Security and Co-Operation in Europe (OSCE) in Kosovo to ensure that more substantial research into the situation is conducted so that a timely and transparent solution is found for this little boy as well as other diabetes patients in Kosovo.