MIDDLE INCOME COUNTRIES

RECLASSIFIED
LEAVING NO ONE BEHIND?
G r a c i a V i o le t a Ros s
B o liv ia n Ne t wor k o f Peo p le L i vin g w it h H I V / A I D S
(REDBOL)
U N I TAI D B o a r d M e m b e r, C o m m u n it i e s L i vi n g w it h
t h e D is e a se s
@ Ros sQ u i r o g a g r a c iavio le t a @ g m a il. c o m
London, March 24th 2016

THE UNETHICAL AND ARBITRARY FALLACY

OF THE MIC CATEGORIZATION IN LATIN
AMERICA
The World Bank (WB) categorization does not reflect the
inequalities at country level. The WB has acknowledged
the limitations inherent in using GNI per capita for
comparing different economies.
The WB categorization has consequences on pricing
policies and voluntary licensing of essentials medicines
(e.g. Mexico pays $2,391 ppy for an antiretroviral fixed
dosed combination available at $143 ppy in LICs)

75% of worlds poor live in MICs.

In Europe and the US, what about migrant populations?
Do the WB categories capture their realities?

THE UNETHICAL ARBITRARY

FALLACY OF THE MIC
CATEGORIZATION IN LATIN AMERICA

In the US 1 person with an income of $11,770/ year ($32/day)

is considered to live under poverty and can access
government aid. In our countries, 1 person with an income
of $2.86/day is considered middle income and
therefore, stops receiving international aid.
For example, OECD (Organization for Economic Cooperation
and Development) classifies Mexico and Brazil as UMIC
(Upper Middle Income Countries), therefore ineligible for
international aid, including the Global Fund.
Mexico and Brazil have incomes of $12,000/year and
$13,000/year respectively, below the poverty lines in the US

BOLIVIA BECOMING MIDDLE INCOME

2010: World Bank announced Bolivia is a Lower Middle Income Country

http://
www.bbc.com/mundo/economia/2010/08/100810_0235_bolivia_banco_mund
ial_gz.shtml
2010: DIFD Office in Bolivia closed in 2010
http://www.boliviainfoforum.org.uk/news-detail.asp?id=32
2013: IBIS asked to leave Bolivia
http://ibis-global.org/press-release/ibis-asked-leave-bolivia /
2013: USAID expeled from Bolivia
https://
www.usaid.gov/where-we-work/latin-american-and-caribbean/bolivia
2015: HIVOS closed office in Bolivia and moved to regional office in
Costa Rica
2016: Global Fund currently funding AIDS, TB and Malaria about to
approve a new Country Proposal with funding ceiling for next round: $
41 million for the 3 diseases, only $ 7.5 for HIV.

BOLIVIAS INVESTMENTS ON
HEALTH (6.99% OF GDP)

THE CASE OF WOMEN AND

GIRLS

Bolivia has good laws (gender based violence, political

participation) that protect women and girls on paper
Women and girls continue to experience gender based
violence and all kinds of gender inequality. On the
International Womens Day, womens organizations
demanded: Budgets for gender equality, Ministerial
Offices for the implementation of womens equality plan,
access to justice, full participation including in budget
allocation, guarantees for womens rights advocates,
recognition of womens organizations as a key actor of
development, law review, recognition of the economic
contribution of women to the national economy, prompt
action for political violence
file:///C:/
Users/HP/Downloads/PRONUNCIAMIENTO8demarzode2016148.pdf

WOMEN AND HIV/AIDS

Bolivias GDP investment on HIV in 2014: 5.200.000 de Bolivianos

(aprox. $ 761.387,85).

Global Fund investments in HIV/AIDS 10 million USD/year.

Women and girls are not considered a key population for HIV in
Bolivia according to UNAIDS reports.

Women only access HIV prevention services if pregnant, in sex work

or drug use.

Activities for women in the AIDS response are: universal testing for
pregnat women, mandatory testing for female sex workers, and
provision of medications for women living with HIV. Most of these
activities are funded by the Global Fund.

Women are a diverse group with multiple layers of vulnerabilities:

indigenous women, rural women, young women, transgender
women, sex workers.

When leaving Bolivia, donors are abandoning women and girls and
forcing us to compete among Civil Society groups for the label of
vulnerable.

WHAT WE NEED?
Donors cant achieve SDG on gender equality without women and girls
The reality is: we are LEFT BEHIND and ALONE. The future looks bleak
for us.
We are pushing our own government for taking its responsibilities but
HIV/AIDS is not a priority.
MIC countries need technical and financial support for gradual transition.
A Middle Income label does not reflect the inequalities at country level
and does not mean better health.
Example: January 26, 2016: 72 hour strike of public health workers in
Santa Cruz (the most populated city which accounts for 52% of the AIDS
cases), they demanded the creation of 600 items for human resources.
No agreement was reached.
Ending the AIDS epidemic by 2020 is a goal for States which will be
discussed in New York (June 2016), many MIC are not going to achieve
it without international aid
As a consequence, people with HIV including women could die. HIV
transmission will rise again. WE

NEED YOUR SUPPORT.

AKNOWLEDGEMENTS
The speaker acknowledges Jorge
Saavedra
Jorge.Saavedra@aidshealth.org from
AIDS Healthcare Foundation
http://www.aidshealth.org/#/ and the
coalition of MICs http://raisethemic.org/
for the provision of key information on
MICs.