One of the challenges for the local government was the conditions imposed by the Netherlands to cut the AZV budget by 5 million florins each month. The Government did not agree with this condition and has set up a national committee of the healthcare sector to come with alternative ways to help reduce the AZV expenses more responsibly. As the commission was deliberating the Government decided not to cut the imposed amount by the Netherlands, but rather cut a much lower amount. The Government has tried to convince the Netherlands on many occasions that the 5 million is impossible. The Dutch authorities, however, insisted that Aruba had to lower the AZV expenses by 5 million florins monthly, totaling 60 million florins yearly to receive the financial funds to cover healthcare expenses, security, education in Aruba, and salary subsidy.
One of the big challenges was the change in the AZV management that on April 1, 2021, started with the positive list policy, where individuals were charged a contribution for certain medications. The Government received numerous complaints of individuals living on welfare or Fase, or their retirement income, to which the Government decided to change this positive list policy by abolishing this. That means that as of May 1, 2021, no one will have to pay for prescribed medicines.