Access to Second-Line Antiretrovirals In India

The successful scale-up of services for people living with HIV (PLHIV) in India "is now at risk," write Loon Gangte, president of the Delhi Network of Positive People, and Leena Menghaney, projects manager in India for Medecins Sans Frontieres' Campaign for Access to Essential Medicines, in a livemint.com editorial.

Although "[t]he need for access to newer combinations of ARVs has been evident from the beginning of the government treatment programme," the authors write that "the government held back from introducing second-line ARVs in the national AIDS treatment programme on concerns about the spiralling prices of second-line ARVs." While ten ARV centers have begun to administer second-line ARVs, there are restrictions on who can access the drugs.

"The refusal to treat spells immense hardship for PLHIV and their families, who are forced to purchase second-line ARVs themselves from pharmacies at prices significantly higher than those obtained by the government through bulk purchases directly from the generics producers," say the authors, adding, "Many will not be able to sustain this expensive treatment, leading inevitably to further drug resistance, continuous ill health, AIDS, and death."

The authors conclude, "The battle to start providing ARV therapy in India has been won. The battle to provide lifelong treatment to all is just beginning" (Gangte/Menghaney, livemint.com, 6/8).

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