last month to make second- line HIV/AIDS treatmen

Despite the Supreme Court’s directive last month to make second- line HIV/AIDS treatment available free of cost to all those who need it, patients in non-metros will have to wait till March.

The National AIDS Control Organisation (NACO), under the Union Ministry of Health and Family Welfare, which has to implement the order, will need time before making second line universally available in all the anti-retroviral therapy (ART) centres in India.
Second-line treatment is needed by patients when resistance is developed towards first-line medication. It currently costs about Rs4,000-8,000 per month in the private market, making it unaffordable to several patients.

The government started giving second-line treatment free from 2008 in 10 ART centres, but laid out a set of criteria, because of which just 1,516 patients have availed of it till now.

Though exact numbers of the patients requiring second-line treatment is unavailable, experts say about 3-4% of HIV patients develop resistance to first line every year, thereby needing second line. India has about 2.27 million HIV-positive patients, as per data by the government, and various international bodies.

With the court order, NACO will start making second line universally available first in centres in New Delhi, Mumbai, Chennai, and Kolkata. March onwards it willroll it out in ART centres in Imphal, Ahmedabad, Varanasi, Bangalore, Hyderabad, Chandigarh.

Gradually, second line would also be rolled out in centres in Pune, Aurangabad, Nagpur, Hubli, Vijayawada, which were till now providing only first-line treatment.

“The process of procuring the medicines, which is done through international competitive bidding, will take six to eight months. Also, time is needed to increase manpower to execute the programme. Thus, it would be rolled out in a phased manner,” said a government official.

This phased roll-out would give NACO time to study and get an accurate number of people needing second line. “In March, NACO will prepare a status report and present it to the Honorable Court, along with a plan for phase II, where the treatment would be made available at all centres,” said the official.

The court order comes as a major relief to HIV/AIDS patients in India who needed second line.

The government considered only those patients eligible for second-line treatment, who were on the government programme for first line for minimum two years.

“This was unfair, as the government started giving first line free of cost only from 2004, while AIDS has been in India since the 1980s. Secondly, only those who were in the below poverty line (BPL) category could get second line. Those economically higher than what the government considered BPL, could not get it,” said HIV patient Deepak Leimapokpam, from the Manipur Network of Positive People.

Eldred Tellis, founder director of Sankalp Rehabilitation Trust, which works with HIV/AIDS patients, and one of the petitioners in this matter in the SC, said the Supreme Court order is in the right direction, as now treatment can be unconditionally available for everyone.