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India drags feet over HIV-DR survey

The UNAIDS 2017 report estimates that up to 62,000 HIV patients in India died last year

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Armed with three empty pill bottles, Khem Chand, 48, is seen sitting in a queue of hundreds of patients at Lok Nayak Hospital's Anti-Retroviral Therapy (ART) centre. Chand realised that he was HIV positive in 2007. Since he has been on medication that has stopped working twice around.

Chand is harrowed as he is on third-line drugs. "What if I develop resistance to these now? There is no drug which can keep me healthy. I am hanging on to my last hope now," he says.

While the UNAIDS 2017 report estimated that up to 62,000 HIV patients in India died last year, National AIDS Control Organisation (NACO) has barely kept record of 15,500 patients on whom first-line drugs have stopped working and 125 patients on whom second-line drugs have stopped working. Such patients have developed drug resistance and are vulnerable to die. There are no records of status or treatment of over 46,000 HIV patients and how they are faring.

Out of the over twelve lakh registered patients, 9,97,869 patients are on ART medication, according to NACO numbers.

While it is estimated that there are many more patients who may be resistant to HIV drugs in India, it has yet not undertaken an HIV drug resistance (HIVDR) survey, according to recommendations made by the World Health Organisation (WHO), the WHO HIV drug resistance 2017 states.

While many countries have submitted their HIVDR data to WHO between 2014-17, India dragged its feet and submitted no data. It is further categorised to be in stage of 'planning', to collect HIVDR data, while many countries have already completed the exercise.

Six out of eleven countries that undertook pre-treatment drug resistance (PDR) surveys show that more than ten per cent of patients had resistance to Efavirenz or Nevirapine, which are the most affordable, and widely used first-line ART drugs.

Gottfried Hirnschall, director of the WHO's HIV and hepatitis programme said, "We need to ensure that people who start treatment can stay on effective treatment, to prevent the emergence of HIV drug resistance."

Up to 1,35,000 deaths and 1,05,000 HIV infections will surface across the globe in the next five years if drug resistance to ART drugs is not tackled effectively, estimates WHO in it's latest report.

India has the world's third largest number of persons living with HIV, an estimated 21 lakh. Of these, over 12 lakh HIV-infected persons are registered on the rolls of the government. Up to nine lakh patients have yet not been picked up under the National AIDS Control Programme (NACP).

Estimated data

Estimated HIV patients in India — 21 lakh
Patients registered with the government — 12 lakh
Patients on anti-retroviral therapy treatment — 9,97,869
Estimated deaths due to HIV in 2016 — 62,000

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