India's fight against AIDS looks like a hollow story.
The country has nearly 2.5 million Persons Living with HIV/AIDS (PLHAs) and the total budget for providing them with the symptom-suppressing anti-retroviral therapy is Rs 4.5 lakh.
And now, the nation is facing a shortage of this anti-retroviral therapy (ART) and patients are being sent back by treatment centres.
The retroviral therapy can help infected persons live normally. Dna has learnt that the shortage is affecting not just patients in interior towns but also cities like Mumbai, New Delhi, Bangalore and Chennai.
So much so, that the National AIDS Control Organisation fears a major collapse of the national ART programme. “The vials we've now for the retroviral therapy may last for 2-3 months. After that, it's going to be dry,” sources said.
A PLHA from Worli in central Mumbai said he was sent back twice from the state-run JJ group of hospitals.
“I cannot afford the expensive treatment and, hence, have to rely on government facilities,” said the daily wage labourer. “I have lost two days. If I keep doing this, the plumbing contractor who gives me work will find a replacement.”
Nearly 600 km away in Gulbarga, a devdasi and commercial sex worker, has a similar grouse.
“Every time I spend hard-earned money to come from my village to the civil hospital in Gulbarga, they say come back later,” she complains. “It takes nearly two hours one way and I end up spending a lot on travel and food,” she said.
Community-based organisations working for HIV/AIDS prevention warn this could increase the chances of drop-out from treatment and lead to a spike in both infection and the number of PLHAs.
“Many PLHAs hail from very poor backgrounds. The ART centres are, in many ways, the last ray of hope. Loss of income and distance make them easy to drop out. If this continues, we will set back the clock on all advances made and the fall in numbers,” said a gay rights activist of Humsafar Trust.
Meena Seshu of the NGO Sangram, which works with sex workers to stop the spread of HIV/AIDS, echoes the view.
“Without any intimation, supply of ART has become irregular. PLHAs, especially, women don’t want to keep coming only to be told to go back. Permanent drop-outs now seem like a real danger for the first time.”
The fears were first voiced at a meeting held in the Union Ministry of Health & Family Welfare as early as August 30.
“Despite its in-principle approval, the Global Fund To Fight AIDS’ and the ministry’s Country Coordinating Mechanism (CCM) haven’t been able to reconcile their differences. So there’s just no money,” said the source.
A copy of the minutes of the meeting, which dna has, reveals the extent of the fund-crunch hitting the HIV/AIDS prevention programme in the country.
Health ministry secretary Keshav Desiraju, who heads the CCM, says even the Global Fund is not helping. UN regional representative Lise Grand and World Health Organisation representative Dr Nata Menabde, too, voiced the same concern.
“Inadequate” is how CCM coordinator Jimreeves describes the Rs 4.5 lakh his scheme has.
According to ART national programme officer, Dr BB Rewari, the phase I grant from the Global Fund ended on Sept 30, 2012.
"A no-cost extension was given only till March 2013,” Rewari said. “The phase II grant for 2013-14 covers 100% ARV procurement from the GF budget. Since an in-principle approval is in place no other provisions have been made."
This according to NACO sources is the root of the problem. “Unless addressed urgently we are in for trouble.” Repeated attempts to get a comment from Union Minister of Health & Family Welfare Ghulam Nabi Azad drew a blank.
Reel life, real life mismatch
Though the recently-released documentary Fire In The Blood which tells the story of Western pharma majors and governments blocking access (using patent laws to increase profits at the expense of peoples' lives) to low-cost AIDS drugs for the poor causing more than 10 million unnecessary deaths shows India in positive light for standing up to the hegemony of the pharma majors, the ground-situation is completely different.