Private boost for cheap HIV drugs

Last month, a global summit was told that a quarter of the AIDS-affected didn't have access to life-saving medicines. With India having about 57 lakh HIV-positive people, the largest in any country, the gap between demand and supply of drugs assumes alarming proportions.
Despite the government providing free AIDS drugs since 2004, only 35,000 have benefited so far.The rest can't access them regularly. Hence, a move by pharmaceutical companies to provide AIDS drugs at discounted rates is welcome.
This year, Emcure Pharmaceuticals Limited, in association with the Network of Positive People (NMP+) and the Indian Network of Positive People (INP+), launched two "Taal" pharmacies in Pune and Nagpur, where those with HIV/AIDS get medicines at subsidised cost.
Says Arun Khanna, executive director, Emcure, "The centres take care of those who don't have access to treatment and doctors, and also their psychological and immunological issues." Emcure provides the drugs on a no-profit basis and the revenue generated by the centres goes to the networks.
The average monthly cost of anti-retroviral drugs (ARVs) in the first line of treatment per person is Rs 500. Drugs for the second line of treatment are more expensive and cost between Rs 7,000-8,000 per month. In the Pune and Nagpur centres, 500 and 100 people, respectively, are receiving treatment.
The company plans to open more centres, with two being set up soon in Namakkal in Tamil Nadu and in Aurangabad. Such a public-private partnership is running parallel to the governments.
Says Umesh Patel, president of Gujarat Network of People Living with HIV/AIDS (GNP), "Even though medicines are free from the government services, there's a high dropout rate because of poor quality of services. People have to wait in long queues for meeting the doctors and for ARVs.
Also, testing takes two-three days. So they prefer to switch to private pharmacies." According to Patel, the largest initiative for providing discounted ARVs is being done by Reliance HIV and TB Centre in Surat.
It's a partnership of Cipla, Reliance, CII and of people living with HIV/AIDS. Here, drugs are provided free of charge for 15 days in a month. That means patients need to spend just Rs 250 per month.
There's also the AIDSCare Network in Surat, says Patel, which gives Cipla drugs at Rs 90 per month. "The company gives concessions but the Network too absorbs part of the subsidy," says Patel. Medicines for the second line of treatment are available here for Rs 1,200 per month.
There are about one lakh HIV positive people in Gujarat. Of these, about 10,000 should get ARVs, says Patel. But government efforts cover just 1,500. There is, however, skepticism about some of the private efforts too.
K K Abraham, president of INP+, says, "Emcure has a vested interest in wanting to sell its AIDS medicines." Patel adds, "Emcure medicines are given out in government outlets because they give low quotations. But there have been complaints of side-effects and of the CD4 count (T-cell) going down after use of Emcure drugs."
CD4 count lowering generally indicates progress of the HIV infection. The irony: India is one of the world's largest suppliers of generic ARV drugs to the developing world.