The treatment and control of HIV, including dispensing drugs and testing, is handled by the government-run public health programme through its 355-odd centres.
Of the over two million HIV-infected people in India, four states — Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu — account for 53%. More than one-third of them, or 7.5 lakh patients, are on the public health programme this year. While the medicines are available in the retail market at a cost, the ones dispensed at government-owned centres come free.
At certain centres in Mumbai and Delhi, partial doses of treatment are being provided to patients for a few days, forcing them to return frequently. Alternatively, drugs are being substituted.
Hospitals such as AIIMS, Safdarjung and LNJP in Delhi, and Nair, KEM, Siddharth and Sion in Mumbai have been grappling with shortage of these drugs.
Prices of first-line HIV drugs in the retail market has come down now substantially due to affordable generic medicines. The treatment costs lakhs of rupees for advanced therapies for certain patients. While, retail first-line drugs cost Rs 5,500 a year, the advanced and complex therapies come at around Rs 20,000 to Rs 2 lakh a year.
In a legal notice to the health ministry sent on August 22, the Delhi Network of Positive People (DNP+), representing HIV patients, has sought emergency procurement and relocation of stocks to government-owned centres experiencing stock-outs of ARVS, particularly in Mumbai. They have also sought strengthening and streamlining drug forecasting, procurement and supply chain mechanism to prevent future shortages.
Stock-outs have hit centres in Delhi, Maharashtra, Gujarat, Karnataka and Manipur the worst, Vikas Ahuja of International Treatment Preparedness Coalition, South Asia, told TOI. Drug supply has been erratic over the past few months, Ahuja said.
Bureaucratic delay in tendering, procurement and supply has been cited as the reason, besides the mechanism not being planned proactively and in a streamlined way.
As per NACO guidelines, patients adhering to the treatment should get the medicines for at least a month.
Industry experts say shortage of second-line therapy has existed in certain centres since 2012, and that of diagnostic kits since last year.