The Indian government will provide free antiretroviral treatment through government hospitals starting from April 2004, Health Minister Sushma Swaraj announced today. The Indian government plans to provide treatment for 100,000 people in the first year, at a cost of 2 billion rupees (US$40 million).
She also claimed that India’s HIV epidemic is plateauing, a suggestion that is likely to provoke further controversy over the true level of infection in the subcontinent. India’s National AIDS Control Organisation estimates the country has between 3.8 and 4.2 million people living with HIV, but some epidemiologists estimate the country may have up to 10 million HIV-positive people.
The treatment announcement follows negotiations between the Indian government and the country’s pharmaceutical manufacturers, who recently struck a deal with the Clinton Foundation to provide a triple combination of d4T, 3TC and nevirapine to selected nations in Africa and the Caribbean for $132 a year. The Indian government has asked the companies to give India a similar deal, in return for tax credits and a waiver on excise duties. On Friday a spokesman for the health ministry told reporters that the likely price would be around 18 rupees a day, representing an annual price of approximately $140.
The government says that it has also been able to negotiate donation of free CD4 counting machines from manufacturers to support monitoring of CD4 cell counts (a marker of damage to the immune system and of improvement in the immune system's health after starting HIV treatment).
The programme will be implemented in the most severely affected states first of all.
These are: Nagaland and Manipur in the northeast of India (bordering Burma), Andhra Pradesh (the state surrounding Hyderabad), Karnataka (central India, capital Bangalore), Tamil Nadu in the south (capital Chennai) and Maharashtra (the state surrounding Mumbai).
Doctors will no longer be able to refuse treatment to people with HIV under a new law being drafted, and discrimination against children with HIV will also be banned. Discrimination against people with HIV in India has been highlighted by a long-running dispute in the southern state of Kerala, where two children have been denied school places after parents and pupils refused to be educated alongside HIV-positive pupils.
Harsher penalties for selling fake medicines or making claims about the effects of untested medicines are also likely to be included in the legislation.