The Hindu Business Line : India makes cheap anti-AIDS drugs, but not for its patients

INDIA may have the second largest number of HIV/AIDS patients in the world, but access to anti-retroviral (ARV) drugs is still very limited. This, despite the fact that Indian generic companies such as Ranbaxy Laboratories, Cipla Ltd and Hetero are globally recognised for providing cheap and quality ARVs.

According to industry estimates, in 2004 sale of anti-AIDS drugs to the Government (both Central and State projects) stood at just Rs 10 crore while private sector accounted for Rs 50 crore. For the current year, sale to the Government is expected to go up to Rs 25 crore, while private sector sales is expected to remain constant.

Speaking to Business Line, Dr S.Y. Quarashi, Director General, National AIDS Control Organisation (NACO), said, "We are providing free ARTs (anti-retroviral therapy) to about 6,800 people in 25 centres. Our target is to reach out to one lakh people by 2007. We hope to start giving free treatment in another 100 centres this year."

He further said that treatment from private sector would be at least three-four times this number. NACO is in the process of collating this data.

"There is a latent growth for ARVs. But the demand will depend on how much the Government is able to push its programmes. Currently anti-AIDS drugs are administered free only in the high-prevalent States such as Maharashtra, Tamil Nadu and Manipur," said a pharmaceutical company representative.

However, the high price of ARVs is the main concern. The Clinton Foundation had managed to strike deals with generic companies, bringing down the cost of therapy to $140 per annum compared with $240-300 for the first line of treatment. In January this year, a meeting was held between generic pharmaceutical companies in India and activists/advocates from different countries to work towards bringing down the prices to as low as the Clinton Foundation prices across the world.

"While no agreement was reached on the prices per se, we are following it up with the companies. The Clinton Foundation was able to negotiate such low prices due to the high volumes promised.

"In India, companies claimed that the absence of bulk orders coupled with high tax component and trade margins have prevented them from bringing down the prices. Neither do companies feel responsible to bring down the prices nor do we make them feel so," said Dr Sai Subhasree Raghavan, Founder and President, SAATHII.

Currently in India, ARV therapy is administered only when the CD-4 count drops to below 200.

(CD-4 is an immune system cell that plays a key role in orchestrating the way the immune system attacks foreign invaders. A normal CD-4 count in a healthy, HIV negative adult is usually between 600 and 1,200 per cubic millimeter of blood. In an AIDS patient it is usually below 200.)

"Adherence to therapy is critical as the chances of developing resistance to these drugs are quite high. Hence, therapy can be delayed by providing healthy nutrition," said Mr Rajiv Dua, Programme Manager for HIV/AIDS, Oxfam India.

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