New Delhi: HIV/AIDS patients may benefit from cheaper access to treatment with the Clinton Foundation announcing this week an initiative to cut prices of some of the most expensive drugs by half, say those who track the epidemic here.
Expensive drugs and lack of infrastructure to distribute them have hindered many patients’ access, while others have developed resistance to initial treatment. The National AIDS Control Organization (Naco), the arm of the health ministry tasked with coordinating response to the epidemic, received details outlining the non-profit Clinton Foundation’s programme on Wednesday and is reviewing them, said Sujatha Rao, Naco’s director general, in an interview.
Naco recently began rolling out the third phase of its national AIDS control policy, which calls for putting three lakh patients on “first-line,” or initial, drug treatment and opening more than 250 drug distribution centres around the country over five years.
Although observers say the need is growing, the plan currently does not include access to second-line treatments, which are used after patients develop a resistance to the initial drugs; these drugs often cost 10 times as much.
“We haven’t taken a position on second-line as yet,” said Rao. “But price cuts are always welcome.”
At the prompting of former US president Bill Clinton’s foundation, India-based generic drug makers Cipla Ltd and Matrix Laboratories Ltd agreed to produce second-line treatments at half the cost for middle-income nations and cut prices by 25% in low-income nations. (Prices were already lower in these countries.) Treatment with brand-name second-line drugs can cost more than $2,000 (Rs82,000) per person per year in middle-income countries such as India.
To buy second-line drugs for developing countries, the foundation received $100 million from UNITAID, which is funded by an airline ticket tax levy in participating nations, including the UK and France.
Though no official estimates exist, “several thousand” patients already need second-line drugs in India, said Dr Denis Broun, country director for UN’s joint programme on AIDS. And as more patients gain access to treatment, those numbers will only rise because 5% of patients on first-line drugs per year typically develop resistance and need second-line treatment, he added.
Activists and volunteer organizations that work with HIV/AIDS patients have described the latest round of national AIDS policy as weak on treatment, largely because it doesn’t include second-line treatment.
“If the government decides to move into second-line, that will do a lot to increase accessibility,” said Ashok Rau, chief executive of the Bangalore-based Freedom Foundation, which currently provides drugs to 6,000 patients in 38 centres around the country.
India has 5.7 million HIV/AIDS patients, the highest caseload in the world, according to UN estimates. However, government figures place the number at around 5.2 million —less than the number of infected people in South Africa, which ranks second on UN’s list.
Matrix will also produce a version of a single-pill first-line treatment, previously unavailable here, which will cost less than $1 a day, according to the foundation.
By 2010, more than 5,00,000 of the nearly 40 million people around the world living with HIV/AIDS are expected to need second-line drugs, according to the Clinton Foundation.