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Antiretroviral shortages in India hit people with HIV

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A shortage of antiretroviral drugs in India for months has led a dozen people living with HIV to protest with a camp in New Delhi, outraged by the lack of essential medicines in what is known as the “world pharmacy”, something that the Government denies.

Between mattresses, protest banners and the incessant noise of fans to keep the heat at bay in the camp at the headquarters of the National AIDS Control Organization (NACO), Loon Gangte expressed to NCT his frustration over the problems of the Indian health system to provide free antiretrovirals.


“We are suffering,” lamented this activist from the Positive People Network of Delhi who has been protesting for two weeks over the lack of access to drugs such as dolutegravir (DTG), recommended by the World Health Organization (WHO).

“There is money, there is medicine, the NACO employees are there, someone is not doing their job,” he denounces.

Gangte explained that it is not a lack of medicines in the country, the largest producer of generic medicines in the world and that according to the Indian Brand Image Foundation (IBEF) it supplies more than 80% of the antiretrovirals used worldwide. to fight AIDS.

Available in private pharmacies at market prices, these medicines are provided free of charge in specialized centers to people living with HIV within the framework of a program dependent on the NACO, which centralizes their purchase to minimize costs and distributes them to the different states.

But the activist explained that, for at least five months, many regions have been suffering from shortages.

“In New Delhi right now people get ten days (of medication), which means that in a month they have to go three times to get antiretrovirals,” he lamented.

Before the coronavirus pandemic, which disrupted the response to AIDS and other diseases such as tuberculosis, it was normal to receive at least several months, in accordance with the WHO recommendation to distribute “preferably” medicines for six months or a minimum of three.

The association has also received reports of shortages in states such as Manipur (northeast), Kerala (south), as well as Uttar Pradesh and Bihar (north).

Almost 1.6 million of the 2.4 million people living with HIV in India use antiretrovirals, according to official NACO data, and shortages have become a heavy burden for many people.

Especially for the most disadvantaged who can barely afford to lose a day of work, in the face of a “bureaucratic” process that forces those living with HIV to go to a specialized center to obtain medication.

Hari, a resident of New Delhi, explained to NCT that “it is very hard to go to one of the centers every ten days, since our livelihood is impacted and our time is also money.”

His situation has improved compared to the time when he started taking antiretrovirals, around 1998, when he was paying thousands of rupees a month out of pocket and was forced to sell properties to pay for the treatment.

But now Hari lamented that the system “has failed” to assess how many people need first, second and third line antiretrovirals.


Why is India, the world’s pharmacy, suffering from this shortage that Gangte describes as “artificial”?

The problem is in the tender for the purchase of antiretroviral drugs published by the NACO, said Gangte.

When the activists began their protest at the agency’s headquarters in the capital, the officials denied that this was the problem, but “in a second meeting they admitted the shortage due to a delay in the tender.”

A situation that infuriates the protesters. For officials, “it’s about a job and a salary, but it’s about our life,” Gangte said.

Holding his bottle of antiretrovirals, which he has been taking for two decades, the activist relies on a NACO circular issued last May in which they recommend “alternative” antiretrovirals against those that are “in critical stock”, and details options therapeutic alternatives to dolutegravir.


Despite complaints from people living with HIV, the Indian government has officially denied the shortage.

Deputy Minister of Health and Family Welfare, Bharti Pravin Pawar, stated last week in a parliamentary response that “antiretroviral drug stocks are adequate for almost 95% of people living with HIV in India who are on various drug regimens.” first and second line.

Pawar acknowledged that some individual centers “might have this problem at times, but the medicines are immediately forwarded from nearby centers.”

From the NACO office, the activists affirm that they are willing to camp “whatever it takes” to demand at least one month of medicine per medical visit.


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