|
Sci Tech
HIV: Free access to drugs imperative
|
Infected people in Brazil became protagonists. They mobilised political and public support for free access to drugs. Over one lakh patients have access to medicines and the government saves nearly the same amount it spends.
|
TWENTY YEARS since its discovery the virus has killed nearly 26 million people. Of this nearly 95 per cent are from the developing countries. That is not all. The fate of about 45 million people who are presently infected with it may not very different. A staggering number of about 10,000 people die every day. You guessed it right — it's HIV we are discussing about.
"Science has already given us powerful tools to stop the disease in its track. Unfortunately the world is not using them where it is needed the most," said former South African President Nelson Mandela at the 2nd IAS conference on HIV pathogenesis and treatment.
All is not lost and the developing world and India in particular can take a leaf or two from the success achieved by certain developing countries, Brazil in particular, in fighting the ravaging disease.
As early as in 1981 the Brazil Government put in place a national coordinating structure to fight AIDS. And in 1996 a special legislation passed by the government ensured the (people's) right to free and universal access to antiviral drugs. This stellar decision by Brazil made it the first developing country to make universal free access to HIV drugs possible. And it has already started reaping the benefits. Death rate has fallen by 50 per cent and hospitalisations have plunged by 75 per cent. Between 1997 and 2001 Brazil saved more than $2 billion.
"Presently more than one lakh patients receive free antiretroviral (ARV) medication and support on a regular basis. The average survival time of affected people has risen from six months to nearly five years," said Paulo Teixeira, Director of National STD/AIDS programme, Ministry of Health, Brazil. "And the number of deaths caused by AIDS now stands at a level of less than half the total predicted by some international agencies a few years ago." This is in spite of the fact that Brazil has approximately six lakh HIV positive people.
Recent estimates indicate the HIV prevalence rate in India is less than one percent of its population. But a report from the CIA's National Intelligence Council projects that the number of people infected with HIV in India will jump to 20-25 million by 2010. "Prevention is important but what use is prevention when access to drugs is beyond the reach of many already infected by HIV?" asked Mr. Teixeira.
Access to drugs becomes all the more important as infection is seen moving from the core high-risk groups of prostitutes and intravenous drug users into the general population. The vicious cycle begins here. With no means for treatment, stigmatization and discrimination become rampant and voluntary testing non-existent. With it comes the issue of transmission (of infection) to more people through ignorance.
But will not the steps taken by the Indian government and some states in particular to educate the mass of HIV prevention pay dividends? "Of course it will, but they cannot match the impact of HIV infected persons championing the cause. Take the case of Magic Johnson and the effect it had on the society. Government's steps alone without involving the affected people cannot win the battle," Mr. Teixeira noted.
"In Brazil the infected people became protagonists. They helped break the silence and create their own organizations and networks. They lobbied governments, the scientific community and pharmaceutical companies and mobilised public opinion and helped to design national and global policies," noted Fernando Henrique Cardoso former President of Brazil.
These infected people broke the shackles and voiced their protest against discrimination and inaction. In the end they succeeded to give political visibility to a problem that was initially considered to affect a small number of people.
"The people's movement had a ripple effect. It prompted the Brazil government to provide guaranteed access to treatment and full respect for human rights and this in turn encouraged people to come forward for voluntary and confidential testing. The net result was access to free drugs which helped HIV infected people improve their quality of life" Mr. Cardoso said.
The biggest success the various organizations of people living with HIV along with NGOs and scientific community had was in making the U.S. withdraw the charges against the Brazilian government in 2001 of violation of the Trade Related Intellectual Property Rights Agreement for reducing the price of drugs.
The good news is that India already has some networks formed by HIV infected people. The National AIDS Control Organisation (NACO) has realised the power they wield and is looking at them as major stakeholders to mobilise political support for treatment and prevention and serve as catalysts to mobilise the public too.
In spite of the success of the programme, Brazilians have their own share of problems. Though they got their local pharmaceutical companies to manufacture generic drugs, the active principles required to manufacture them are still being imported from India and China. This may not be possible post 2005.
India is in a different league with the capacity to manufacture drugs indigenously. As a matter of fact it does export them to many African countries. Can the people in India look forward to the day when (free) access to ARV drugs becomes a non-issue?
For this to happen people infected with HIV have to first come out of their shells and the government has to realise that subsidising ARV drugs pays in the long run. Brazil for instance spends nearly $500 million a year on its programme and stands to benefit an equal amount through reduced cost of hospital treatment and economic benefits derived from people living a productive life.
"I am greatly concerned about India, China and Russia which have rapidly evolving epidemics. The results will be calamitous if they follow the trends of Africa," Mr. Mandela warned. "These countries should learn from the mistakes already committed by African countries and also from those countries that have taken steps to contain the epidemic."
R. Prasad
recently in Paris
Printer friendly
page
Send this article to Friends by
E-Mail
Sci Tech
|
