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Pay now or pay forever

Over 17 million people living with HIV in developing countries are on treatment — most of them on affordable Indian generic medicines.

Sixteen years ago, the historic AIDS Conference in Durban, South Africa — the first in Africa — brought together governments, UN bodies, researchers, health workers, people living with HIV/AIDS and marginalised communities on the same platform. People living with HIV/AIDS and activists led by Treatment Action Campaign (TAC) stormed the conference to confront governments and leaders to “break the silence” about HIV and Big Pharma’s propaganda that HIV treatment in developing countries was not feasible.

A year later, in 2001, in the absence of patent barriers in India, Dr. Yusuf Hamied from Cipla proudly announced the availability of generic antiretroviral treatment for less than $1 per day. With this breakthrough, the public health response to AIDS changed forever. Today, over 17 million people living with HIV in developing countries are on treatment — most of them on affordable Indian generic medicines.



Leena Menghaney


Just two months ago, world leaders including India’s Health Minister J.P. Nadda gathered at the UN and promised to “end AIDS” by 2030. And last week, South Africa once again hosted the International AIDS Conference in Durban marking the progress that has been made in the public health response to HIV/AIDS in the last 15 years.

We have witnessed time and again how early treatment saves lives and prevents transmission of the virus, valuable evidence of which was provided by the ‘HPTN 052’ trial. There are newer HIV medicines that are better-tolerated and treat those who have grown resistant to the virus.

The lessons learned from working with marginalised communities on HIV/AIDS prevention over the last decade, combined with the latest science that treatment is prevention, could help us break the back of the epidemic.

We are at a unique point in time. Yet complacency is setting in internationally: 20 million of the 37 million people with HIV do not have access to treatment; tuberculosis continues to be the main killer of people living with HIV; over one million people die every year of AIDS and neglected co-infections, and HIV funding from countries has fallen substantially in 2015.

In India, the aim to have over two million people living with HIV know their status and offer quality HIV treatment for life will only be possible with increased investment in the public health system; implementation of WHO’s “test and treat” policy will push the already strained limits of the medicine supply chain of the Department of Health & Family Welfare.

Role of civil society

Without sustainable funding, civil society cannot continue its valuable work.

These are the organisations informing people at the grassroot-level of their right and need to get tested and access treatment if they are HIV-positive. They are the marginalised communities that are the cornerstone of prevention strategies, who work at minimum wages — to distribute condoms; encourage and support sex workers to test for sexually transmitted infections; provide clean needles to people who use drugs and reach out with essential sexual health information to the extremely vulnerable men who have sex with men. They are the counsellors who increase treatment literacy and support adherence to HIV treatment in already overburdened and strained ART clinics across the country.

They are the networks of people living with HIV combating stigma and discriminatory practices that otherwise exclude people from care and treatment. And, finally, they are the legal aid lawyers who push for the successful implementation of any new HIV policy and support government by challenging patent monopolies that would otherwise result in high prices for HIV, TB and HCV medicines.

As has been said: “pay now, or pay forever”.

India has made a commitment to end AIDS. Let’s do it. Help us save lives and stop the virus.

Leena Menghaney is a lawyer working on HIV, public health and access to treatment.

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Printable version | Aug 3, 2020 10:36:46 PM | https://www.thehindu.com/opinion/op-ed/Pay-now-or-pay-forever/article14517154.ece

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