India To Expand Free Antiretroviral Program in States With Highest HIV Prevalence, Government Officials Say
India plans by April 2004 to expand its antiretroviral drug treatment program to include all HIV-positive children under age 15 and all HIV-positive new parents in the six Indian states with the highest HIV prevalence, government officials say, the New York Times reports. The government hopes to eventually expand the plan to provide drugs to everyone with AIDS in those six states. The program is expected to support as many as 100,000 people in the first year. However, the government has yet to identify budgetary support for the measure and must still reach a final agreement with generic pharmaceutical companies over price reductions similar to those agreed upon in Africa and the Caribbean (Waldman, New York Times, 12/1). The William J. Clinton Presidential Foundation HIV/AIDS Initiative in October secured a deal with Indian generic drug manufacturers Ranbaxy, Cipla and Matrix Laboratories and South Africa's Aspen Pharmacare that will reduce the cost of commonly used three-drug regimens for countries in Africa and the Caribbean to 38 cents per patient per day, down from the already discounted price of 55 cents per patient per day; the lowest available price of the same three-drug regimen using brand-name antiretrovirals is $1.54 per patient per day. Clinton estimated that the treatment programs will cost $700 million over the next five years (Kaiser Daily HIV/AIDS Report, 11/21). A fourth Indian pharmaceutical company, Hetero Drugs Ltd., has also agreed to participate in the pricing plan.
However, no such pricing agreement is planned for India, where two weeks of what one participant called "backbreaking" negotiations over drug pricing have been ongoing, the Times reports. India's Union Minister for Health and Family Welfare Sushma Swaraj has said that she wants the Indian pharmaceutical companies to give the government lower prices than those agreed to for the Clinton Foundation plan. "That's only natural because these companies are based in India," Swaraj said. However, pharmaceutical industry representatives say that the Clinton Foundation agreement leaves them a small profit margin to keep their businesses growing and to appease shareholders. Offering lower prices to the Indian government would require concessions, such as sales and excise tax exemptions, the companies say. Swaraj on Sunday ahead of elections in four important states announced that an agreement had been reached with the companies but industry and government officials say that negotiations are still continuing, the Times reports (New York Times, 12/1).