India To Provide Second-Line Antiretroviral Access to About 5,000 HIV-Positive People Beginning in January
India's National AIDS Control Organization plans to provide about 5,000 HIV-positive people with access to second-line antiretroviral drugs beginning in January 2008, Health Minister Anbumani Ramadoss is expected to announce on World AIDS Day on Dec. 1, the Times of India reports. According to the Times, NACO currently provides access to no-cost first-line antiretrovirals to more than 105,000 HIV-positive people in its 127 antiretroviral clinics. NACO estimates that 3% of people who receive first-line drugs have developed resistance because of poor adherence to their treatment regimens.
Health Secretary Naresh Dayal said that UNITAID has offered to donate the drugs to India during the first two years of the program. NACO plans to partner with the country's generic drug manufacturers to provide the drugs after the UNITAID support ends, the Times reports. According to a health ministry official, Ramadoss has not decided if the ministry will accept UNITAID's donation or partner with generic drug makers at the outset of the program. "We had planned to introduce second-line treatment only after" 100,000 HIV-positive people "were put on first-line drugs," Dayal said, adding, "Now that we have crossed that mark, second-line [drugs] will be introduced in January in a controlled manner." Only people who have received first-line drugs through NACO's antiretroviral clinics and have become resistant to the drugs will be eligible for the program, Dayal said.
Mumbai-based J J Hospital and the Tambaram antiretroviral center in Chennai will start providing the treatment in January 2008, the Times reports. Maulana Azad Medical College in New Delhi, PGI in Chandigarh, and antiretroviral clinics in Kolkata, Manipur and Nagaland will introduce the program in April 2008. Ten physicians from these centers will be sent to Thailand to study operational issues relating to second-line treatment in December, according to the Times. About 3,000 HIV-positive people who have developed resistance to first-line drugs will receive second-line antiretroviral access in December 2008 (Sinha, Times of India, 11/22).