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Drugs price rise may affect fight against AIDS

By Divya Sreedharan

BANGALORE, DEC. 7. A four-year-old is the latest patient to be put on antiretroviral treatment (ART) at the Government-run Bowring and Lady Curzon Hospital here.

P. Chandrasekhara, who heads the ART unit, now has 208 patients undergoing free ART. "The child's parents are both HIV positive but they are healthy," he says. The doctor says the unit only has drug stocks till next March. He is not sure what will happen after that.

ART drugs are also given free at the Karnataka Institute of Medical Sciences, Hubli, and the Mysore Medical College. These drugs are to be taken lifelong. A basic course of the drugs — they kill or inhibit the multiplication of retroviruses such as HIV — now costs about Rs. 1,200 a month per person if bought privately.

TRIPS regime

But the drugs may not be so cheap for long. Under the Trade Related-Intellectual Property Rights (TRIPS) regime of the World Trade Organisation, Indian pharmaceuticals could face legal action if they make and sell generic anti-AIDS drugs after January 1, 2005.

As of now, no one here knows how much the drugs will cost next year.

Patients are on ART in other places too. Ashok Rau, executive trustee and chief executive officer of Freedom Foundation, a non-governmental organisation (NGO) working with HIV/AIDS patients, says 589 people are on ART at its four units in the State.

New dangers

Apart from drug prices, another issue concerns new dangers that might be emerging among the young and educated in the State.

Surveys suggest that the State's emerging business process outsourcing industry might have to tackle problems such as AIDS, and that young professionals in Bangalore call centres, for example, find themselves in environments where risky behaviour is easier. For instance, when Dr. Rau's NGO did a survey on HIV/AIDS awareness among call-centre employees, they found that "62 per cent thought no condoms were needed if the partner was a `known' person."

Karnataka, with an estimated five lakh HIV positive people, is now aiming at stopping the spread of AIDS by promoting condom use, conducting awareness programmes in schools and colleges, counselling/training and through focused intervention among sex workers, truckers and migrant workers.

But is the link between low condom usage and alcoholism/drug abuse being ignored? Some critics point out: "Sex workers and their clients use alcohol (and drugs) as a means of `escape' and to shed inhibitions. How can you expect either to ensure that condoms are properly used?"

Consistent and correct use of condoms "during risky sexual behaviour provides essential protection against HIV/AIDS," yet a Behavioural Surveillance Study by the National AIDS Control Organisation in 2001 found "regular condom use well below what is needed in Karnataka, leaving large segments of its population vulnerable."

How is that situation going to change?

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