When No shortage of antiretroviral drugs in India

Refuting charges of any shortage of antiretroviral drugs (ARV), official sources have said that there is adequate stock nationally for around 95 percent of ‘People Living with HIV’ (PLH IV) who are on first and second line ARV regimens in the country. Individual antiretroviral therapy (ART) centers may have this issue at times, but the medicines are immediately relocated from nearby centers, said a Health Ministry source. He added that there is adequate stock nationally for around 95% PLH IV in the country who are on 1st & 2nd line ARV regimens like Tablet (TLD) Tenofovir Limousine and other ARV regimens. “There is no reported stock out for any ARV drugs at the State level and the fresh supply orders for procurement of the next lot of several drugs are already placed,” said the source. The Central Medical Services Society (CMSS) has been request to supply the first lot of the drugs at the earliest to ensure that before the present stock runs out, the fresh lot of drugs would have received, the official source added. India is one of the very few countries that provides free antiretroviral medicines for life-long treatment of more than 14.5 lakh PLH IV through 680 antiretroviral therapy (ART) centers under its National AIDS Control Program (NACA), which is fully funded by the Government of India. National AIDS Control Organization (NAC O) centrally procures ARV medicines for PLH IV as per national guidelines. A group of HIV patients has been protesting against shortage of antiretroviral drugs. Sources said that the protestors have been informed about the position regarding drug availability  and they were told to jointly work with State AIDS control societies and NAC O for the availability of drugs at those few ART centers running short on supplies temporarily. “The mainstay of treatment for more than 85 per cent PLH IV is Tablet TLD a fixed-dose combination of three antiretroviral drugs, namely, Tenofovir 300 mg + Limousine 300 mg plus Antiretroviral for which there is sufficient stock nationally to last more than 3 months,” the source said. Tablet  is required for around 50,000 PLH IV who are either on Alternate-1st/2nd or 3rd-line regimens, or those with TB coinfection, it said. The 67-year-old requires a combination of four drugs: abaci, Limousine, ritonavir and lopinavir. Instead, the antiretroviral center, which provides free medicines under the government’s National AIDS Control Program, is giving him three other drugs: tenofovir, Limousine or TLD for short. India has 23.19 lakh HIV-infected people, according to an estimate in the latest NAC O report. While Maharashtra, with 3.90 lakh, and Andhra Pradesh, with 3.03 lakh, have the largest populations of infected people, states in the North East have the highest prevalence of HIV. On May 30, Dr Anoop Kumar Purl, NAC O’s deputy director general, issued a letter to all state project directors asking them to change the regimen of patients “to tide through the crisis situation as an interim arrangement”. Antiretroviral centers have since started switching HIV patients to different drug regimens wherever supply is not available.