A group of HIV-positive people has been protesting for more than a month at the central office of India’s National AIDS Control Organization, or NACO, in New Delhi, demanding a regular supply of life-saving antiretroviral therapy — also known as ART — drugs across the country.
NACO is the nodal organization of the government of India that manages programs for the prevention and control of HIV and AIDS in the country. ART drugs work by stopping the virus from replicating in HIV-infected people, helping them live longer and reducing or stopping the infection of the virus to others.
Centers that supply ART drugs across India have been out of stock on several antiretroviral drugs for months, threatening the lives and well-being of hundreds of thousands of HIV patients, according to leaders of the group that has been protesting in Delhi since July 21.
“I have been getting distress calls from hundreds of HIV-infected persons from different states of the country reporting the shortage in supply of the ART drugs from the ART centers across the country,” Hari Shankar, a leader of the ongoing Delhi protest, told VOA.
“The crisis has been acute since April. Most of them cannot afford to buy the drugs from the market privately,” Shankar added. “We will not withdraw from this protest until they, all across the country, start receiving the ART drugs supply regularly.”
According to a government estimate, India has 2.3 million people living with HIV. In 2004, the government began providing free ART to the people living with HIV in the country. Now around 1.5 million HIV patients are dependent on the ART provided by the government.
NACO procures ART drugs and distributes them through more than 675 ART centers spread across the country. People undergoing ART visit the centers every one, two or three months to collect their drugs. But since April, the supply of the drugs has been irregular in many parts of the country, many people said.
“Earlier, we regularly used to get the stock of the drugs for one to three months. Now we get the drugs just for one week or 10 days. The ART centers even in some big hospitals in New Delhi are turning us away because of the shortage of the drugs,” said Shankar, a member of the Delhi Network of Positive People or DNP Plus, which works to facilitate better medical treatment for people living with HIV/AIDS in New Delhi.
The Delhi protest demanding a regular supply of ART drugs across the country is organized by DNP Plus.
Nisha Jha, another DNP Plus member, said that many people across the country are reporting a shortage of Dolutegravir (DTG) 50 mg, a key ART drug, from the ART centers.
“Those HIV patients who have been on the first line, second line, or third line ART for years, and are also infected with tuberculosis, need to take DTG 50 separately,” Jha told VOA.
“Because of the crisis of DTG, lives of thousands of our PLHIV brothers and sisters are in jeopardy now.”
There is a crisis of drugs like Nevirapine, Ritonavir, Lopinavir, Abacavir, and Zidovudine — which are used in different ART regimens for HIV patients — at ART centers across the country, Jha added.
The ART centers are asking patients to change their drug regimens because of the shortages of some drugs, many people said.
Surmick Waribam, a leader of HIV patients group Manipur Network of Positive People, or MNP Plus, in the northeastern state of Manipur, said the normal protocol calls for HIV patients to undergo certain medical tests before their ART regimens are changed.
“The ART centers are asking HIV patients to change the regimens without conducting any such medical tests. The patients are scared to change the regimen, fearing adverse impacts on their health. Being very poor, most of them cannot afford to buy the drugs from the market. So, they are left with no option but to change the regimen,” Waribam told VOA.
In response to a query from VOA, Dr. Manisha Verma, a spokesperson for the Indian health ministry, said in an emailed statement that there is “adequate stock for around 95% [of HIV patients] in India.”
“There is no stock-out of drugs and there are no instances of disruptions or non-availability of treatment services or ARV medicines at the national and state levels,” Verma said.
Dr. Mothi SN, an HIV and AIDS specialist, said that since the global roll-out of ARV medicines began in 2004, the HIV/AIDS scenario changed from being a “rapidly progressing fatal illness” to that of “a chronic manageable illness like diabetes or hypertension with a near-normal life expectancy.”
“Regular intake of ARV medicines and prompt adherence to treatment are resulting in added years of life. People with HIV may survive the infection and finally die of other age-related diseases like stroke, heart disease, cancer, etc.,” Mysore-based Mothi told VOA.
“To achieve the optimum outcome, prompt adherence to uninterrupted ARV therapy becomes the cornerstone of management of people living with AIDS.”
Waribam from Manipur said the shortage in supply of his regular ARV drugs forced him to switch to a new regimen of drugs.
“For my ARV drugs, I am dependent solely on the ART center. So, in June, like most of around 14,000 [people living with HIV] in Manipur, I agreed to switch to the new drugs the ART center offered. Even then, the ART centers are giving us drugs for three, five or 10 days,” Waribam said.
“Like thousands of others, I am also anxious and in doubt, if the new drugs would succeed to keep my viral load under check and not cause any damage to my health. …The authorities are playing with the lives of the PLHIV.”