India To Expand Availability of First-Line Antiretroviral Treatment, Official Says
India's National AIDS Control Organization by 2012 plans to expand the availability of first-line antiretroviral drugs to 300,000 people, according to Po-Lin Chan of the World Health Organization, which is also an adviser to NACO, Reuters UK reports (Allen, Reuters UK, 8/10). According to the "2006 Report on the Global AIDS Epidemic" released in May by UNAIDS, India has the highest number of HIV-positive people in the world, with 5.7 million people living with the virus. Despite the high number of HIV-positive people in India, the country's HIV prevalence is less than 1% because of its large population (Kaiser Daily HIV/AIDS Report, 7/17). Chan said the program's planned expansion has helped to define the country's priorities, adding, "Probably 90% of [HIV-positive people] will need first-line drugs for quite some time, so let's keep them on them as long as possible." NACO says that it expects each year 2% to 3% of the HIV-positive people taking first-line antiretrovirals to develop resistance to the drugs. As a result, some opponents of the planned expansion have said they believe that to curb the spread of HIV, India needs to provide second-line antiretrovirals to people who become resistant to first-line treatments. Second-line drugs in India cost between about $85.88 and $182.50 monthly, compared with about $9.66 monthly for first-line antiretrovirals, according to Reuters UK. Some economists have said that if governments worldwide started to include second-line treatments in their drug-provision programs, the price gap would narrow. Indrani Gupta, head of the health policy research unit at New Delhi's Institute of Economic Growth, said, "[T]here isn't yet a critical mass of demand for second-line drugs, so there's no incentive for manufacturers to bring down prices." In addition, India needs to develop a program that encourages people to undergo HIV testing, according to Reuters UK. Loon Gangte of the Delhi Network of Positive People said an effective treatment program that includes second-line treatment might encourage people who are unaware of their status to get tested. "Prevention starts with positive people," he said. Researchers are expected to discuss people who are resistant to first-line antiretrovirals at the XVI International AIDS Conference in Toronto (Reuters UK, 8/10).
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