Indian government taken to court over lack of treatment

The Indian government is being taken to the country’s Supreme Court in a public interest petition that says poor people with HIV who require hospital care and drugs are given no treatment “in any public hospital” and are “simply left to die”.

The petition filed by the Voluntary Health Association of Punjab (VHAP) also names the National AIDS Control Organisation, all States and all Union Territories.

India has between 3.8 million (government estimate) and 5.5 million (an NGO estimate) people with HIV, even though government policy has concentrated on prevention rather than treatment. The Supreme Court petition seeks a direction from the court to the governments to recognise and implement the right of people to treatment, and to provide free access to antiretroviral therapy (ART).

The petitioners point out that India has an advantage over other developing countries in that 10 of the 12 anti-HIV drugs recommended by the World Health Organisation are produced by Indian pharmaceutical companies. They argue that the cost of providing ART is less than the cost of treating opportunistic infections and they want to see a complete change of government policy so that India uses compulsory licences to make generic versions of patented drugs available to its own people.

Comment

Much international attention has been focused on South Africa in the last four years and people inside and outside that country have tried to persuade the government that it must act to treat as well as prevent HIV. Emotions were particularly fuelled in that case because South Africa had the worst HIV epidemic in the world and it seemed the lack of action was prompted by President Thabo Mbeki’s refusal to accept a causal link between HIV and AIDS.

Now, as we report above, South Africa has had a change of heart and is preparing a treatment programme. Clearly, it is time for the spotlight to move to other nations that have yet to act, and that list must include India, where the epidemic is second only to South Africa and the immorality of the inaction of the government is magnified by the existence of Indian pharmaceutical companies, like Cipla, manufacturing low cost generic antiretrovirals.

Phase 2 of India’s National AIDS Control Programme (NACP), supported by the World Bank, focuses on prevention, but leaves citizens with no right to treatment. Pressure must be exerted for treatment and care to be a major part of the NACP Phase 3. The Voluntary Health Association of Punjab (VHAP) hopes the Supreme Court petition will be the first step towards such a policy change. The VHAP executive director, Shri Manmohan Sharma, has appealed for help, urging supporters to write to local and national media about the case. “The more this case gets publicity, the more chances there are of a favourable verdict,” he says.

Activists in India have issued a prayer for the successful conclusion of the Supreme Court case. It prays for the court to direct the respondents to provide free and equitable access to ARVs, to review public policy, to create the necessary health infrastructure and to declare a national emergency and invoke the compulsory licensing provisions of the TRIPS Agreement so that treatment can be provided using generic drugs.

It is predicted that in the coming years India will overtake South Africa as having the worst AIDS pandemic in the world, with 35 million positive people by 2015. There is clear evidence that treatment is not only humanitarian of itself, but also a necessary part of prevention; there is now every reason to make India a major focus of international attention.