Indian government only plans to provide access to second-line ARVs after first-line drug treatment targets are met

The Indian government plans to provide HIV-positive people with access to second-line antiretroviral drugs as early as next year, National AIDS Control Organization Director-General Sujatha Rao said on Tuesday. Rao said the second-line drugs, which can cost 12 times as much as some older drugs, will be provided after NACO meets its goal of providing first-line antiretroviral treatment to 100,000 people in the country.

According to Rao, the government currently provides about 67,000 people with access to first-line drugs, and between 3,000 and 4,000 new people are added to the program monthly. She added that based on these numbers, NACO could meet the 100,000 treatment target by December 2007. Currently,. second-line antiretroviral drugs cost $239 per person monthly, compared with $239 per person annually for first-line medications.

We are committed to provide second-line drugs by next year, maybe, hopefully by January, Rao said . She added that it has been a conscious decision to provide first-line treatment to the positive people first, which is affordable and cheaper to provide. The second-line treatment needs more investment and infrastructure. According to Rao, NACO provides access to no-cost, first-line antiretroviral drugs through its 127 treatment sites, which the organization plans to increase to 250 in the next two years.

Rao said that 3% to 4% of people who are on an antiretroviral regimen could become resistant to the drugs within four to five years. She said that when the government begins to offer second-line treatment, it will seek funding from international sources. Rao also said a primary concern for NACO is the unethical practices by some private doctors of prescribing second-line drugs to HIV-positive people rather than following the national treatment guidelines of initially offering first-line drugs.