At present, the HIV-infected community in India has greater woes than internal conflicts and losing priority attention. The antiretroviral treatment (ART) programme in India is facing a stock-out crisis in many states—from condoms in Haryana to ART in Delhi and Mumbai and HIV test kits in many others.
Thousands of people on ART are only receiving weekly supplies instead of monthly supplies and many who cannot cope with this inconvenience are missing their doses. The prevention of parent-to-child HIV transmission has been shaken by frequent unavailability of Nevirapine syrup in many centres.
The reasons for stock-outs in the national programme are numerous, such as bad forecasting due to inadequate information technology (IT) infrastructure, delayed payments and procurements and agreement renewal with the logistical supporter (Rites Ltd), cancellation of tenders and tardy approval of contracts.
The bureaucratic delays in awarding contracts for procurement in the ministry of health add to the trouble. Unlike many developed countries, in India healthcare in general does not get its due, garnering a national investment of only 2% of gross domestic product (GDP). Most state governments have poor drug procurement and distribution systems, which need to be strengthened. This is in part due to the inadequate funding for these systems.
There have been recent instructions to state AIDS control societies in India to cut down on their expenditures. Clearly, fighting AIDS is no longer a priority for the government. The prevailing opinion is that there are more successful programmes and chronic diseases that the funds should be diverted to, but what about those who have already been identified and those that have already been put on treatment?
How does the fund crunch affect them? Will the lack of funds to procure essential medicines not affect availability of stocks for them in view of the recent stock-outs? Will we not create a greater public health hazard by allowing development of resistant strains of the virus due to the rampant non-adherence in the absence of drugs?
There needs to be a renewed vision in HIV/AIDS advocacy. The communities need to come together while keeping the internal conflicts at bay, and speak up against the deprioritization of HIV/AIDS. The PLHA (People Living with HIV/AIDS) community in India needs to understand that they are being divided and ruled and their voices are thus silenced. If HIV activism in India is not reignited now by the voice of community members and organizations, their own sustenance will be put at risk in the near future.
The author heads global HIV advocacy group AIDS Healthcare Foundation.
