Forget the figures, save lives

Pharma companies8212;Indian or MNCs8212;are not waiting at the doorstep of the India8217;s HIV-affected community to provide them with drugs. They, especially Indian pharma companies, are more interested in making their money in the US or the Europe. As for the other argument, there is no need to be shy about demanding money where it is needed. More money comes in today for HIV/AIDS than before, but it is a mere drop in the ocean.

Then what is the controversy about?

UNAIDS estimates that nearly four lakh HIV-related deaths occurred in India last year. By any measure, the figure is shocking. And it is no wonder the government and National AIDS Control Organization NACO find the figure unacceptable. The government8212;while it has commissioned their own studies about the figure8212; wants to know the methodology that UNAIDS has used to arrive at the figure. The government8217;s doubts are justified. After all, UNAIDS had severely overestimated the HIV sero-prevellance projections in southern Africa based on modeling studies.

But ultimately it is of little comfort.

Even if the government were to come up with a lower figure8212;say 50 per cent or 25 per cent of the UNAIDS figure, which amounts to 2 lakh or 1 lakh deaths8212;the figure is still shocking. The government simply cannot take cover of the alleged overestimate by UNAIDS to abdicate its responsibility towards the HIV-affected in India.

HIV even today means a certain death sentence. But since 1996, the anti-retroviral therapy ART has helped millions to live with the disease. And Indian generic pharma companies make these drugs available to the third world countries. So why should four lakh or even one lakh HIV affected have to die in India 8212;where drugs are available at the cheapest price in the world? Therein lies the key question, and some would say the culpability, of the government.

Way back in 1997, Brazil showed the way to help its citizens. Based on the idea that no Brazilian need to die of HIV/AIDS as long as treatment is available, the Brazilian government is currently providing treatment to all those who need it. That is approximately 1,40,00 of a total of 620,000 HIV-affectd people. Not surprisingly, the death rate has fallen drastically.

It must be noted that both UNAIDS and NACO accept the figure of 5.7 million point estimate as the number of HIV-affected in India in 2005. They also do not disagree that as of today the number of HIV-affected who need treatment in India is anywhere between 5 and 7 lakhs.

But India made a late start in providing treatment to these people8212;from April 1, 2004. As of now, the government is providing free ART to only about 20,000 people. Another 15,000 are provided free ART by the ESIC, railways and the armed forces. By any standard this is abysmal, as it does not amount to even 2.5 per cent or 3.5 per cent, including the other 15,000 of those who need treatment.

The corresponding international figure for 2005 is 40 per cent8212;about 1.3 million against the targeted 3 million. This has been criticised internationally and rightly so. But our figures are humiliating.

By 2010, the government hopes to cover 1,80,000 people8212;far short of 25 per cent of today8217;s requirement. In another five years, with the number of HIV-affected going further up, it can only only fall shorter. The rest are supposed to be left to goodwill of private sector, where goodwill is sadly lacking8212;and will probably face death without any treatment.

This is again totally unacceptable. Under the circumstances, the government cannot afford to complain about the UNAIDS methodology and data and figures and hope to be taken seriously itself. The provision for treatment has to be taken with a missionary zeal8212;with the Brazillian motto that 8220;no Indian shall die only because he/she cannot afford or access ART8221;.

Anand Grover is a practising lawyer and the Director of the Lawyers Collective HIV/AIDS Unit, which drafted the HIV/AIDS Bill