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Tuesday, January 26, 2021

How is India doing on HIV AIDS drugs front? Here are all details in 8 points

India's HIV AIDS drugs scene is a mixed pot of positive and negative experiences. Here's all you need to know. Read the full article.

Along with the rest of the world, India observed World AIDS Day yesterday. Over the ages, our country has experienced lots of positive and negative factors concerning the disease, its treatment, diagnosis and medicines. And we have a long way to go in our fight against HIV AIDS. Amid such a scenario, we shall talk about India’s experience with HIV AIDS drugs.

How is India doing on HIV AIDS drugs front? All details in 8 points

1. India’s cheap HIV AIDS drugs, courtesy Cipla

In early 2000, Indian drug company Cipla offered to supply a triple-drug anti-AIDS “cocktail” to sufferers in developing countries at less than one-twentieth of the standard cost in the West. Cipla of Mumbai said it developed its own methods for producing the three drugs — stavudine, lamivudine and nevirapine — thereby avoiding the process patents owned by the major manufacturers in India.

The company supplied a combination of the drugs to the French charity Médecins sans Frontières (Doctors without Borders) for $350 a year per patient, on condition that the organization provides the treatment free to patients. Cipla also offered the combination directly to wholesalers at $1,200 and to governments at $600 a year. “We’re not making money, but we are not going to lose money either, since with the average of the three prices we should break even,” Yusuf Hamied, the chairman of Cipla, told The Times of India that time.

The action was seen as a bid to force the major producers of anti-AIDS drugs to reduce their prices in developing countries to an affordable level. At that time, the standard annual cost of the triple therapy in the United States and Europe was between $10,000 and $15,000.

2. India supplies 80% HIV AIDS drugs globally

India has said that over 80 per cent of the drugs used globally to combat the deadly AIDS are supplied by Indian pharmaceutical firms and the low-cost generic medicines have helped scale up access to HIV treatment across developing countries. Addressing the high-level General Assembly meeting on HIV/AIDS, Minister for Health and Family Welfare J P Nadda said that India had faced the “spectre of disastrous consequences” on account of AIDS epidemic 15 years back but was able to manage the challenge effectively. The country today is significantly contributing in the global fight against AIDS as more than 80 per cent of the antiretroviral drugs used globally are supplied by the Indian pharmaceutical industry, he said.

3. India’s HIV AIDS drugs stock may face a shortage

India along with 72 other countries may exhaust their stocks of critical anti-HIV drugs because of supply disruptions caused by the Covid-19 pandemic, a World Health Organization (WHO) survey said. Twenty-four countries are either critically low on antiretroviral medicines (ARVs) or are facing supply bottlenecks, said the survey. It also said that 8.3 million people benefited from ARVs in these countries last year. “This represents about one-third (33%) of all people taking HIV treatment globally,” WHO said.

India is a key manufacturer of these medicines, with eight local drug companies together manufacturing more than 80% of global generic ARVs. UNAIDS said on 22 June that the coronavirus pandemic could raise the cost of producing HIV drugs, warning of stock-outs in the next two months due to higher costs linked to global lockdowns and border closures. These include increased manufacturing and transport costs, the need to find new sources of key pharmaceutical ingredients and currency fluctuations caused by the economic shock of covid-19.

UNAIDS warned that a 10-25% increase in costs could make the final cost of exported ARVs from India alone between $100 and $225 million a year more expensive. According to UNAIDS and WHO data released on Monday, new HIV infections fell 39% between 2000 and 2019. HIV-related deaths fell 51% over the same time period, and some 15 million lives were saved through the use of antiretroviral therapy.

Dr Tedros Adhanom Ghebreyesus, WHO director-general said, in Tuesday’s report, that the findings of the survey are deeply concerning. “Countries and their development partners must do all they can to ensure that people who need HIV treatment continue to access it. We cannot let the covid-19 pandemic undo the hard-won gains in the global response to this disease,” he said.

4. Modi govt said no to new HIV AIDS drug patent

Though the Centre launched its Make in India campaign in 2014, but in contrary to its ideas, in 2016, the government of India denied a patent for a new medicine that would have helped patients suffering from HIV/AIDS. Cipla, an Indian pharmaceutical company, was seeking a patent for a combination of two anti-retroviral medicines, Ritonavir and Darunavir, which had previously been incompatible in a combined single-dosage form. The new medicine had already been granted patents in the United States, Europe and Australia, and represented a significant innovation of great benefit to patients. By finding a way to combine the two medicines into a solid pill form, Cipla greatly simplified patients’ dosing schedules while simultaneously decreasing pill burden. It is precisely these kinds of follow-on innovations that help patients better cope with diseases like HIV/AIDS and improve their quality of life.

Despite the great potential of this new medicine, the Mumbai Patent Office denied a patent for Cipla’s drug citing Section 3(d) of India’s Patent Act, which adds an additional hurdle to patentability standards on medicines, especially follow-on innovations. The Patent Office ruled that Cipla’s new combination of Ritonavir and Darunavir lacked an “inventive step” even though it was a novel invention and did not satisfy Section 3(d) requirements, thus denying patients in India the benefits of an improved version of a powerful HIV/AIDS medicine.

5. India’s free HIV drugs experience not satisfying

India had the third largest number of people living with HIV in the world at the end of 2013 and accounts for about four out of 10 people living with HIV in the Asian region, according to the U.N. AIDS programme UNAIDS. Out of 2.1 million HIV/AIDS patients in India, about 750,000 people depend on the free distribution of drugs through government-run centres, according to NACO.

A senior official at the Maharashtra State AIDS Control Society, a government body, said the agency was facing a shortage of three HIV/AIDS drugs – two for treating children and one for adults. The society, in the western Maharashtra state whose capital is Mumbai, is looking to get those drugs from other states where it is available, said the official, who declined to be named.

In 2014, activists and A.S. Rathore, deputy director general of NACO, named Indian drugmaker Cipla Ltd as one of the firms that had stopped bidding in the tender process. Activists said delayed payments were the reason for the dropout. It was not immediately clear which other companies had withdrawn from the bidding process in the recent past. A large number of domestic and overseas companies participate in the process to supply HIV/AIDS medicines and testing kits.

Several government distribution centres in states including Maharashtra, Gujarat and Karnataka are facing shortfalls because NACO has not supplied adequate quantities, activists said. With around 40 percent of the population in India living below the poverty line, healthcare is a luxury for many.

6. Free drugs not sufficient for poor patients

The poorest patients beg for treatment outside a chronically underfunded and overstretched healthcare system. Corruption and a sometimes dysfunctional supply chain mean drugs procured from companies for free distribution often do not reach them. India has been providing free antiretroviral drugs for HIV treatment since 2004, but only 50 percent of those eligible for the treatment were getting it in 2012, a report last year by the World Health Organisation said.

According to industry officials, the first line of HIV/AIDS drugs costs about 3,000 rupees ($50) for one month’s supply in the retail market in a country where, according to the World Bank, one in three were living on under $1.25 a day in 2009/10. Drugmakers in India, the world’s largest source of cheap generics, have been hit in the recent past by a raft of regulatory changes that included expansion of a list of drugs whose prices are capped.

7. Modi govt to launch new HIV AIDS drug

The Union Health Ministry has planned to introduce a new drug for the treatment of patients suffering from HIV/AIDS. “Dolutegravir” is a new drug which is likely to be available in the market by February 2020.

Dr Naresh Goel, Deputy Director-General of National AIDS Control Organization (NACO) told ANI: “Previously, we have been using the combination drug of TLE. But now, the health ministry has decided to use TLD combination drug – known as Dolutegravir. It has fewer side effects and tolerance is better.”

Informing about the other advantages of Dolutegravir drug, the official said that the resistance to the new drug will develop late and adherence is better. “The viral suppression is faster with the use of this new drug. We have started training our doctors on how to prescribe the new drug to the patients. By January, it will be done and in February, we will launch the drug,” he added.

As of now the current estimates of People Living with HIV (PLHIV) is about 21 lakh 40 thousand, said the official. The health ministry has set the target to achieve the target of Sustainable Development Goal (SDG) by eliminating the epidemic of HIV/AIDS from India by 2030.

8. Unique cure for HIV AIDS

Acquired Immunodeficiency Syndrome (AIDS) is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV).
It primarily spreads through unprotected sex, contaminated blood transfusions, hypodermic needles, and from mother to child. Even after 40 years of research for HIV/AIDS, drugs have not produced a cure for the same.

According to a report by ANI, Rajesh Raja Radhakrishnan has accidentally managed to find a cure for HIV/AIDS. Radhakrishnan, a 47 years old computer engineer from Coimbatore, was diagnosed with HIV. After years of battle, he could beat the infection and is now living a healthy life by finding a cure for HIV/AID. He has also filed a patent for the same. In 1992 April, Radhakrishnan was exposed to the HIV virus due to unprotected sex. He had an infection in the urinary tract but after treatment the urinary tract got cleared and he had no symptoms for four years. Then in 1996, symptoms started kicking in again after which he went for an HIV screening test (ELISA) but it was negative. Then he did a PCR DNA for HIV1 as per prescription, and the test results for PCR DNA arrived as positive.

The man found a Siddha doctor who claimed a cure for HIV with his herbal medicine. He tried his medicine for six months and found good improvement. All the test results like western blot, PCR DNA became negative, but the host cell infection existed in the body and the infection was multiplying every day, so he continued to take herbal powder for the next two continuous years and in 2004, he found a Protein. Next year, he took proteins for a heavy weight lifting job in a quantity of about 50g whey isolate, every day for three months. Accidentally, he found a high intense reaction as he was taking herbal medicine in the morning and protein in the afternoon. Patches started to appear in various parts of the body due to high intense reactions.

“Then I realized it could be a cure. As all the joints in the body started to become healthy while I took proteins with herbal extract for one year. In the year 2010 November, I did a CD4/CD8 count test and found the ratio to be 3.23 and that count had eliminated host cell infection which led to a cure. In the year 2014, found CD4 per cent increased by 20 per cent and CD8 per cent increased by 7 per cent. The ratio increased to 3.8. It is because of this healthy CD4 & CD8 count that increased immune response to 100 per cent and the only side effects were cuts appeared in the skin and mild to severe headache. After treating the side effects for 5 years, the side effects also vanished, and I am now enjoying 100 per cent good health,” Radhakrishnan said.

India’s HIV AIDS scene and NACO efforts

As per the official data by NACO, every year about 88,000 new infections are added to their list. NACO has strengthened its monitoring mechanism with more than 35,000 reporting units providing information on completely IT-enabled system.

Since 1980s NACO is playing a key role in fighting against the disease and reducing the prevalence of HIV/AIDS in the country. It has signed MOU with 18 Central government ministries to combat the disease.

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