India To Provide Second-Line Antiretroviral Access
Second-Line Antiretroviral Drugs
India's National AIDS Control Organizationplans to provide about 5,000 HIV-positive people with access tosecond-line antiretroviral drugs beginning in January 2008, HealthMinister Anbumani Ramadoss is expected to announce on World AIDS Day on Dec. 1, the Times of India reports. According to the Times,NACO currently provides access to no-cost first-line antiretrovirals tomore than 105,000 HIV-positive people in its 127 antiretroviralclinics. NACO estimates that 3% of people who receive first-line drugshave developed resistance because of poor adherence to their treatmentregimens.
Health Secretary Naresh Dayal said that UNITAIDhas offered to donate the drugs to India during the first two years ofthe program. NACO plans to partner with the country's generic drugmanufacturers to provide the drugs after the UNITAID support ends, the Times reports.According to a health ministry official, Ramadoss has not decided ifthe ministry will accept UNITAID's donation or partner with genericdrug makers at the outset of the program. "We had planned to introducesecond-line treatment only after" 100,000 HIV-positive people "were puton first-line drugs," Dayal said, adding, "Now that we have crossedthat mark, second-line [drugs] will be introduced in January in acontrolled manner." Only people who have received first-line drugsthrough NACO's antiretroviral clinics and have become resistant to thedrugs will be eligible for the program, Dayal said.
Mumbai-basedJ J Hospital and the Tambaram antiretroviral center in Chennai willstart providing the treatment in January 2008, the Times reports. Maulana Azad Medical Collegein New Delhi, PGI in Chandigarh, and antiretroviral clinics in Kolkata,Manipur and Nagaland will introduce the program in April 2008. Tenphysicians from these centers will be sent to Thailand to studyoperational issues relating to second-line treatment in December,according to the Times. About 3,000 HIV-positive peoplewho have developed resistance to first-line drugs will receivesecond-line antiretroviral access in December 2008 (Sinha, Times of India, 11/22).
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