Plea for better HIV drug stock

Interactive session stresses on shelters and trained doctors

Students participate in an AIDS awareness rally in Guwahati.

Guwahati, July 16 : HIV-positive patients of the Northeast complained about lack of adequate stock of drugs at centres administering anti-retroviral therapy (ART) in the region during an interactive session here today.

In the Northeast, Manipur is the only state to have a second-line ART centre, while the rest just have a first-line ART centre adding to the hardships of HIV-positive patients.

The interactive session was organised by World Vision, India, a Christian humanitarian organisation.

According to available statistics, Manipur has an estimated HIV population of 38,016, while the number of registered HIV cases in Nagaland is 11,224. Around 19,000 individuals in Assam are estimated to be infected by HIV, of which only 6,000 have been registered so far.

Although first-line ART centres are available in the northeastern states, the stocks of certain medicines keep fluctuating. In such a situation, doctors often substitute the prescribed medicines with some other drug and later, when stocks are available, the patient is switched over to the original medicine.

Jahnabi Goswami, president of the Indian Network of People Living with HIV/ AIDS said, “The state governments of the Northeast should ensure that adequate stocks of ART drugs are available at all times. Suppose a patient has been taking Stavudine. When its stock gets depleted, doctors switch him over to Nevirapine for a few months. Again he is switched back to the original drug after its stock arrives or vice versa. This is dangerous as changing of ART drugs frequently can make a patient develop resistance to a particular drug. Besides, anyone who requires the second-line ART has to travel to Manipur or Calcutta and that proves to be expensive. It is essential that such centres be made available in every northeastern state.”
Reni Jacob, the advocacy director of World Vision, India, said in keeping with WHO recommendations, state governments should phase out the ART drug Stavudine (d4T) from the first-line regiment as it has long-term irreversible side effects. Instead the National AIDS Control Organisation should substitute it with Tenofovir (TDF).
Moreover, lack of appropriate shelters for HIV-affected children and unavailability of trained doctors to treat such patients are major problems in the states.
“I and my three-year-old daughter are living with HIV. Although ART treatment is provided for free in Meghalaya, I face problems finding doctors to treat my child when she develops some sickness. It would be nice if we have doctors who are trained to deal with small children with HIV,” an HIV-positive mother from Meghalaya said.
“We require specific shelter homes for HIV-positive orphans in the region, as most shelter homes refuse to keep them citing one reason or the other. Moreover, when we get a child admitted to school, the school authorities after knowing his positive status refuse to keep him. They give excuses like the child’s academic performance is not good. This discrimination affects the child very deeply,” Goswami said.