Inter Press Service (10.24.03) - Wednesday, October 29, 2003

The pledge of $200 million from the Bill and Melinda Gates Foundation to help India fight HIV/AIDS will center on prevention, and none of the money will go towards the antiretroviral drugs that activists say could help alleviate the suffering of the 4 million people living with the virus.

"The Indian government cannot afford to provide antiretroviral treatment to those already suffering or even subsidize it," said Prasada Rao, secretary in Union Health Ministry. "The overall goal is to decrease the prevalence of HIV in high-risk groups and stabilize it in the general population by 2008," said Rao, former director of the National AIDS Control Organization.

But those caring for HIV patients say the money could greatly extend the lifespans of those already suffering. "It is time that the Indian government moves out of its preventive approach and helps hundreds of thousands of HIV-positive people rather than leave them to die," said Shruti Pandey, an activist with the Human Rights Law Network.

According to Helene Gayle, director of the HIV/AIDS, TB and reproductive health program at the Gates Foundation, India has a "very small window of opportunity within which to control the HIV/AIDS epidemic." Gayle estimates that infection levels could be rising by as much as 20 percent per year.

The Indian government spends less than $1 per person on HIV/AIDS treatment and less than $12 overall per capita on health care. Estimates by the Lawyers Collective's HIV/AIDS unit have placed the annual cost of antiretroviral treatment at $1,000 per head, exclusive of the costs of needed changes to the ailing public health delivery system.

Ironically, Indian pharmaceutical firms like Cipla and Ranbaxy are poised to provide generic triple-drug cocktail regimens at less than 40 cents a day per person to several African and Caribbean countries under a William J. Clinton Presidential Foundation agreement.

Less than 10 percent of the 300-odd patients at the Naz Care Home, one of New Delhi's four voluntary institutions providing HIV care, have had antiretroviral treatment, said its coordinator Irfan Khan. Most just cannot afford treatment - even at 40 cents per day, said Khan.