Health Services and HIV Treatment : Complex Issues and Options

[Guest guest]

Dear FORUM,

The following is an important contribution to the discussion on isues relatd to

HIV treatment and financing HIV care in India by Ritu Priya. For the complete

report please refer to the EPW url (epw.org.in) If you have difficulty to

access the report please contact me, I will be glad to e-mail you a copy of the

article with in few days. Moderator]

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Health Services and HIV Treatment: Complex Issues and Options

The issue of providing anti-retroviral (ARV) treatment in a public health

programme is a vexed one. While there are at least four public interest

litigations in India petitioning for the state to provide ARV therapy to all who

need it, there are those who point out the drawbacks of depending on ARVs for

dealing with the problem. These complex issues need to be addressed squarely.

The challenge is to develop systems for provision of anti-retroviral drugs that

heed all the warnings and minimise the drawbacks.

The three by five initiative to provide anti-retroviral (ARV) treatment to three

million persons world-wide by 2005 has strong positive and negative implications

when viewed from a health systems perspective, a political economy perspective

and a positive persons' perspective. The suffering due to the human

immunodeficiency virus (HIV) warrants focusing on treatment and care, its

integration with prevention being long overdue [Priya 1994]. However, the issue

of use of ARVs in a public health programme is a vexed one.

At least four public interest litigations have been filed in India itself,

petitioning for the state to provide ARV therapy to all who need

it. `Access to Treatment' campaigns have been on, energised by HIV positive

persons' networks, NGOs and doctors treating HIV positive persons. But all

efforts get stymied by recognition of the complex issues that have to be

addressed when such a measure is undertaken.

There are also pro-people perspectives that oppose ARVs and remind activists of

the drawbacks of depending on ARVs for dealing with the problem [ABVA 2002].

Therefore the complexities need to be discussed widely and addressed squarely.

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