AIDS drugs: Too many patients, too little time

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FREE ANTI-RETROVIRAL THERAPY

AIDS drugs: Too many patients, too little time. 131 patients in Pune, plans on

for more centres in the region

Anuradha Mascarenhas

Pune, May 11: Living with AIDS for three years, Pandurang (name

changed), has been ostracised by his parents and given food in

separate utensils. Today, as the farmer from Parner waits for free

medicines at the Anti-Retroviral Therapy (ART) centre at Sassoon

General Hospital, he is scared to reveal that his 30-year-old wife

and eight-year-old son are also sero positive.

Neeta lost her husband to HIV two years ago. Last November, she fell

sick and started losing weight. Tests revealed that she too had

contracted the virus. With just a class X pass certificate, she is

unemployed, worries constantly and makes weekly rounds at the ART

centre hoping that her name will be considered for the free drugs.

Pandurang and Neeta are among the several patients queuing up at the

Anti-retroviral Therapy (ART) centre at Sassoon, hoping to be

included in the programme that provides free medicines to HIV

positive patients. Even as five or six patients are registered

everyday, the medical worker at the centre is patient with the

others, promising to enroll them soon.

An ambitious anti-AIDS initiative by the government aided by the

World Bank, the ART programme aims to provide free medicines — a

combination of three drugs (see box) supplied by the National AIDS

Control Organisation (NACO) — to HIV patients whose CD4 count is

less than 200. There are 33 centres all over the country.

In Pune, the ART centre was set up in January and according to Dr A

L Kakrani, Head, Department of Medicine, Sassoon, 1,011 patients

(588 men, 403 women) have been screened. Of these, free medicines

are given to 131 patients. ``We have written to the Maharashtra

State AIDS Control Society who have promised to upscale the

programme,'' Kakrani told Newsline when asked about the long queues

outside his centre everyday.

Given that Maharashtra with an estimated 7.5 lakh patients has the

highest number of infections, making a success of ART is a daunting

task. Also, once started, ART cannot be stopped midway. Hence the

need to ensure that whoever is enrolled is supplied drugs for a

lifetime.

Dr V L Kulkarni, Deputy Director, Sexually Transmitted Diseases and

in-charge of the ART programme in Maharashtra, explains the

issues. ``We are going slow on the ART programme,'' he admits

pointing out there should be sufficient stock of drugs to ensure

that the lifelong programme is successful. ``It is dangerous to

discontinue the programme once patients are administered the

drugs.''

Dr Mukund Penurkar, Senior Medical Officer with the ART centre in

Pune, agrees. ``We feel bad turning away patients. People from as

far as Latur, Aurangabad and Ahmednagar come here seeking free

ART,'' he says. Though they have to select their patients carefully,

depending upon the CD4 count, wives of HIV patients who have also

contracted the virus are admitted on priority. So far, there is one

child on ART at SGH.

But the government has plans to upscale the ART programme. According

to New Delhi-based Ajay Khera, Joint Director for Training and ART,

the idea is to have 100 centres across the country by the year-end

and treat at least 25,000 HIV infected persons this year.

Apart from ART centres at Mumbai (1,750 patients), Miraj (350

patients), Pune (131 patients) and Nagpur (140 patients), the other

centres will come up at Yavatmal, Akola, Aurangabad, Ambejogai and

Kolhapur.

THE REGIMEN: ART

Anti-retroviral therapy is a government programme that aims to

provide free drugs to AIDS patients with CD4 count less than 200. In

Pune, 131 patients are on ART. But there are more who need it.

MEDICINES

The cheapest combination of drugs Stavudine, Lamivudine and

Nevaripine comes in a capsule ``Tri Omune'' costing Rs 1,239 for a

month.

The other combination is Duvoir-N that includes Zidovudine and

Lamivudine. Nevaripine has to be taken separately. This costs Rs

1,350 per month. So far, 10 patients in Pune are on this treatment.

Efavir 600 is the costliest at Rs 2,826 per month. This includes

Efavirenz (suitable for patients on anti-TB drugs), Lamivudine and

Stavudine.

http://cities.expressindia.com/fullstory.php?newsid=129772