India must join UNITAID:Civil Society letter to PM of India.

[Guest guest]

The Honourable Prime Minister of India

Dr. Manmohan Singh

Prime Minister’s Office, New Delhi

Subject: India@UNITAID – A Call for Collective Solidarity.

Honourable Sir,

This comes to you with warmest greetings from the communities living with and

affected by Tuberculosis and HIV/AIDS in India, and civil society

representatives.

India has been reeling under the twin epidemics of Tuberculosis and HIV/AIDS.

However, it is now known that with a prompt and effective response, both

diseases are preventable and treatable. The National

TB and HIV initiatives, which are implemented through the Ministry of Health and

Family Welfare, are now starting to be rolled-out in a way that shows the

National Government taking a leading role in saving millions of lives.

While we laud the government’s efforts, we also recognize that civil society has

played a crucial role in shaping this effective response, driven by the common

belief that it is fundamental right to stay healthy, and in case of illness, the

right to access quality treatment

and care should be respected. In spite of concerted efforts

to respond to the pandemics, evidence shows that actually providing treatment

and care for TB and HIV poses very serious challenges, and even more-so for

vulnerable and marginalized Indians due to social and

economic reasons.

With the rise of deadly and highly contagious Multi Drug Resistant Tuberculosis

(MDR-TB / XDR- TB), as well as rapidly spreading drug-resistant HIV disease,

second line medication becomes as vital as the first line drugs. Drug resistance

means that the standard, or first line medicines have no effect - the virus or

bacteria has become stronger than the treatment to manage it.

Second Line Drugs (SLD) are the only hope for sustaining life, yet these drugs

are much more expensive and as the ‘market’ is less developed, often impossible

to find where they are needed. Although, the Indian government at present

provides first line treatment for HIV and Tuberculosis free of cost, access to

the second-line of lifesaving drugs is denied to all those without the means to

buy these essential but expensive medicines.

To address a similar situation in many countries, inter-governmental financing

and development experts from France, United Kingdom, Norway, Chile, and Brazil,

joined with specialists in confronting TB, HIV and Malaria from many countries,

and all worked for a year to create UNITAID, the International Drug Procurement

Facility.

Launched in September, 2006 at the United National General Assembly, UNITAID

has quickly become an important resource that is bringing

down the costs and ensuring the quality of medicines and diagnostics to treat

resistant HIV, TB and malaria. Hosted by WHO in Geneva, this international

institution has been designed to be ‘lean and efficient’, with minimal overheads

and staff, so that almost all of its resources can be directed to high burden

countries. It is mostly financed through a small tax on airline that the UNITAID

member governments have established in their countries.

In the spirit of global solidarity, these contributions of airline passengers go

specifically to the lifesaving purchase of drugs urgently needed by the millions

of people struggling against drug resistant HIV, TB or malaria. With the

increasing access to these medicines that UNITAID is bringing, more and more of

those patients now surviving on the ground are saying “You Fly, We Live -

Thanks!” when they look up into the skies and see UNITAID-contributing

passengers flying high.

With annual resources approaching $300 million for 2007, UNITAID is already

helping to provide treatment to people, including many children, in some 80

countries, of which 85% are low-income. UNITAID is also geared to increase the

accessibility not only of essential medicines, but also essential diagnostics to

assure rational management and treatment of HIV, TB and malaria.

UNITAID is important because: it has pioneered innovative sources of sustainable

funding, such as the levy on airline tickets; its focus is on the most in need

of the least accessible drugs and diagnostics; and it is the only global

institution that aims and acts to influence,

and bring pressure by the power of collective bargaining, on

manufacturers of HIV, TB and malaria medicines to decrease the prices. The

UNITAID driven increase in production volumes and quality creates the market

environment to ensure the availability and accessibility of these lifesaving

products.

To ‘Influence Market Dynamics’ is vital to ensure the maximum price reductions

which allow more people access to treatment. Although there are now some thirty

member countries, India has not yet joined the growing group of nations

participating in UNITAID. As we approach the first anniversary of the founding

of UNITAID, it is essential for the Government of India to become a member, and

to establish a ‘solidarity contribution’ through its booming airline passenger

traffic. This is an essential act of leadership towards providing

essential medicines to those most in need.

The government of India has a constitutional obligation to ensure protection of

the right to health (which includes access to affordable life saving drugs) of

its people and joining UNITAID could be a step towards fulfilling that legal

responsibility. In the recent

Chennai High Court Judgment on Novartis challenging sec 3d of the Patents

(Amendment) Act, 2005, the court explicitly recognized that the State has the

duty «to provide easy access to the citizens of this country to life saving

drugs and to discharge their Constitutional obligation of providing good health

care to its citizens.»

This letter from Civil Society is to urge the Government to become a signatory

to UNITAID, and not lose time which means lost lives. India must act now. The

Government of India must show global leadership in

increasing access to lifesaving drugs and diagnostics.

We believe that the time has come for all of us in ‘New India’ to emerge out of

the complacency shell, and assume its responsibilities in the global fight

against TB and HIV, driven by the deep-rooted solidarity of Indians.

Sir, the heightened demand for safe and effective second line medicines that

will be created by India joining UNITAID will largely benefit Indian generic

drug companies and thereby positively affecting Indian economy.

We are all aware that the market pressures have already produced a historic drop

in the price of first line antiretrovirals from US $ 10,000 per year in 2000 to

as low as US $ 130 today, thanks largely to the competitive pressures created by

the Indian generics and the

massive demand created by the 3x5 campaign.

On 20th of September, a global family will be celebrating the first anniversary

of UNITAID, and we urge the Government of India to fast track the process and

announce its willingness to be part of this important global breakthrough

initiative.

A delegation of civil society will be at this anniversary celebration and we

hope to be proud of our Nation having taken this important step

in saving millions of lives.

Anticipating your immediate action

In solidarity and strength

India @ Unitaid is a new broad-based Indian civil society initiative mobilising

support through the Indian Network For People living With HIV/AIDS – INP+, World

Care Council (Asia), Delhi Network For People Living With HIV/AIDS – DNP+, the

Lawyers Collective, International HIV-AIDS Alliance (India), Misbah, Naz

Foundation, Sahara,

Sharan Society for Urban Poverty

India @ Unitaid

c o n t a c t : unitaid@...

DNP+ <dnpplus@...>