Hopes Soar with Second Line ART. But, it is not accessible to needy

[Guest guest]

Dear FORUM,

Hopes Soar with Second Line ART but it is not accessible to who are in need

Some days back I came across a Newsletter from National AIDS Control

Organisation (NACO) vide Vol. V Issue 1. dated Jan-March 2009 where in there was

a section on 2nd line ART Roll Out in India and the title was also quite catchy

and beautifully phrased “Hopes Soar with Second Line ARTâ€. When I read

through, it was not what I had expected. The content of the page was so also

quite confound and reflected preferential treatment. Although it’s a FREE FOR

ALL but to access the 2nd line ARV services we need to fulfil some criteria. 

We all recognise and agreed that to run an effective program we need some

guidelines so that the program can be implemented effectively and it should not

go haywire. Policies and program can save lives but sometimes it kills too.

When the NACO declared that Indian Government is going to start the Free 2nd

line ARV Roll Out program in India, obviously every PLHIV was excited. It was

like a dream come true for every PLHIV whether on 1st or 2nd line ARV. Till this

moment I’m also on 1st line ART even though I’m sticking to my treatment

adherence but  can’t forecast when this will stop working on me.

As for me to achieve the maximum benefit of the treatment I search every now and

then for best treatment practices. It is not the doctors, nurses or counsellors

who are taking ART we (PLHIV) are taking the ARV drugs so we need to educate

ourselves on treatment.

When I say treatment literacy means not all those technical stuffs like how the

virus replicates or where the virus is hiding. But at least we should know how

many doses we need to take per day, when to take it, why we are taking it.

Today I’m writing on behalf of 2.5 million people living with HIV/AIDS in

India because I was shocked and angry after reading some mails on the issues of

2nd line ART roll out in some letters on e-forums.

All those mails were valid to my knowledge and I will always stand with the

PLHIV community as I’m one of them.  The mails depicted a pathetic picture on

treatment and all those mails related to human lives.

As a human being everybody wants to live and not die prematurely. Why should

they die prematurely when drugs are at our doorsteps. So the only thing is to

fight for our rights. As a citizen of the country we have some fundamental

rights to enjoy. We need to take the help of these fundamental rights which are

assigned for an Indian citizen.

We all know that we (human being) are not mortal, one or another day we are all

going to die and this is a Universal Truth.

When I tested HIV positive way back in 1995 at that point of time I thought that

I’m not going to see my 30th birthday but today I am 44 years old and living a

healthy life since I’m getting the ARV from the Government ART Centre without

paying any single penny.

However, when I started my therapy I procured medicines from my pocket. At that

point of time there was no free ART program and we were quite lucky that the

government started the free ART program in 2004 in India but unfortunately most

of the potentials activists passed away without seeing the ARV drugs.

In mid 90s every PLHIV thought that ARV is like a rich man medicines and we

never thought/dreamt that one day we will get these wonder drugs for free. In

those days it was believed that if you tested HIV positive then it was like a

death sentence.

At that point of time most of PLHIV were not able to afford the treatment due to

price barrier. But now in most of the countries free ARV program has already

initiated and PLHIV are accessing these services and living a productive life.

Then, why all these criteria?

Here I would like bring up the issues behind the current free 2nd line roll out

in India.

I would like to clarify myself with this burning problems faced by those PLHIV

who needs 2nd line ART. I had some questions to everyone who are concerned with

the programs.

According to the page it was cited some Eligibility Criteria

Criteria No.1.  Free treatment and free viral load testing for all PLHA below

poverty line, widows and children.

Here my question is how we define a person is living below poverty line (BPL).

Anyway I agreed to the definition of BPL that a person should be earning not

more than Rs. 5000/- per month, if I am not wrong. And according the calculation

in the same page the costing for second line was budget Rs.1 Lakh per person per

years.

When I divide the total costing with 12 months it comes to Rs. 8.333. per person

per month.  But what about those people who are earning Rs.5,500 or let it be

Rs. 8,000. Can these people afford it? And is it that besides ARV, these people

don’t need anything as human beings to survive.  There will be thousands and

thousands of questions hiding behind.

According to the criteria, widow and children can get the 2nd line ART from the

govt. ART program. How do we define a widow? There are hundreds of widows who

remarried and running a family, are these women widow too?? Enlighten me if

I’m wrong.

There are widows who are earning a handsome salary more than me and you. Here I

am not discriminating women, widows, children, MSM, IDUs, as I am also quite

concerned and do have a soft corner for them in my heart since I’d been

working with widows, children, MSM, IDUs for 11 years and I am not a gender

fanatic too. My only concern is that why categorising in delivering the services

like women, men, widows, MSM, IDUs, children etc.

Is the critera No. 2 is not applicable to those widows who had already started

2nd line ART buying from their pockets.

Criteria No.2. Patients who have been under treatment in Govt. ART centres

continuously for at least 2 (two) years, irrespective of income status.

 According to the criteria a PLHIV who is buying the 2nd line ARV from his or

her pockets is not able to get the 2nd line ARV from Govt. ART Centres. Most

these people started 2nd Line ARV because no such program existed at that point

of time. Why they can’t access the services from Govt. program?? We should

have some flexibility for all and should give some room to compromise. Otherwise

we are discriminating people when we are implementing program for them.

However the system ultimately compels and teaches the people to cheat. To live

they will do anything.

Ratan

Ratan Singh

E-MAIL: <ratanng@...>