2nd Line ART Criteria and OBITUARIES!

[Guest guest]

Dear Friends,

 

Re: /message/11072

Vikashâs and Snehansus mail on obituaries has made me think and wanted to raise

some issues.

I do understand and support the perspective that both my friends are raising. I

would like emphasize more on the criteria of accessing second line ART from NACO

centers, which is relevant to what my friends are raising.

 

We all have debated and questioned the usefulness of these criteria.

Whether it is facilitating the process of saving lives or impeding access to

treatment is in question. There are outstanding court cases and rulings in the

country.

 

This criteria is either being interpreted incorrectly or used at ones advantage,

or denying treatment (Eg. SACEP is suppose to review  maximum of 15 to 20 cases

per sitting but SACEP in some states interprets this as Minimum 15 to 20) and

postpones meetings, which delays valued treatment for people who needs it. Look

how many SACEP report says NO, according to NACO Guidelines and a physicians

signature below that.

Some simple questions that I would want to raise to our friends at INP+ and

hopefully someone from NACO can also throw some light.

 

Are there any INP+ members or PLHIV representatives in the TRG (Treatment)/ NACO

of fixing this second line Criteria? If yes, what were there inputs and why did

they endorse and sign off the criteria which our own people have to fight in the

court and ITPC India hosting a National consultaion to discuss it?

 

Where are the meeting minutes/notes available for us to know what kind of

inputs, suggestions and objections raised by our PLHIV representatives in the

entire discussion process of fixing these criteria?

 

Does NACO Representatives feel that our representatives in the TRG (if any) were

competent and technically sound enough to provide valued inputs representing the

hundred thousands of PLHIV in the country?

 

The cost of India’s second line combination is approximately 2666 Rupees a

month (32,000 Rupees per annum) per person. How much amount is spent on SACEP

meeting every week? Maybe one month of SACEPs meeting cost is a person’s One

years life saving drugs?

 

The criteria of BPL is it going to be reviewed or would NACO still deny the

Right to life and and Right to Health because a person happens to earn 5000

Rupees a month and does not fall under BPL?

 

Criteria are meant to facilitate any accessibility process but it seems our

criteria are there to create obstacle. Aren’t the court cases, these e mails

an indicator that people are finding it hard to access.

If not, put these as indicators in your M & E framework, which is always presented

in many international platforms as success or good practices.

 

My Questions are not at all towards the technical or clinical aspect of the

criteria but it is on the fundamentals of how this criteria was framed and I do

not intend to hurt anybody’s ability or competence.

 

There may be many more other questions or apprreciations, which my valued

friends may raise.

 

Looking forward to hearing from you all.

 

Giten

Giten K H

e-mail: <gitenkh@...>

[Guest guest]

Dear Friends,

Re: /message/11072

I sent this mail last month in AIDS India but got no response. I have been

advised by my friends now to address it directly to Ms Jahnabi, President of

INP+ and Dr Rewari of NACO.

 

The mails that are being circulated in some E groups like, ITPC India and all

provides a good opportunity to continue the dialogue.

 

On SACEP- Dr Rewari please check with your own ART Nodal officers if they are

happy with this structure. The doctors who are deciding whether a person who

will receive 2nd line drugs have not even looked after, diagnosed or prescribed

a first line regimen to a PLHIV in some cases.

 

SACEP is suppose to review  maximum of 15 to 20 cases per sitting but SACEP in

some states interprets this as Minimum 15 to 20 and postpones meetings, which

delays valued treatment for people who needs it. Look how many SACEP report says

NO, according to NACO Guidelines and a physicians signature below that.

Allow me to summarize my questions to Jahnabi, President INP+, 

Are there any INP+ members or PLHIV representatives in the TRG (Treatment)/ NACO

of fixing this second line Criteria? If yes, what were there inputs and why did

they endorse and sign off the criteria which our own people have to fight in the

court and ITPC India hosting a National consultaion to discuss it?

Where are the meeting minutes/notes available for us to know what kind of

inputs, suggestions and objections raised by our PLHIV representatives in the

entire discussion process of fixing these criteria?

 

Dear Dr Rewari, NACO

 

Does NACO and its representatives feel that our representatives in the TRG (if

any) were competent and technically sound enough to provide valued inputs

representing the hundred thousands of PLHIV in the country?

 

The cost of second line combination is approximately 2666 Rupees a month (32,000

Rupees per annum) per person. How much amount is spent on SACEP meeting every

week? Maybe one month of SACEPs meeting cost is a person’s one years life

saving drugs?

 

The criteria of BPL is it going to be reviewed or would NACO still deny the

Right to life and Right to Health because a person happens to earn 5000 Rupees a

month and does not fall under BPL?

 

Criteria are meant to facilitate any accessibility process but our criteria are

there to create obstacle. Are the court cases, these e mails not an indicator

that people are finding it hard to access.

If not, put these as indicators in the NACP M & E framework, which is always

presented in many international platforms as success or good practices.

 

My Questions are not at all towards the technical or clinical aspect of the

criteria but it is on the fundamentals of how this criteria was framed and I do

not intend to hurt anyone’s ability or competence.

 

There may be many more other questions or apprreciations, which my valued

friends may raise.

 

Thanks

Giten

e-mail:<gitenkh@...>

[Guest guest]

This is in response to the questions to me by Giten through AIDS INDIA.

Dear Giten,

Re: /message/11081

TRG/NACO is basically a technical consultation process and the Criteria for

fixing the second line is not a matter of TRG but it is a government policy

fixed by the policymakers of NACO mostly determined by external factors.

Obviously, we are also aware of the critical factors that formed the criteria.

We are also making strong advocacy efforts to sensitize the policymakers and

amend the criteria to easily avail second line ART.

After the initiation of Second line Treatment, there were two meetings and Mr. K

K Abraham participated in one of them. In order to access meeting minutes/notes,

you can approach the convener of the meeting.

And I hope you are still in Bangkok. Convey my regards to Shiba.

Thank you brother

Jahnabi

President, INP+

e-mail: <inp@...>