HIV drugs shortage is a challenge to ending AIDS in India

HIV drugs shortage is a challenge to ending AIDS in India

Subject: Government Schemes

Section: Health

Context: In June, PLHIV (People Living with HIV) networks across the country started witnessing an acute shortage of certain Antiretroviral (ARV) drugs in Anti-Retroviral Therapy (ART) centres. Among them were pediatric formulations and dolutegravir, the backbone of HIV treatment.

• Staying on anti-retroviral therapy continuously is crucial to keep the virus suppressed.
• But the virus can mutate into a resistant form if treatment delivery is poor or patchy.
• The National AIDS Control Organisation (NACO) under the Ministry of Health and Family Welfare is the nodal agency responsible for overlooking and coordinating activities of the National AIDS Control Programme (NACP) along with the Central Medical Services Society, which is responsible for centralised tendering and pooled procurement of different HIV products, including Antiretroviral drugs. 

National AIDS Control Organization (NACO)

• National AIDS Control Organization is a division of the Ministry of Health and Family Welfare that provides leadership to HIV/AIDS control programme in India through 35 HIV/AIDS Prevention and Control Societies.
• In 1986, following the detection of the first AIDS case in the country, the National AIDS Committee was constituted in the Ministry of Health and Family Welfare.
• As the epidemic spread, need was felt for a nationwide programme and an organization to steer the programme. In 1992 India’s first National AIDS Control Programme (1992-1999) was launched, and National AIDS Control Organization (NACO) was constituted to implement the programme.

Central Medical Services Society

• Central Medical Services Society (CMSS) has been established with the approval of Cabinet on 24.08.2011 as a Central Procurement Agency (CPA) to streamline drug procurement and distribution system of Department of Health & Family Welfare (DoHFW), Ministry of Health and Family Welfare, Government of India and to eliminate existing deficiencies.
• The Mission of the Society is to procure high quality health sector goods in a transparent and cost-effective manner in line with the directives of the Government of India and ensure timely and un-interrupted supply of health sector goods & services for State Government and Union Territories.
• The CMSS Head Office is at New Delhi and Warehouses are at State capitals, at present there are 20 warehouses.

National AIDS Control Programme (NACP)

• The National AIDS Control Programme (NACP), launched in 1992, is being implemented as a comprehensive programme for prevention and control of HIV/ AIDS in India. Over time, the focus has shifted from raising awareness to behaviour change, from a national response to a more decentralized response and to increasing involvement of NGOs and networks of People living with HIV (PLHIV).
• The NACP I started in 1992 was implemented with an objective of slowing down the spread of HIV infections so as to reduce morbidity, mortality and impact of AIDS in the country.
• In November 1999, the second National AIDS Control Project (NACP II) was launched to reduce the spread of HIV infection in India, and (ii) to increase India’s capacity to respond to HIV/AIDS on a long-term basis.
• NACP III was launched in July 2007 with the goal of Halting and Reversing the Epidemic over its five-year period.
• NACP IV, launched in 2012, aims to accelerate the process of reversal and further strengthen the epidemic response in India through a cautious and well defined integration process over the next five years.
• The Programme will offer free HIV Prevention, detection and treatment services in facility and community settings to high-risk, vulnerable and other ‘at-risk’ populations and PLHIV without any stigma and discrimination promoting equity and inclusiveness.
• The Programme includes community system strengthening through formal and informal engagement with an emphasis on the decentralized model of district-level programme monitoring and community feedback loop.
• The Programme will continue special attention to most at-risk populations, youth, and pregnant women offering a comprehensive package of services.  The community will be engaged in the design, concurrent appraisal and feedback to the project for providing strategic guidance and mid-course corrections.