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ARV Drug Procurement: Letter to Minister of Health and Family Welfare

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ARV Drug Procurement: Letter to Minister of Health and Family Welfare

9th June 2004

To

Dr. Anbumani Ramadoss

Hon'ble Minster of Health and Family Welfare

Ministry of Health & Family Welfare

Nirman Bhavan,

Maulana Azad Road

New Delhi - 110011

Dear Dr. Ramadoss

Sub: ARV Drug Procurement

The Affordable Medicines and Treatment Campaign (AMTC), is a national campaign

aimed at creating an environment that will ensure sustained accessibility and

affordability of medicines and treatment for every individual in India. Our

mission statement is:

The right to life and health is a fundamental right guaranteed to every person

living in India and is non-negotiable. This campaign aims to demand and create

an environment that will ensure sustained accessibility and affordability of

medicines and treatment for every individual in India, including access to

affordable Anti-Retroviral Therapy for persons living with HIV/AIDS. This

campaign shall be democratic and participatory. It will seek the mobilization of

communities and civil society to make state, national and international agencies

and industry accountable for securing health for all.

We are writing this letter to seek your immediate attention and intervention to

ensure adequate and sustained supply of antiretroviral (ARV) drugs for the free

antiretroviral therapy (ART) programme. As you know, on 1st of April of this

year Government of India initiated a free ART programme for people living with

HIV/AIDS (PLHA) in the six high prevailing states (Andhra Pradesh, Karnataka,

Maharashtra, Manipur, Nagaland and Tamil Nadu) and New Delhi. Even though, the

first phase of the programme envisaged fifteen delivery points to deliver ARV

drugs the present number of delivery points are only seven (one hospital in each

state). This inadequate number of delivery points will restrict the number of

beneficiaries. We estimate that at this pace the treatment plan will cover only

less than 1200 PLHAs in the first phase. This number is minuscule of the PLHA

population currently in need of ART in these six high prevalence states.

Further, this number is far below the overall target of providing treatment to

1,00,000 PLHAs within the first year of the programme.

We understand that the inadequate procurement of drugs is the main reason for

the inadequate intake of the ART programme. As you are aware, the programme was

launched with limited stock of drugs received from WHO, which is inadequate to

meet the demand. We feel that only large-scale procurement of ARV drugs can

address this issue. As you know, it is the Indian pharmaceutical companies that

supply ARV drugs to majority of African and Latin American countries. Indian

companies shook the international pharmaceutical industry and civil society by

announcing the supply of ARV drugs for $340 per annum against the then

international price of $12000 per annum. These companies went further and are

presently supplying ARV drugs for $140 per annum (around Rs 6500). On 9th of

April 2004 Clinton Foundation announced an agreement to procure drugs for $140

per annum from six generic manufactures which include 4 Indian companies.

However, the paradox is that ARV drugs are still not accessible to vast majority

of Indian PLHAs. The price of ARV drugs in India is Rs. 14,400 per annum, which

is about 120% more than the price at which the Clinton Foundation is procuring.

We seek your urgent intervention to end this inequity.

We also have information that the current stock of ARV drugs will be exhausted

in July. Any discontinuance in the supply of ARV drugs will have life

threatening consequences to those people benefited under the programme. This

scenario calls for an urgent intervention from you.

We learned from the newspapers that the Government initiated negotiations to

facilitate procurement of ARV drugs for the free ART programme in the months of

December 03 -January 04. We request you to not only restart the negotiations but

also expand the mandate of the negotiation to bring down the price of all ARV

drugs available in the market.

Against this background, we request you to take necessary steps to achieve the

following

1. To ensure the immediate procurement of ARV drugs before the exhaustion of

current stock under free ART programme

2. To scale up the procurement of ARV drugs to meet the needs of those PLHAs who

require immediate treatment

3. To engage with the Indian pharmaceutical companies to bring down the price

below $140 per annum to increase the accessibility of ARV drugs.

Expecting a positive response

For AMTC

Anand Grover

Lawyers Collective HIV/AIDS Unit, Mumbai

E-mail: <aidslaw@...>

On behalf of AMTC

Mr. Ashok Rau

Freedom Foundation, Bangalore

Dr. Jayasree

FIRM, Trivandrum

Cc

1. Hon'ble Prime Minister of India

2. Hon'ble Minister of Chemical and Fertilisers

3. Hon'ble Minister of Finance

4. The Project Director, National AIDS Control Organisation (NACO)

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