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Can India sustain expenditure on a very expensive HIV/AIDS intervention policy?

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Can India sustain expenditure on a very expensive HIV/AIDS

intervention policy?

Bhat, R.; Saha, S. / Indian Institute of Management, Ahmedabad (IIM-

A) , 2004

The development of antiretroviral therapy has given a new hope for

people living with Acquired Immuno Deficiency Syndrome (AIDS). In

the face of increased disease burden due to AIDS the global and

political commitment towards controlling the pandemic has received

renewed thrust in recent times. The Government of India has also

initiated an ambitious antiretroviral treatment strategy as a part

of the national public health programme in the six high-prevalence

states. The aim of this paper is to provide programme planners and

other stakeholders information about the impacts of initiating

antiretroviral therapy programme in India.

The objective of this paper is to address financing issues in the

proposed HIV/AIDS intervention of providing anti-retroviral drugs to

selected regions in India. The paper first discusses the

epidemiology of HIV/AIDS in India and how India has geared itself to

respond to the challenge. It highlights the importance of

infrastructure and logistic requirement for developing a

comprehensive treatment programme for the affected population in


A brief review of pros and cons of prevention and treatment is

presented. In reviewing the data, the paper draws from examples of

how the world has geared itself to deal with the problem. The paper

discusses the global commitment towards fighting the disease in the

light of the development in affordability and accessibility of

antiretroviral drugs therapy. The paper also develops broad

financial implications of the antiretroviral therapy initiative

under different treatment scenarios.

The estimated financial requirement for treatment vary from Rs.92

crores per annum (if focusing on 400,000 HIV/AIDs cases of

identified patients requiring ARV Therapy) to Rs.1008 crores per

annum (if all 4 million patients are screened for coverage). Against

this, the National AIDS Control Organisation (NACO) has allocated

total of Rs.113 crores for treatment part of the proposed

intervention. The paper therefore concludes that even under the most

conservative estimate, achieving the treatment target in India with

the proposed programme budget will be a challenging task.


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