В Индии зафиксирован острый дефицит АРВТ из-за сбоев при госзакупках

Indian companies and global health groups are stepping up efforts to provide a critical medicine for the country's free HIV/AIDS drugs program after more than 150,000 patients risked going without their dosages this month.

Delayed tender approvals and poor co-ordination with states left the National AIDS Control Organization (NACO) scrambling for supplies. Reuters reported on Oct. 1 that the supplies were due to run out next week.

India produces a large part of the world's HIV/AIDS medicines so the shortage has been awkward for the new government of Prime Minister Narendra Modi, which has promised to cut red tape.

Pharmaceutical companies who won orders for tenofovir/lamivudine tablets under the tender are increasing efforts to supply them. Some firms have put other orders on the backburner, industry executives said.

One company, Macleods Pharmaceuticals, is working on a government order for 13 million tablets, two sources with direct knowledge of the developments said.

"There is pressure to deliver," said one source within the company. "Some orders have been shuffled. (Other) clients have been told we have an emergency situation."

Aurobindo Pharma will supply 2.4 million tablets by the end of October, said a senior executive, who did not wish to be identified because of the sensitivity of the matter. India needs 7.2 million tablets a month, according to NACO's website.

The drugs are expensive in the open market, so the government provides more than a third of India's 2.1 million HIV/AIDS patients with free antiretroviral drugs procured via a tender process.

The tender delays meant that final approval to procure tenofovir/lamivudine tablets, prescribed in the initial stages of treatment, was not given until late September. Since it takes at least 60 days for supplies to reach patients, that left the prospect of some going without.

To help overcome the shortage, NACO has also authorized states to procure medicines directly if they run out of stocks and to seek reimbursement from NACO later, a World Health Organization email seen by Reuters says.

GLOBAL EFFORTS, DONATIONS

The UN health agency is closely co-ordinating with New Delhi on the supply crisis, Joseph Perriens, a co-ordinator with WHO's HIV department said in the email.

A WHO representative is holding talks with India's health ministry on ways to avoid a similar problem arising again.

"The situation is likely to be normalized by next month," Perriens wrote in the email. It was dated Oct. 1 and was sent to several activists and executives of other health organizations.

Medical charity Medecins Sans Frontieres has agreed to donate 70,000 tablets, while 40,000 tablets procured under a corporate social responsibility program have been sent to western Gujarat state.

Still, some activists say NACO needs to do more.

"What they (NACO) are trying to accomplish is patch work for 2-3 months," said Vikas Ahuja, president of an HIV activist group, Delhi Network of Positive People.

"Whether they'll be able to go ahead and ensure regular supplies for all patients is yet to be ascertained."