National lockdown over Covid-19 leads to drug shortage for HIV patients
HIV patients in remote areas of Odisha and Bihar who are on antiretroviral therapy (ART) drugs have not received their dosage of medicines for the month of March due to the national lockdown over the threat of the coronavirus.
A 40-something HIV patient in a remote village of Odisha’s Khurda district was planning to get his ART drugs last week when the lockdown was announced, putting his plans of getting his medicine on hold.
“I was not prepared for the lockdown. Normally I take a bus or auto to get the medicine from the ART centre. But with no transport available, I don’t know what to do,” he said.
In another village of the same district, a 45-year-old HIV man as well as his HIV-positive wife and son have been frantically calling the president of HIV Positive People Network, an NGO supporting the HIV positive persons, to help them get the drugs as far as possible. “None in the family can move out and get the drugs from ART centre while it is difficult for outreach workers to deliver the drugs to all of them,” said Prabasini Pradhan of the HIV Positive People Network in Khurda district.
In Ganjam district, that has the maximum number of HIV positive patients in Odisha, 5,000 are on therapy. But least 2,500 are yet to get the drugs, said Nilambar, of the HIV Positive People Network in the district. The outreach workers who can help in carrying the medicines to the doorsteps of those who need, are scared of getting beaten up by police. “A couple of days ago, one of our outreach workers was thrashed by police. Naturally we are scared,” he said.
Though the government could have distributed the medicines through NGOs working among HIV patients, there was a risk. “In villages where everyone knows the other, sending the drugs through NGO worker would lead to identification and possible social ostracism of the HIV patient,” said Ajay Patra, an NGO worker.
Project director of Odisha State Aids Control Society, Sanjukta Sahu admitted that some of the HIV patients have not got their medicines due to the lockdown. “Those who are in Bhubaneswar and nearby have managed to take their medicines from the ART centre, as police allows them to travel after seeing their green book. Those who are in remote areas are facing difficulties. By tomorrow we may reach all HIV positive persons,” said Sahu.
There are more than 2.4 million HIV patients in India, of whom more than 1.2 million are on ART drugs.
Odisha has over 35,000 HIV positive people living of which around 21,000 are availing the ART. The rest though registered with the Odisha State Aid Control Society, have discontinued the therapy.
Getting supplies of anti-retroviral therapy (ART) drugs is proving difficult for patients in far-flung areas of Bihar too. With immunity levels already compromised, walking to ART centres to collect the drugs in the absence of public transport is not easy.
There are only 20 ART dispensing centres to cater to Bihar’s 38 districts, with two in the state capital Patna, which must be accessed by patients on the periphery of the city too. For instance, patients in Barh, located 70 kilometers away, have to travel to Patna. Doing so on foot during the lockdown is proving hard for patients.
“My monthly stock of ART drugs was getting over today. I panicked because missing a single dose can have serious repercussions. I then came to know about the NGO, Patna Network for People Living With HIV Society, who arranged for the drugs to be sent to our local district hospital,” a 35-year-old HIV-positive widow in Barh said.
It was not easy for workers of the NGO to convince the state health authorities to part with the drugs either.
“After much persuasion, the Bihar State AIDS Control Society (BSACS) provided us two ambulances and health staff yesterday to deliver ART drugs among people living with HIV in various districts”, the NGO’s president Gyan Ranjan said.
BSACS additional project director Dr Abhay Prasad confirmed that there is no shortage of ART drugs and pointed to the difficulty in collection only due to the absence of public transport.
“We have instructed our civil surgeons in districts and superintendents in medical colleges to make available drugs at the doorstep of HIV patients. NGOs, who are part of our support system, are also helping us ensure delivery,” Prasad said, adding that supplies for three months will be disbursed in one go and that even migrants with HIV infection who are in Bihar but not enrolled at the state’s ART centers, will be accounted for.
Bihar has 60,033 people living with HIV enrolled at its ART centres.
Earlier this month, an elderly Italian couple who underwent treatment for Covid-19 in Jaipur were administered a drug combination commonly used to control HIV infection. The drugs have been employed during clinical trials in China and Thailand. The Union Health Ministry has approved the use of the anti-HIV drugs in Covid-19 cases on a case to case basis and depending on the severity of the condition of a patient of Covid 19, giving rise to fears that patients may resort to stock-piling of the drugs.
Visakhapatnam-based AIDS specialist Dr K Surya Rao said there was no cause for worry.
“The production of anti-HIV drugs like Lopinavir and Ritonavir is on a large scale in India. While there are more than 2.4 million HIV patients, victims of Covid-19 are still in the hundreds. So, for now, there is no scarcity,” Rao said. Rao also pointed out that anti HIV drugs had not received FDI approval for Covid-19 treatment yet and that once they do, Indian drug companies would ramp up production immediately.
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