Drug stock-outs in India's AIDS programme

Affects access and may lead to drug resistance
[हिंदी] The Delhi Network of Positive People (DNP+) is calling on the Health Ministry and National AIDS Control Organization’s (NACO) Director General to urgently address the issues of stock out of AIDS medicines in ART treatment centres in Uttar Pradesh and Bihar. Life-saving AIDS drugs aren’t reaching people living with HIV (PLHIV) in desperate need. According to the local PLHIV networks, there have been several stock outs of AIDS medicines between February and May 2011 at the Allahabad and Gorakhpur ART centres in Uttar Pradesh and Gaya, Bhagalpur, Darbhanga, Muzzafarpur, and Patna ART centres in Bihar. PLHIV networks estimate hundreds of PLHIVs may have been affected by the stock outs of AIDS medicines.

Naresh Yadav from the UP Network for People Living with HIV/AIDS (UPNP+) explains, “The Allahabad centre was first forced to ration the ARVs and is giving patients ARVs sufficient to cover treatment for five days and is now faced with a complete stock out. Other ART centres are facing a similar situation”.

“Last month TB drugs were not available at the DOTS centres in Delhi. Now PLHIV networks report that there are ARV drug supply interruptions in several states”, said Vikas Ahuja of Delhi Network of Positive People. “They are risking the lives of PLHIVs. Drug stock-outs at facility level may lead to HIV and TB drug resistance, which means that their treatment may stop working for them”, he adds.

In December 2010, PLHIVs across the country reported that they were quickly  switched from Nevirapine (NVP) to Efavirenz (EFV) at their respective ART centres, without information. This was attributed to excess stocks of the medicine EFV, which NACO was keen to exhaust before they expired in March 2011.

What causes these drug stock outs and inconsistencies in the supply of medications meant to prolong the life of people living with HIV in India?

Problems in access are often related to inefficiencies such as poor planning, incorrect projections of local requirements, poor distribution and supply at treatment facilities, expiry of medicines as the stock that came in earliest first is not distributed first and corruption.

PLHIV networks are calling on the Health Ministry and NACO to immediately reform the pharmaceutical supply management system for essential medicines as it is an important element in treatment programmes such as TB and AIDS. Issues around ‘drug procurement and supply management’ need to be addressed without delay as it will prevent stock outs and expiry, helping in the process of distributing drugs and supplies to treatment facilities and ultimately to patients.

PLHIVs in Delhi, concerned about the lives of PLHIVs in UP and Bihar, are doing a dharna in NACO office in Janpath to demand immediate action to to provide emergency supplies of ARVs to ART centres in the affected states in 24 hours. This must be followed by an investigation into the reasons for the drug interruptions.

Rahul Dwivedi-CNS

Published in:
Citizen News Service (CNS), India/Thailand
Health Dev.net, India 
Finance Azienda 
Micron With AIDS,   
Friend Feed.com
World Care Council