"Back then India was already ranking number one in few completely curable STIs - like syphilis, gonorrhea, or chancroid. It was but obvious that India was likely to have an alarming burden of HIV, given that the STIs were already well established in our population and posing a serious public-health challenge," said Dr Ishwar Gilada.
When diseases hit the rich and powerful, world notices!
A black truth is that when diseases hit the rich and powerful, the world takes notice. Drug-resistant TB had raised its ugly tentacles decades ago soon after the discovery of first anti-TB medicine. But it took a USA citizen who was 'suspected' to have extensively drug-resistant TB to board a flight from USA to Italy in 2006 to turn heads of world powers on the menace of drug-resistant TB. Better late than never, significant progress has since happened globally on fighting drug resistant TB, and more recently on anti-microbial resistance across sectors, although a long battle still lies ahead of us. HIV experience was no different.
"This is VIP syndrome -- till some VIP is affected people do not realize that it is our problem, as till then it is someone else's problem. Till that time it was a problem of the 'prostitutes', 'drug users' or 'truckers' - but it was not 'our' problem! It was only HIV activism that broke the opaque wall between 'them' and 'us' (which HIV had already penetrated long back); and made the world realise that HIV is everyone's problem. Thankfully, many networks of PLHIV and other organizations, like People's Health Organization, kept mounting pressure and advancing rights-based approaches to HIV care and management, which helped shape India's response to AIDS," said Dr Gilada.
Access to medicines: Big Pharma vs generic drug manufacturers
Indian pharmaceutical companies (generic manufacturers) are major providers of not only HIV medicines but also of drugs for other health conditions globally. "A big advantage in India was that domestic pharmaceutical companies made medicines affordable and accessible not only for our citizens but also globally. In 1990s, HIV medicines were so expensive (costing over INR 25000 per month) that less than 2% of our patients could barely afford them, putting them out of reach for a large majority of people who needed them to stay alive. It was a fierce battle, fought with patent-holding Big Pharma, that finally opened the doors for generic manufacturers to help reduce the cost substantially and help millions of people stay alive and be healthy," said Dr Gilada.
Dr Gilada added that it was only because of HIV that we came to know that Indian pharmaceutical sector has been saving lives of millions of people globally on a range of health issues for decades. Many of the Indian pharmaceutical company plants are approved by FDAs of different governments.
Self-sufficiency is possible to #endAIDS
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