HIV Drugs Shortage

• 02 Sep 2022

For Prelims: Human Immunodeficiency Virus (HIV), National AIDS Control Programme.

For Mains: Implications of HIV Drugs Shortage, Human Immunodeficiency Virus (HIV) and its prevalence.

Why in News?

Recently, India is witnessing the shortage of HIV (Human Immunodeficiency Virus) Drugs, certain Antiretroviral (ARV) drugs in Anti-Retroviral Therapy (ART) centres.

• The National AIDS Control Organisation (NACO) under the Ministry of Health and Family Welfare is the nodal agency responsible for overlooking and coordinating activities of the National AIDS Control Programme (NACP) along with the Central Medical Services Society, which is responsible for centralised tendering and pooled procurement of different HIV products.

What is Human Immunodeficiency Virus (HIV)?

• HIV attacks CD4, a type of White Blood Cell (T cells) in the body’s immune system.
  • T cells are those cells that move around the body detecting anomalies and infections in cells.
• After entering the body, HIV multiplies itself and destroys CD4 cells, thus severely damaging the human immune system.
  • Once this virus enters the body, it can never be removed.
• The CD4 count of a person infected with HIV reduces significantly. In a healthy body, CD4 count is between 500- 1600, but in an infected body, it can go as low as 200.
• If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome).

Why is the shortage Concerned?

• People living with HIV need access to treatment with a combination of drugs known as antiretroviral therapy to suppress the virus, preserve their health, and prevent transmission of the virus to an HIV-negative partner.
• Staying on antiretroviral therapy continuously is crucial to keep the virus suppressed.

What has Driven the Shortages of These drugs?

• The failure of the pooled procurement mechanism. The tender for pooled procurement of life-saving antiretroviral medicines has faced bureaucratic delays in 2014, 2017, and now again in 2022.
• Although the state is not facing an acute shortage, medicines are running low, with some stocks set to expire.
• Officials are forced to compromise, for example, by portioning drugs meant for adults and giving them to children.

What are the Implications?

• If not addressed in time, the drug shortage could result in a full-blown public health concern.
• According to NACO, any irregularity in following the prescribed regimen can lead to resistance to HIV drugs, and therefore can weaken or negate its effect.
• If ART is not taken daily the probability of infection building up in the body increases, making the person unwell and infectious.
• These risks undoing India’s hard-won gains against HIV/AIDS and further derails global progress, which is not on track to meet the goal of ending AIDS by 2030.

What is the Prevalence of HIV/AIDS in India?

• As per the government's HIV Estimation 2021 report, the number of People Living with HIV (PLHIV) in India is 24.01 lakh.
  • Annual new HIV infections have declined by 46% in India since 2010
  • Maharashtra had the maximum numbers followed by Andhra Pradesh and Karnataka.
  • The Adult Prevalence (15-49 Yrs.) rate of HIV is highest in Mizoram (2.37%) followed by Nagaland and Manipur.
    • HIV/AIDS in Mizoram is 10 times higher than the national average (0.22%).

Way Forward

• What is urgently needed is the political will from the Ministry of Health to take necessary measures to ensure that drug shortages, as happened over the last decade, are not experienced by its programmes, such as HIV and TB, in the future.
• If ignored, the consequences impact the right to health and drive drug resistance, a significant public health challenge for the country.

UPSC Civil Services Examination Previous Year Question (PYQ)

Prelims

Q1. Which one of the following statements is not correct? (2019)

(a) Hepatitis B virus is transmitted much like HIV.
(b) Hepatitis B unlike Hepatitis C, does not have a vaccine.
(c) Globally, the number of people infected with Hepatitis B and C viruses are several times more than those infected with HIV.
(d) Some of those infected with Hepatitis B and C viruses do not show the symptoms for many years.

Ans: (b)

• Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. The virus is transmitted through contact with the blood or other body fluids of an infected person, much like HIV transmission.
• A vaccine against Hepatitis B has been available since 1982. The vaccine is 95% effective in preventing infection and the development of chronic disease and liver cancer, due to which it came to be known as first ‘anti-cancer’ vaccine.
• According to the WHO data, an estimated 296 million people are living with Hepatitis B, whereas an estimated 58 million people have chronic Hepatitis C infection. There were approximately 37.7 million people living with HIV at the end of 2020 with 1.5 million people becoming newly infected in 2020 globally.
• Hepatitis C is a liver disease caused by the Hepatitis C virus, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness. The Hepatitis C virus is a blood borne virus and the most common modes of infection are through exposure to small quantities of blood. This may happen through drug use, unsafe injection practices, unsafe health care, and the transfusion of unscreened blood and blood products.
• Therefore, option (b) is the correct answer.

Q2. Which of the following diseases can be transmitted from one person to another through tattooing? (2013)

1. Chikungunya
2. Hepatitis B
3. HIV-AIDS

Select the correct answer using the codes given below:

(a) 1 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3

Ans: (b)

• The problem of transfusion-transmitted diseases (TTD) is directly proportionate to the prevalence of infection in the blood donor community.
• Several infectious diseases have been found to be associated with tattooing, including some TTDs.
• Hepatitis B virus spreads when blood, semen, or other body fluid infected with the hepatitis B virus enters the body of a person who is not infected. Hence, 2 is correct.
• HIV-AIDS spreads only through certain body fluids from a person who has HIV. These fluids are blood, semen, pre-seminal fluids, rectal fluids, vaginal fluids, and breast milk. It is transmitted by sexual intercourse or sharing injection, drug equipment, such as needles, etc. Hence, 3 is correct.
• Chikungunya virus is transmitted from people to people through mosquito bites, most often by Aedes aegypti and Aedes albopictus mosquitoes. These are the same mosquitoes that transmit dengue virus. Mosquitoes become infected when they feed on a person already infected with the virus. It is not a TTD. Hence, 1 is not correct.
• Therefore, option (b) is the correct answer.

---

Mains

Q. Identify the Millennium Development Goals (MDGs) that are related to health. Discuss the success of the actions taken by the Government for achieving the same. (2013)

Source: DTE