Four decades after the first HIV cases were diagnosed in the world and 36 years after the disease was first documented in India, we have come a long way,” according to Dr Ishwar Gilada, the country’s foremost HIV and Infectious Diseases physician and president of the AIDS Society of India.
“Today when we look back at the global fight against AIDS, India’s mammoth contribution becomes self-evident. Over 92 per cent of people living with HIV (PLHIV) worldwide are staying healthy on generic antiretroviral therapy (ART), drugs for which are produced in India,” says Dr Gilada, who has been elected to the governing council of the International AIDS Society.
Most generic antiretroviral medicines cost one per cent or less when compared to those from innovator companies in the rich nations. For example, the best available three-in-one medicine cost $10,452 per patient per year but the lowest quoted cost from India was $69, which is merely 0.7 per cent of the international cost and that too with 100 per cent comparable efficacy and quality, Dr Gilada adds.
“Until the late 1990s, India was begging the powerful countries for support, but now it is a donor,” the expert points out.
Globally, ART has been a game-changer due to which PLHIVs can lead a normal, healthy and fulfilling lives. If they remain virally suppressed, then they become untransmittable too (undetectable equals untransmittable or U=U).
As opposed to popular belief, HIV is no more a killer but a chronic manageable condition, like or even better than diabetes. ART ensures four things for PLHIVs – at whichever time in their lives they are diagnosed with HIV, they get a full life as per their life expectancy at birth. Once on ART for three months, PLHIVs stop transmitting the virus even to their spouses/sex partners or unborn child. They don’t have to be hospitalised for HIV-related conditions and they don’t have to compromise on any social, physical or psychological aspects.
“Only when all PLHIVs are on ART and virally suppressed, no one will need to die of AIDS and no new infection should occur too. This progress in the fight against AIDS is conceivable only because of India,” Dr Gilada reiterates.
Without India’s robust generic pharmaceuticals – both quality-wise and quantity-wise – and streamlined global supply chains to make it affordable and accessible, millions of people, especially in low- and middle-income countries (LMICs), would have been deprived of the developments of the Global North and many more millions could have lost lives in addition to the 35 million we’ve lost already. The battle of ‘patents versus patents’ wasn’t easy but finally tilted towards India, says Dr Gilada.
Currently 28.7 million out of 38 million people with HIV worldwide are receiving anti-retroviral therapy. “We must reach out to the missing million people who are not currently receiving the medicines if we are to end AIDS. And India’s and Global South’s contribution is critical to even this crucial gap in the last mile… If we are to scale up life-saving medicines along with a full spectrum of HIV care services, particularly in LMICs, the role of India is pivotal,” he says.