Bombay High court rejects plea to direct his wife to undergo check-up for HIV #Womenrights


, TNN | Jun 15, 2013,

High court rejects plea for wife to undergo check-up for HIV
The HC said it was “absurd” for husband to say it was in the interest of his wife to go in for early HIV detection.
MUMBAI: The Bombay high court on Friday upheld a family court (FC) order rejecting a man’s plea to direct his wife to undergo a medical check-up as he strongly suspected her to be HIV positive. The court said it was “absurd” for him to say it was in the interest of his wife to go in for early detection.

Justice Roshan Dalvi heard a petition by Santa Cruz resident Joel D’Souza (name changed), who met Joan (name changed) through a marriage bureau. Both professionals, they married on December 26, 2009. In June 2010, Joan had typhoid and went to her mother’s place nearby. Thereafter, Joel stopped calling or receiving her calls. On July 7, 2010, he took her call but told her he would not take her back, without explanation. The medical test report of July 7, 2010 confirmed Joan was cured of typhoid and tests included for HIV antibodies.

On July 10, 2010, on reaching her matrimonial home, she found Joel had changed the lock. On October 22, 2010, he filed for divorce alleging impotency/non-consummation of marriage and cruelty. Pending the petition, on March 16, 2011 Joel filed an application praying for direction to Joan to undergo HIV, TB and hepatitis tests along with tests for impotency/failure to consummate the marriage as he suspected she was HIV positive.

In his application before the FC, Joel gave many reasons, including fever, tiredness, body ache, dry cough, diarrhoea, abdominal pain and headache. He said Joan had a bloated abdomen although her face, hands and legs were very thin and due to this she wore long outfits. “On an official website of HIV, it is documented that HIV is medically caused due to accumulation of fat in the stomach,” he stated. He said she spoke in her sleep using the words ‘HIV’ and ‘AIDS‘ and mentioned ‘Jack Dorsan’, who he found on the Internet was in the prostitution business. He said his wife had stored Dorsan’s telephone number and spoke to him on the day of their wedding.

He said she applied lip balm five to six times a day “as the best treatment for Herpes Simplex Virus is keeping the lips moist”. Joan said Joel’s suspicion was “reckless, wild and cruel” and he himself needed treatment.

The FC on May 16, 2012 rejected his application with costs saying, however strong his suspicion, he had to prove the allegations by furnishing evidence so that the court can grant him relief. Joel moved the high court in October 2012.

Joan’s advocate Mini Mathew argued that the July 7, 2010 report confirming she was cured of typhoid was sufficient to hold that it was not necessary to send her for an HIV test. She said Joel had been spreading rumours about her. “These allegations are stigmatizing. Her reputation is ruined,” she said.

Joel’s advocate Uday Warunjikar said, “He caught his wife taking HIV medicines. If she is not suffering from HIV, why is she afraid of the test?” he asked. Justice Dalvi remarked, “I doubt the marriage can be reconciled. Both sides must move for an amicable settlement.” She added, “Why don’t you throw her out in a little respectable way? It will boomerang on you.

 

Morning after’ pills legit for 15-year-olds in US #womenrights


TNN | May 2, 2013,

WASHINGTON: The US government has lowered to 15 the age at which girls can buy the morning-after contraceptive pill without a prescription. The US Food and Drug Administration (FDA) on Tuesday announced to approve a contraceptive known as Plan B or popular as “morning after pill” for all women 15 and older.The announcement is expected to stir the controversy among conservatives who consider it another form of abortion. In a statement, the FDA said the approval of Plan B One-Step for use without a prescription by women 15 years of age and older is based on an actual use study and label comprehension data submitted by Teva showing that women age 15 and older understood that the product was not for routine use and would not protect them against sexually-transmitted diseases.

These data also established that Plan B One-Step could be used properly within this age group without the intervention of a health care provider. “Research has shown that access to emergency contraceptive products has the potential to further decrease the rate of unintended pregnancies in the US,” said FDA commissioner Margaret A Hamburg. “The data reviewed by the agency demonstrated that women 15 years of age and older were able to understand how Plan B One-Step works, how to use it properly, and that it does not prevent the transmission of a sexually transmitted disease,” Hamburg said.

FDA said because the product will not protect a woman from HIV or AIDS or other sexually-transmitted diseases, it is important that young women who are sexually active remember to see a health care provider for routine checkups.

 

#India 436 deaths recorded during clinical trials last year


 

New Delhi |  March 12, 2013 5:06:02 PM IST

 

A total of 436 deaths were recorded during clinical trials in India in 2012, parliament was told Tuesday.

While 438 deaths took place during clinical trials in 2011, 668 people died during 2010, Health Minister Ghulam Nabi Azad said told the Rajya Sabha in reply to a question.

Out of the 436 deaths in 2012, 16 were caused due to the clinical trials, he said. Rest of the deaths might have been disease-related in the cases of terminally ill patients suffering from cancer, cardio-vascular diseases and AIDS or due to side effects of drugs administered during the trial.

Azad said compensation is paid in cases of deaths and injury which are attributable to clinical trials.

The Drugs and Cosmetics Rules, 1945 have been amended specifying the procedures to analyse the reports of serious adverse events occurring during clinical trials and procedures for payment of compensation in case of trial related injury or death as per prescribed timelines, he added.

Indo-Asian News Service spc/vd/dg

 

 

 

Child’s HIV cure won’t mean new treatments immediately #healthcare


Liz Szabo, USA TODAY6:38p.m.March 4, 2013

Doctors are thrilled with the cure of a 2½-year-girl infected with HIV at birth but say that extending that success to others will be a challenge.

More than 300,000 babies a year worldwide are born infected with HIV, the virus that causes AIDS.

As of this week, doctors appear to have cured exactly one.

And while the Mississippi child’s story has generated excitement in the medical community, researchers also note that it will likely take years before they’re able to extend that success to a broader community of patients, if ever.

“This is a really groundbreaking report,” says Diane Havlir, a professor and AIDS researcher at the University of California-San Francisco, who attended a presentation of the new study Monday at an Atlanta medical conference.

“This tells us a cure is possible,” says Havlir, who wasn’t involved in the new study, which reported on a 2½-year-old girl who was infected with HIV at birth but apparently cured after 18 months of triple-drug therapy. “That is thrilling news.”

Doctors credit the child’s cure to early treatment; her physicians began treatment soon after delivery, which is the standard of care for the child of an untreated, HIV-positive mother.

STORY: Doctors report first cure of HIV in a child

Most adults can’t benefit from such early therapy, because they typically don’t even learn that they’re infected for months or years, says Rana Chakraborty, an associate professor of pediatrics at Emory University School of Medicine. The only adult to have been definitively cured of HIV had a unique situation: He had a bone-marrow transplant to treat his leukemia from a donor with a genetic mutation that provided protection from HIV.

Scientists will first have to learn what exactly allowed the child to be cured before they can apply that knowledge to developing vaccines or new drugs, he says.

And Havlir notes that doctors are unlikely to make any changes to children’s care before they can verify the study’s results. She notes that, in developed countries, doctors focus far more on prevention than treatment. Giving women anti-HIV therapy while pregnant reduces the risk of mother-to-child transmission by 98%.

But if the results hold up and doctors can identify the best medications, they could start anti-AIDS therapy on high-risk newborns even before getting results of their HIV tests, Havlir says.

That could be important in developing countries, where many women — like the mother of this Mississippi child — don’t get recommended care. The girl’s mother had no prenatal care, let alone anti-HIV therapy, before delivery. Then, when the girl was 18 months old, the mother stopped bringing her to the doctor, which left the child with no anti-HIV treatment for five months.

While the child’s story has been hailed as a victory for science, Chakraborty says the case also illustrates the single greatest challenge in treating AIDS: actually getting care to patients.

Delivering on the promise of scientific breakthroughs has been a challenge not just in developing countries of Africa, but in the USA.

Only 28% of people of the 1.2 million HIV-positive Americans have been diagnosed and treated successfully so that their levels of virus are undetectable, according to the Centers for Disease Control and Prevention.

HIV has become entrenched among the poor in the USA. Many patients lack access to health care and grapple with other problems that keep them from getting the care they need, such as homelessness, drug addiction or mental illness, Chakraborty says.

“Many individuals fall out of care, especially in adolescence or young adulthood,” Chakraborty says. “Young people think they’re invincible.”

Yet Havlir says scientists are ready to confront such obstacles.

“There are daunting challenges,” Havlir says, “but they are challenges that the field is going to embrace, because many people think they are surmountable.”

 

Medicine, monopoly and malice: documentary on access to medicines ‘Fire in the Blood


 

POSTED BY ARADDHYA MEHTTA ON FEB 20TH, 2013 IN ACCESS TO MEDICINESHIV AND AIDS | 

Fire in the BloodA new documentary film opening in UK and Irish cinemas this week tells the story of what its makers call “the Crime of the Century” – how available low-cost antiretroviral medicine was blocked from reaching Africa and other parts of the global south in the years after 1996. The film signals the dangers of the increasingly-perilous outlook for access to essential medicine in developing countries.

Fresh from its much-talked-about premiere at the Sundance Film Festival in Park City, Utah, last month, Fire in the Blood opens at the Irish Film Institute (IFI) in Dublin and the Prince Charles Cinema in London later this week. The film will be released in cinemas  across the UK on Monday 25th February.  The film tells a harrowing story of inhumanity and heroism, with a highly compelling cast of characters.  It details how it could come to pass that millions upon millions of people, primarily in Africa, were left to die horrible, painful deaths, while the drugs which could have saved them were being safely and cheaply produced and distributed just a short airplane ride away.

“I was curious to see what the reaction in the US would be”, says writer-director Dylan Mohan Gray.  “So much indoctrination about the necessity of high drug prices has gone on there that the Big Pharma Research & Development (R&D) defence is very much a sacred cow… even those with profound reservations about how the industry behaves tend to grudgingly accept its validity.  This is very easy for me to understand, since I was more or less that way myself when I began digging into all this.”  Gray was, however, gratified to discover that the American audiences who waited in line to attend six sold-out screenings at Sundance had much the same reaction after seeing the film that he had had when he began to work on the story.  “There is a very strong sense of betrayal when people find out what their governments have done in their name… and a very powerful conviction that the prevailing system of developing and commercialising medicine has to change”.

As the film points out, drug companies actually do very little basic research for drug discovery.  “84% of drug discovery research is funded by government and public sources”, says Gray, citing the landmark work of Professor Donald Light, “Pharmaceutical companies fund just 12% of such research, while the lion’s share of their spending goes into marketing and administration.”  These facts will come as little surprise to those familiar with the industry, but many have never really contemplated the repercussions of pricing essential medicines at levels only a tiny sliver of the world’s population can afford.

While the film tells the story of how multinational drug companies and the Western governments collaborated to keep low-cost generic AIDS drugs out of the hardest-hit countries at the height of the HIV/AIDS pandemic – at a cost of ten million or more lives – it also tells the fascinating story of the unlikely group of people which came together in order to try and break this blockade.  Among this number were front-line doctors, HIV-positive activists, generic drugmakers, intellectual property specialists and individuals of global stature such as Desmond Tutu and Bill Clinton (both interviewed in the film).  “That’s what really set this story apart for me”, says Gray.  “It was a real-life David versus Goliath tale, full of incredibly interesting, daring, courageous mavericks who took on the world’s most powerful companies and governments to do what virtually everyone else at the time said was impossible (i.e. mass treatment of HIV/AIDS in Africa), and against all odds they won…”

While the inspirational story of how low-cost generic AIDS drugs, first and foremost from India, came to save millions upon millions of lives in Africa (and beyond) is at the heart of FIRE IN THE BLOOD, the film concludes on a distinctly alarming note.  “The story this film tells was on the verge of being forgotten, something we can’t afford to let happen”, says Gray. The film details the tireless efforts of Western governments, working on behalf of industry, to impede and cut off supplies of affordable generic medicine from countries like India and Thailand to other parts of the global south, primarily by means of bi- and multilateral trade agreements which low- and middle-income countries are placed under enormous pressure to sign.

“The drug industry is stagnant, its pipeline is anemic and it has pinned all its future hopes on China and India”, notes Gray.  “Almost all these companies are publicly-traded, which means their bosses have to keep turning profits quarter-by-quarter if they want to try and keep their jobs… as they see it, they simply can’t afford to take a humanitarian view on issues of access.”  With the World Health Organisation having estimated that one-third of all deaths worldwide are attributable to treatable and preventable diseases, largely due to lack of access to medicine, the stakes could not be higher.

Meanwhile, for all its insistence that high prices are the only practical trade-off for an industry that spends so much money on R&D to find new and innovative medicines, Gray noted with a wry smile that the who’s who of senior pharma executives will be gathering in London for the industry’s can’t-miss event, the Pharma Summit, just a few days after FIRE IN THE BLOOD opens theatrically in the UK.  “I was amused, but not surprised, to read that the theme of this year’s summit is Should pharma cut its losses and get out of R&D?”.

Araddhya Mehtta is a global heath campaigner for Oxfam GB.

 

IMMEDIATE RELEASE-Slavery in the name of religion; modern manifestation of Devadasi


PRESS RELEASE

: Dr. Ruth Manorama, Dalit Foundation

 

Bangalore 17, Jan 2013.

A two days (15th & 16th Jan2013) national round table consultation organised by Dalit Foundation and Samta Trust on eradication of Devadasi system held at Aashirvad, Marks Road, Bangalore. The consultation began with the key note address by Ruth Manorama, National president of NAWO. In her address she stressed on how in spite of strong laws and government welfare programmes Devadasi system is prevailing in the country.  And the only difference we see in present day is that it has manifested in modern forms in terms of name and its existence particularly in four states Karnataka, Tamilnadu, Andhra Pradesh and Maharashtra”. She said, we are not just flesh stock but we are human who have the right to be free from all kinds of exploitation, to be treated with respect and dignity. Social activists, academicians, leaders from civil society, govt officials and victims of Devadasi system came together to share & discuss to form a strategy for the eradication of Devadasi system through proper implementation of law and welfare programmes.

 

Chandrashekhar, a researcher and founder of SAMATA TRUST shared his experience of working with the devadasi women in Koppal and partial findings of his PhD research. He says more than 99% Devadasi women belong Scheduled caste community. Giving the historical context of devadasi system he pointed out the problems that the victims of devadasi women face in the society, while dealing with the systems of government. Even they hold voter ID card but do not have access to the govt welfare programmes. He stresses that this is specifically due to lack of sensitivity, caste mind set and ignorance among govt officials. The victims of Devadasi system suffer multiple levels of discrimination and ignorance not only from the government but civil society too.  Children of Devadasi, who do not have father’s name to give in the schools during admissions, suffer from discrimination as they are not getting admissions in the schools and other benefits ensured by the govt through various welfare programmes made exclusively for the eradication of devadasi system. .Even opening a bank account is not possible for the devadasi. There are around 28,000 devadasi in the ten districts in the state of Karnataka who suffering acute exploitation due to this social evil in the most developed state of the country.

 

Divya, a researcher from TISS shared part of her research experience with the Devadasi of Northern Karnataka, which focussed on to understand the present form of devadasi from the experience of devadasi women. The relationship between caste hierarchy and patriarchal values of the social cultural set up of the region has a greater role in the perpetuation of the system and complicating the life of devadasi women in terms of their kin relations, and their relation with other people in the society, occupation and livelihood.  Even opening a bank account is not possible for the devadasi.

 

Akhilavasan, Co-convenor, People Health Movement, Karnataka said that Health is a fundamental rights under human rights which must be non discrimination and with the perspective of social justice and equality. Majority of Devadasi are suffering from critical health diseases including HIV and AIDS but due to the acute discrimination on the basis of caste, they are not getting proper treatment.

 

Academicians, social activist and victims demanded five acres of land which can be cultivated to the victims of Devadasi, time bound status report from the Govt on Devadasi’s and ensure free admission with hostel facilities to the children of Devadasi. The victims of Devadasi system vibrantly participated and shared their experience of being a devadasi.

 

On the second day strategic planning for the future action was the focus. This session was facilitated by Mr. Pradeep Esteeves, where devadasi women themselves participated in forming the future plan of action by identifying their problems that they were facing.  The major concern that came up was social exclusion, stigma, redtapism in availing the government services, identity. The need was felt to have a national level movement with a strong grass root level participation.  The groups felt the need of involving the community, government, media, social activists and organisations in carrying out the action to eradicate the system.

 

Chandrashekhara  HR                                                                                                                  Date: 15.01.13

0-9242889918

 

HIV in Chhattisgarh jails, debate over what caused it


Ashutosh Bhardwaj, Indian Express Nov 12, 2012

A nationwide health survey in jails has found 80 of Chhattisgarh’s prisoners HIV-positive, out of 13,000-odd tested. Prison authorities insist that the inmates had probably arrived already infected, but health authorities don’t rule out the possibility that it was after being jailed that they got infected, with unsafe sex or drug use the likely causes.

This has turned into a contentious issue. The health authorities are contemplating distribution of condoms and syringes, but the jail authorities say there is no reason to do so. Their resistance comes apparently because allowing distribution of condoms would amount to an acceptance of the fact that homosexuality exists in jails.

The 80 found HIV-positive include women prisoners too. “This is the first instance of an ELISA test being conducted in jails anywhere in India. Figures for none of the other states are available,” said S K Binjhwar, additional project director, Chhattisgarh Aids Control Society.

“Of these 80 prisoners, 65 have a CD4 count less than 350. They are being given ART. So far we have tested only those we suspected to be from a high-risk group, but since the infection also spreads to others in jails we are expanding our sample size,” he said. “We counsel them about safe sex.”

The jail administration says the health authorities should focus on sources of infection beyond prisons. “Instead of focusing on jails, the health authorities should focus on red-light areas and drug addicts and on improving the health situation at village level, especially checking quacks who use old syringes. These are the major sources of spreading HIV infection,” said ADG (jail) Giridhari Nayak.

“A jail has a mobile population, like a train. People board at a station and get off at the next. Only a few remain till the final destination,” Nayak added. “Of the total HIV-positive inmates in Chhattisgarh jails, only 12 are convicts while the rest are undertrials; they keep getting released and new ones come in. The infection comes from outside; it is not spreading in jails.”

Dr K K Gupta, Raipur jailor, said that the possibility of homosexual behaviour in jails “is merely hypothetical”. Gupta said, “There is no question of distributing condoms or syringes as such activities are yet to be seen in jails.”

Homosexuality in jails has been discussed globally and opinions have been sharply divided. A California study notes that the rate of HIV prevalence among people who are incarcerated is nearly seven times higher than that of the general population. San Francisco jail authorities installed a condom-vending machine on their premises after HIV infection was found to be rapidly spreading in the area in the 1990s.

In Chhattisgarh, the project began in March 2011, when the state AIDS control soc

 

HIV and the Law-Risks, Rights & Health


Thursday, 25 October 2012, IFHHRO

Earlier this year, the Global Commission on HIV and the Law published a report presenting the available evidence on human rights and legal issues relating to HIV: HIV and the Law: Risks, Rights & Health.

The Global Commission on HIV and the Law consisted of fourteen individuals who advocate on issues of HIV, public health, law and development. Some of the Commission’s findings include:

  • 123 countries have legislation to outlaw discrimination based on HIV, and 112 legally protect at least some populations based on their vulnerability to HIV. However, these laws are often ignored or badly enforced.
  • In over 60 countries it is a crime to expose another person to HIV or to transmit it, especially through sex. At least 600 individuals living with HIV in 24 countries have been convicted under HIV-specific or general criminal laws.
  • In many countries, the law dehumanises many of those at highest risk for HIV: sex workers, transgender people, men who have sex with men (MSM), people who use drugs, prisoners and migrants. Rather than providing protection, the law renders these “key populations” all the more vulnerable to HIV. The criminalisation of sex work, drug use and harm reduction measures create climates in which civilian and police violence is rife and legal redress for victims impossible.
  • 78 countries make same-sex activity a criminal offence, with penalties ranging from whipping to execution.
  • A growing body of international trade law and the over-reach of intellectual property (IP) protections are impeding the production and distribution of low-cost generic drugs. IP protection is supposed to provide an incentive for innovation but experience has shown that the current laws are failing to promote innovation that serves the medical needs of the poor. The fallout from these regulations—in particular the TRIPS framework—has exposed the central role of excessive IP protections in exacerbating the lack of access to HIV treatment and other essential medicines.

Reason for hope

Notwithstanding these problems, the Commission has found reason for hope: “There are instances where legal and justice systems have played constructive roles in responding to HIV, by respecting, protecting and fulfi lling human rights. To some such an approach may seem a paradox—the AIDS paradox. But compelling evidence shows that it is the way to reduce the toll of HIV.” Examples given are police cooperation with community workers who assist sex workers; the promotion of harm reduction programmes for injecting drug users; effective legal aid for people living with HIV; and court actions and legislative initiatives promoting the rights of sexual minorities, women and young people. Despite international pressures to prioritise trade over public health, some governments
and civil society groups are using the law to ensure access to affordable medicines, while exploring new incentives for medical research and development.

The report is available in English, Spanish,French and Russian.

Download HIV and the Law: Risks, Rights & Health

 

India- Govt to bring essential medicines under price control #goodnews


 

, TNN | Sep 28, 2012, 12.54AM IST

Govt to bring essential medicines under price control
Once these essential medicines are brought under Drug Price Control Order (DPCO), it cannot be sold at a price higher than that fixed by the government.
NEW DELHI: India will, for the first time, put a cap on the maximum price at which essential drugs, like some commonly used anti-AIDS and anti-cancer drugs, besides a horde of painkillers, anti-TB drugs, sedatives, lipid lowering agents and steroids, can be sold in the country.

In a landmark decision, a group of ministers (GoM) headed by agriculture minister Sharad Pawar on Thursday cleared the proposal to bring all 348 drugs on the National List of Essential Medicines (NLEM) under price control. These drugs, with annual sales of around Rs 29,000 crore, account for about 60% of the domestic market.

Once these essential medicines are brought under Drug Price Control Order (DPCO), it cannot be sold at a price higher than that fixed by the government.

The GoM, which included health minister Ghulam Nabi Azad, decided on a “weighted average price formula”. This means the average price of all the brands sold in individual segments with a minimum market share of 1% will be the maximum retail price now.

The GoM will send its recommendations to the Cabinet within a week for approval. “The proposal will now go to the Cabinet which will take the final view,” Pawar said.

Prices rose 40% in 10 years

At present, the government, through the National Pharmaceutical Pricing Authority (NPPA), controls prices of 74 bulk drugs and their formulations. Drug prices have shot up phenomenally in India over the past decade and a half. There was a nearly 40% rise in all drug prices between 1996 and 2006. However, during the same period, the price of controlled drugs rose by 0.02%, while those in the Essential Drug List (EDL) increased by 15%. The price of drugs that were neither under price control nor under the EDL grew by 137%.

Interestingly, experts say there could a small downside to the proposal. “Price of costly drugs will definitely come down. But because the formula will put a cap on the MRP, the price of drugs for the same ailment, which are presently sold at a lower price, will go up,” experts said.

Minister of state for chemicals and fertilizers Srikant Jena said, “The GoM arrived at a consensus on the option which entails the use of weighted average prices for all the drugs which have a market-share of more than 1%.”

The concept of essential medicines, first introduced by the World Health Organization in 1977, has been adopted by many countries including India.

The list includes the most cost-effective medicines for a particular indication. Essential medicines are those that satisfy the priority healthcare needs of the majority of the population. The list is specific to India and addresses the disease burden of the nation besides being the commonly used medicines at primary, secondary and tertiary healthcare levels.

The latest NLEM 2011 has 348 medicines which cover 489 formulations, including 16 fixed dose combinations. These drugs are considered to be adequate to meet the common contemporary health needs of the general population of the country.

Planning Commission panel had suggested that all drugs on the NLEM should be brought under price control since the cost of medicines constitutes over 60% of the total cost of healthcare of Indians. The commission’s report had said, “Taking advantage of lax regulations on drug pricing, the pharmaceutical industry has been able to reap high margins through complex price setting activities.”

It added, “It has been observed that the price of a therapeutically similar drug could vary around 1,000% between the most expensive and the cheapest brands. The variation between the market and procurement price of similar drugs could range anywhere between 100% and 5,000%. The panel recommends price control on all formulations in the EDL.”

The report said direct price control should be applied to formulations rather than on basic drugs.

A note prepared by the drug controller general of India and available with TOI says, “A total of 348 medicines excluding repetitions are present in NLEM 2011. In NLEM 2011, 181 medicines fall under the category of primary, secondary and tertiary use, 106 medicines fall under category of secondary and tertiary use while 61 medicines are categorized as tertiary use only. In comparison to NLEM 2003, number of medicines deleted is 47 and 43 medicines have been added.”

It added, “Out of the 348 medicines, 37 medicines are currently under prices control by National Pharmaceutical Pricing Authority.”

 

Free medicines for all from October



Kounteya Sinha, TNN | Jun 23, 2012, 01.51AM IST

NEW DELHI: India‘s ambitious policy to provide free medicines to all patients attending a government health facility across the country will be rolled out from October.

Strongly backed by Prime Minister Manmohan Singh himself, the free-medicines-for-all scheme — being referred to as the “real game changer” — has received its first financial allocation  from the Planning Commission for 2012-13.

At present, the public sector provides healthcare to 22% of the country’s population.

The ministry estimates that this will increase to 52% by 2017 once medicines are provided for free .

The ministry has sent the National List of Essential Medicines, 2011, (348 drugs which includes anti-AIDS, analgesics, anti-ulcers, anti psychotic, sedatives, anesthetic agents, lipid lowering agents, steroids and anti platelet drugs) to all the states to use as reference.

The states, however, have been asked to create their own Essential Drugs List (EDL), keeping in mind the diseases that worst affect them. Around 75% of the funds under the scheme will be borne by the Centre, while the rest will be the state’s responsibility.

Around 5% of the district funds will be allowed to be used to purchase drugs outside the EDL. The Cabinet has approved the setting up of a Central Procurement Agency (CPA) for bulk procurement of drugs.

The PMO has asked the ministry to set up the CPA as early as possible. At present, 78% of the entire health expenditure in India is from out of pocket (OOP). Purchasing drugs alone accounts for 72% of this OOP expenditure.

They have also been asked to devise standard treatment protocols in order to avoid unnecessary and irrational treatments.

The states will procure drugs directly from manufacturer or importer through an open tender. Companies applying for the tenders will have to have GMP compliance certificate, a no conviction certificate and should have a specified annual turnover. The drugs must carry a not-for-sale label printed on the packaging.

A district-level state-of-the-art warehouse will have to be set up by states to store the drugs and a passport driven system will move the medicines to district hospitals, CHCs and PHCs will then send the drugs to the sub centres.

It is being made mandatory for all doctors in the public sector to prescribe generic drugs and salt names and not brands. Action will be taken against doctors found prescribing brands.

A Planning Commission panel had said drug prices have shot up by 40% between 1996 and 2006. It said that during the same period the price of controlled drugs rose by 0.02%, while those in the EDL increased by 15%. The price of drugs that were neither under price control, nor under the EDL grew by 137%.

The Commission says 39 million Indians are pushed to poverty because of ill health every year. Around 30% in rural India didn’t go for any treatment for financial constraints in 2004. In urban areas, 20% of ailments were untreated for financial problems the same year. About 47% and 31% of hospital admissions in rural and urban India, respectively, were financed by loans and sale of assets.

Outpatient expenditure  increased from 30.63% to 46.16%. Catastrophic spending, or percentage of households spending more than 10% of their overall income on healthcare, is nearly 15% in states that have insurance in place as against 11% in states that lack such policies