Rights group and positive networks press for easy access to second-line ART

IMPHAL, July 14: "We should do away with systems that impede access to treatment. Patients should not suffer waiting for doctors to convene at their convenience and take decision on treatment. SACEP instead of delivering speedy second-line treatment has delayed it thereby endangering lives". L. Deepak, President, Manipur Network of Positive People (MNP+), said today while speaking at a consultative meeting to improve access to alternative first-line and second-line ART for people living with HIV and AIDS undergoing treatment.
The State AIDS Clinical Expert Panel, popularly known as SACEP, was instituted in November 2008 to provide first-line alternative and second-line ART. Presently SACEP in Manipur comprises eight clinical experts including Deputy Director (Care, Support & Treatment), MACS.
NOOs and positive networks in Manipur and other states said that they have come across a number of cases in which treatment is delayed due to SACEP. Delay in treatment, red tape and other difficulties faced by patients are reasons why positive networks all over the country have demanded review of SACEP or scrap it altogether.
Speaking at the inaugural session of the consultative meeting, Dr.Sailesh Kumar Chourasia, Project Director, Manipur State AIDS Control Society (MACS), said that the role of SACEP is critical in the state HIV and AIDS programme however treatment strategies and systems must be in tune with needs of patients. "Sometimes we fail to identify gaps between need (of patients) and ystems meant to address these needs. Such consultations will ensure that gaps are plugged. MACS will do whatever it can to improve service delivery".
On difficulties faced by patients in getting their viral load test being done in Kolkata, Chourasia said that MACS will look into the possibility of engaging a private clinical laboratory in the state for the same.
Presently Babina Diagnostics Centre is the only laboratory in the state which has facilities for viral load testing, a clinical investigation necessary for most patients requiring initiation of second-line ART.
Representing Human rights Alert (HRA), BasantakumarWareppa said that it is only police and armed forces who are often looked at as human rights violators. "Doctors or any government employee who fail to deliver services that he is mandated to provide also amounts to rights violation. People living with HIV should speak up for their rights to ensure appropriate systems are activated and services are delivered in time".
In recent past the Manipur Network of Positive People (MNP+) came across cases of PLHIV who died while awaiting SACEP to take decision on their treatment. "We as responsible human beings must not allow this to happen in future", said Ratan, MNP+.
Sharing her experiences during the consultation Sushila (name changes) urged MACS to take immediate steps to ease access to second-line ART. Sushila's husband and son died, in 2010 and 2012 respectively, waiting for SACEP board members to convene and take a decision.
Patients who fail to respond to or cannot benefit from first-line ART are recommended for first-line alternative treatment or second-line ART. Presently 88 persons are under first-line alternative treatment while 87 are on second-line ART. RIMS cater to patients requiring first-line alternative treatment or second-line ART from all NE states except Assam and Sikkim.
The consultation came up with a ten-point recommendation which will be submitted to the Minister, Health & Family Welfare, RIMS, MACS, and JNIMS. Renowned rights activist Khaidem Mani moderated the discussion sessions.
On December 1, 2008 Manipur became the fifth state in the country to roll out free second-line ART at RIMS, Imphal. In trying to avoid difficulties in accessing second-line ART from RIMS, if a person opts to buy it on his own then he/she has to spend anywhere between 4,000 and 8,000 rupees every month.
Experts claim that around three to four percent of patients on ART develop resistance to first-line every year. As on October 2010, Manipur has 36,854 people infected with HIV and 6,833 people are on ART.
The consultative meeting was jointly organised by the All Manipur Anti-Drug Association (AMADA), Community Network for Empowerment (CoNE), Centre for Organisation Research and Education (CORE), Human Rights Alert (HRA), Human Rights Law Network (HRLN), All Manipur Bar Association (AMBA), Kuki Women Union, Kripa Society, Care Foundation, Lifeline Foundation, Dedicated People's Union (DPU), Manipur Cycle Club (MCC), Coalition Against Drug and Alcohol (CADA), Christian Network of Positive Women of Manipur (CNPWM), All Manipur NupiManbi Association (AMANA), Solidarity and Action Against HIV infection in India (SAA THII), Manipur Network of Positive People (MNP+), Social Awareness Service Organisation (SASO), Population Foundation of India (PFI), FXB Manipur, Centre for Advocacy and Research (CFAR).