InterPress News Service (IPS) - July 23, 1998
Dev Raj

Officials at the federal government's National Aids Control Organisation (NACO) said the trials will be conducted in Mumbai city and in southern, Tamil Nadu and Kerala states.

"We have selected these centres because of the existing large number of hospital cases there which would facilitate trials," said J.V.R Prasad Rao, additional director-general of NACO.

Rao said a list of research institutes which would supervise the trials was presently being finalised.

The tests are meant as "double-checks" on results of successful AZT trials on HIV-positive pregnant women already conducted in various countries around the world including Thailand, said Dr. D. Sengupta, advisor to NACO.

Studies released at the 12th World Conference in Geneva in June showed mother-to-child transmission rates dropping to a low one percent especially when Caesarean sections are resorted to on delivery of mothers under AZT treatment. According to Dr. Sengupta, the drug, a 'protease-blocker' when administered from six months of pregnancy onwards, reduces the viral load in the mother's blood and therefore the chances of transmission to the child.

But even if the Indian trials are successful nobody can say how affordable it is going to be in a country where the average annual incomes is 1,000 dollars. Initial estimates place costs to the HIV-infected mother at 400 dollars.

"The drug may be affordable for the well-to-do but will not help, for example, the thousands of sex-workers in the big cities who have tested positive for HIV," said Dr. Mira Shiva of the Voluntary Health Association of India (VHAI). "As usual they have come up with a technological fix with little emphasis on prevention or any attempt to tackle poverty which is forcing an increasing number of women to take to prostitution in this country," she said.

Besides, said Dr. Shiva, if the drug is being used merely to reduce viral load, many immuno-modulating ayurvedic drugs can be used far more reliably, safely and affordably and that is where the money should be going.

Ranjana Kumari, convenor of the Women's Forum suspected the whole move to be "another attempt to use women in the Third World as guinea pigs instead of concentrating on preventive methods."

Suspicion among activists are not allayed by the fact that the major drug companies which produce drug-combinations using AZT have recently announced large-scale discounts to promote their use in developing countries.

More than 90 percent of the world's 30 million HIV infected people live in the developing, impoverished countries of Sub- Saharan Africa and Asia, and UNAIDS has said that an additional 3,000 people will benefit from the price reductions.

India already has recorded more than 4,000 cases of full- blown AIDS while there have been more than 50,000 infections resulting in a an estimated sero-positivity rate of 18.0 per thousand, according to NACO surveys.

"Obviously these companies are looking for new markets in the developing countries and want to cash in on countries like India where HIV infections are expected to reach explosive proportion early next century," Shiva said.

Activist Purushottaman Mulloli says NACO as well as the anti- AIDS policy in India has been hijacked by the vast amounts of World Bank funds flowing into the country beating even the sanctions imposed after its nuclear-tests in May.

"The funds only benefit bureaucrats who siphon money out for their personal wealth and are never accountable for the failure of programmes even if they have disastrous consequences," Mulloli said.

Echoing his sentiments, Shiva said failures of similar tests in the past have been lamely attributed to "genetic differences," and the people involved have got away with it simply because the public is unsuspecting.

The activists also point to the fact that several major studies have shown the rapid resistance HIV develops when AZT is administered after seeming to subside for a few months of treatment.

Results of a study conducted by Dr. Robert Shafer at the Stanford University in California and published last month says the virus has become immune to AZT and its variants because of extensive use over several years.

"Contrary to the assurance of pharmaceutical companies that their AIDS medicines are very specific, individual drugs do not show much difference between each other," Shafer's study said.

However, Rao said NACO would go ahead with the tests. "This is the first time a drug is available in the country with which to tackle the serious problem of HIV transmission from mother to child," he said. (End/IPS/rdr/an/98)

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