Healthcare NGOs, physicians and networks of people with HIV/AIDS have sent a memorandum to Prime Minister Manmohan Singh, urging him to speedily ensure that India joins UNITAID, an international drug purchase facility.

They say that in the next few years there will be huge fund shortages to buy essential medicines in countries like India. Malaria, tuberculosis (TB), HIV/AIDS are illnesses for which, experts say, a second line of medicines will soon be needed.

The healthcare sector and positive people’s networks are now asking India to join UNITAID, set up in September 2006 to generate money for medicines. France, Brazil, Chile, Norway and Britain were the founding members of UNITAID, which is administered by the World Health Organisation (WHO). India’s National Aids Control Organisation (NACO) chief Sujata Rao was an observer at the initiative, which now has 30 members but India is yet to become one.

The fund’s money is generated through an aviation-linked levy called solidarity tax. A part of the fund generated by each country goes to UNITAID. With this UNITAID does bulk purchase of drugs and gives it to needy countries.

Celina D’Costa from the India Network for People Living with HIV/AIDS (INP+), detailed the concept: ‘UNITAID boils down to you fly – I live and I fly – they live’.

Every flight ticket purchased automatically donates a dollar or two to UNITAID. In the past one year, over $300 million has been collected from nine member countries through this mechanism.

India has about 450 airports, 50 foreign airlines flying in, and 12 domestic airlines. Air traffic in India is projected to be to the tune of 90 million people by 2015. Today there are 50 million air travellers in India, annually. If each ticket can contribute Rs.100, ‘that gives the measure of the kind of money that can be generated to support the cause of second line medicine’, Celina told IANS.

UNITAID members like Norway contribute through a kerosene tax while Britain, Spain and South Africa do so through budgetary allocations.

France has been particularly pro-active with Air France making across the world contributions for every seat on its flights and the tax has not hindered its growth.

The money is needed urgently because even if cured once, malaria can attack a person time and again, making the immune system drug resistant after a period of time. Then more powerful drugs are needed to combat even malaria.

TB may be contained with medicine, but the same person can contract a deadlier kind of TB that is resistant to the earlier drug and may require new medicine.

In 2001, India, along with other 189 member states, endorsed the UN Declaration of Commitment on HIV/AIDS. As a signatory nation, India has also pledged ‘in particular to ensure their (AIDS patients’) access to treatment’ and India’s universal access target date is 2012.

India has the third largest population of those living with HIV/AIDS and health officials say about 700,000 need Anti Retroviral Therapy (ART). In 2004, the government launched a free-ART programme, but in 2006 only about 40,000 had access to the medicine.

Along with free ART, TB is treated freely too and there is a demand in India’s north eastern states that free treatment for Hepatitis C also be provided.

‘NACO has begun the third phase of its control initiative in the country, but has no word on the second line of ART that will be required soon,’ Sundar Sunderaraman, a physician, told IANS.

‘The people already getting first-line treatment will soon get immune to their drugs. What will we tell them? No more medicines, go die now?’ he asked.

‘Of what use will the first line ART be if India cannot manage to start second line ART programme?’ Stanzin Dawa of the International AIDS Alliance in India asked.

Financing mechanisms in India are not in place to meet the full costs of HIV prevention, universal access to treatment and full coverage of support for children living with or affected by HIV/AIDS, activists said.

‘In countries like India, most of the fund generated from air tickets can be pumped back into drugs for India’s unwell population,’ says Sunderaraman.

India receives a lot of donations for AIDS control, but has never contributed so far to the global AIDS care initiative.

‘Through UNITAID, it will be India’s opportunity to also make a great contribution to the world effort to contain AIDS,’ he said.