Why India Should Join UNITAID?
By Stanzin Dawa
15 September, 2007
Countercurrents.org
India has been reeling under the twin epidemic of Tuberculosis and HIV/AIDS. Due to various reasons access to treatment and care for TB and HIV pose very serious challenges, precisely for children, women and men who are more vulnerable to HIV due to social and personal reasons. As more and more people will get sick and more and more people will know they have HIV. That's why it's so important that we have a long term sustainable funding mechanisms which will allow us to continue treating people. To address this situation last year in September, the United National General Assembly ratified the setting up of UNITAID housed with WHO as a single largest facilitator of treatment access through procurement of Drugs for TB and HIV. UNITAID is being established as an innovative funding mechanism to accelerate access to high-quality drugs including second line and diagnostics for HIV/AIDS, malaria and tuberculosis in countries with a high burden of disease. According to the new estimates Indian is the third largest country in the world in terms of people living with HIV/AIDS, putting it behind South Africa and Nigeria.It is mostly financed through a small tax on airline tickets and other innovative sources of funding that the UNITAID donor governments have established. In the spirit of global solidarity, these contributions of airline passengers go specifically to the lifesaving purchase of drugs urgently needed by the millions of people struggling against drug resistant HIV, TB or malaria. Second Line Drugs are the only hope for sustaining life - yet these drugs are much more expensive. Indian government at present provides first line treatment for HIV free of cost, but not the second-line. Under such situation UNITAID gives a ray of hope for people living with HIV who are in need of second line treatment. With the increasing access to these medicines through UNITAID, more and more of those who are surviving on the ground are saying "You Fly, I Live - Thanks!"
UNITAID is a lean mechanism which complements the existing global national architecture for health, inside and outside the UN system. With annual resources approaching $300 million for 2007, UNITAID is already helping to provide treatment to people, including many children, in some 80 countries, of which 85% are low-income. Several countries who are members of the UN are signatories and members of UNITAID while India at present is not a signatory to UNITAID. On 20 th of September, the UN family will be celebrating the first anniversary of UNITAID and on this auspicious occasion civil societies and people living with HIV/AIDS, TB and malaria appealing the Government of India to fast track the process and announce its commitment to be part of this important global life saving initiative by signing UNITAID.
Why India should sign UNITAID? Because:
India being one of the principal countries along with other 189 member States that initially endorsed to adopt Declaration of Commitment on HIV/AIDS in June 2001 at United Nations General Assembly Special Session (UNGASS). As a signatory nation, India has also pledged: "…in particular to ensure their access to treatment…" The new AIDS treatment access numbers released by the World Health Organization (WHO) on 17 th April 2007 are a grave warning about the state of AIDS treatment scale up. In 2006, treatment access grew by 700,000 to an estimated total of 2,015,000 people, leaving many millions more in urgent need of antiretroviral therapy. At this rate of expansion the world will fall five million people short of the internationally declared and reaffirmed Universal Access target of 9.8 million on treatment by 2010. Each day 8200 people living with HIV/AIDS die, and 13,000 become HIV positive. By 2010, 100 million people will be infected with HIV worldwide--45 million new infections in only 5 years. India is the third largest country in terms of people living with HIV. By joining UNITAID India has an opportunity to live up to the promises made at UNGASS, as universal access is still a big challenge in India.
Under the situation sustainable financing mechanisms in India are not in place to meet the full costs of comprehensive services including HIV prevention, universal access to treatment and full coverage of support for children living or affected by HIV, TB and malaria. Though government funding for HIV/AIDS has increased considerably in this year's budget, it is still not enough. UNITAID is a long term sustainable funding mechanisms which will allow us to treating people irrespective of their paying capacity. In order to have sustainable financing mechanism the government of India has an obligation to sign UNITAID.
ICAO ( International Civil Aviation Organization) forecasts predict worldwide growth in air traffic at 5% a year or doubling in the volume of traffic once in 14 years. The Asia Pacific region is set for higher than average growth. According to an AUTC study, it might account for more than 50% of the world air traffic by the year 2010. There are 449 airports/airstrips in India. Considering the forecasts made by AAI taking a reasonably pragmatic view, the projected traffic scenario in 2007-08 will be 298.24 lakhs domestic passengers and 209.64 lakhs international passengers. By the year 2016-20017 projected air traffic will be 523.16 lakhs domestic passengers and 329.88 international passengers. This is a massive number to enhance and ensure sustainability of UNITAID funding. India can demonstrate its leadership and global solidarity by sharing the benefit of its booming civil aviation industry with those who are living with fear of death due to lack/absence of second line treatment.
The population in India as at 0:00 hours on 1st March 2001 stood at 1,027,015,247 persons. With this, India became only the second country in the world after China to cross the one billion mark. (India is the 2nd most populated country in the world). It has got a moral responsibility to demonstrate global responsibility to ensure health for all. UNITAID is an opportunity for the Government of India to gain the confidence of other countries, communities and individuals in ensuring access to treatment.
Even more than 50 years after independence from almost two centuries of British rule, large scale poverty remains the most shameful blot on the face of India. India still has the world's largest number of poor people in a single country. Of its nearly 1 billion inhabitants, an estimated 260 million are below the poverty line, 75 per cent of them in the rural areas. More than 40 per cent of the population is illiterate, with women, tribal and scheduled castes particularly affected. Under such situation access to second line treatment is a distant dream as the second line treatment is very expensive. Free provision and availability of lifesaving second line treatment for AIDS must be ensured at the earliest. The preamble of the Indian constitution says India is a socialist country, keeping this into consideration India must sign UNITAID so that everyone one can access to second line treatment by choice not by chance.
India , which is now the fourth largest economy in terms of purchasing power parity, will overtake Japan and become third major economic power within 10 years. Indian Economy experienced a GDP growth of 9.0 percent during 2005-06 to 9.4 percent during 2006-07. By 2025 the India's economy is projected to be about 60 per cent the size of the US economy. In order to sustain the galloping economy India must protect its human resources, which is the backbone of any economy. This time India can show its gesture and concern for public health and economic growth by signing UNITAID without any delay.
The civil societies and people living with HIV/AIDS, TB and malaria are calling the Government of India to change the course of history by signing UNITAID to ensure access to treatment more precisely access to second line treatment to bolster prevention efforts and improve overall health systems throughout the country. Comprehensive Treatment and care of people living with HIV/AIDS and effective prevention cannot wait. People living with HIV/AIDS, TB and malaria are demanding for real Access for All.
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