Karnataka runs out of third-line ART drug; HIV patients in the lurch

When contacted, Health Commissioner Pankaj Kumar Pandey said he would look into the matter

Raltegravir, a third-line anti-retroviral therapy (ART) drug meant for HIV patients who are resistant to first and second line of therapy, is out of stock in the state, leaving 171 patients in the lurch.

Two months ago, the National AIDS Control Society (NACO), in a letter to state AIDS control societies (SACS) of 10 states including the one in Karnataka, had said, “NACO is in the process of procuring ARV drug Dolutegravir scheduled to replace Raltegravir through Central Medical Services Society. However, the supply of this drug may take some time to be materialised ... the SACS are hereby authorised to make emergency procurement of Raltegravir in sufficient quantities ... so as to meet three months’ requirement.”

Sources in the Health department said the Karnataka State AIDS Prevention Society (KSAPS) is unable to procure the tablet while complying with The Karnataka Transparency in Public Procurements (KTPP) Act, 1999, as there is only a single bidder to supply the drug to the public sector - MSD (Merck & Co). While the drug’s MRP is Rs. 8,000, it is supplied to NACO at Rs. 3,800.

However, procurement through tenders is exempted under Section 4(b) of the Act - that is in case the goods or services are available from a single source. The KSAPS has invoked this clause in the past in the interest of patients, but is not doing so this time.

Thyagaraj D T, Karnataka Network for People Living with HIV/AIDS (KNP+) president, told DH, “The third-line treatment involves a triple drug regimen of Efavirenz, Abacavir and Raltegravir tablets. From the past few days, our community members have not got Raltegravir. We’re told it will be supplied soon.”

There are 64 ART centres across the state but the one at Bowring and Lady Curzon Hospital is the only Centre of Excellence that provides Raltegravir to HIV patients.

Dr Vijayalakshmi G N, Medical Superintendent, Bowring and Lady Curzon Hospital, told DH, “We have written to KSAPS saying Raltegravir is out of stock. They said they will supply it shortly.”

M K Sreerangaiah, Project Director, KSAPS, said that the the tender process was underway. “We had given Rs 2 lakh to each district to procure third-line drugs.” However, the funds were only to procure Efavirenz and Abacavir. On probing further about the single bidder and the exemption clause, he refused to comment and asked to request information from his office under the Right to Information Act.