A travel reimbursement scheme for HIV patients was launched in Karnataka to ease the burden of expense to approach Anti-Retroviral Therapy (ART) centres for treatment. However, what was to exemplify as a model for other states, has run into implementation issues since its launch in 2013.
Even as the state continues to witness rise in number of infection cases, it has already witnessed a 80 cases drop for treatment across the 66 ART centres spread. The prime reason is the lack of affordability for travelling to the centre, from their daily earnings.
The first such issue faced by the administrators of the scheme- Karnataka State AIDS Prevention Society (KSAPS) is over the budget. An initial allocation of Rs 12.5 crore was made in the 2014 budges; but KSAPS has just received Rs 10 lakh for the implementation of the scheme. Even the allocated payment of conveyance (at 80 paise per kilometre) has been stopped from June. This has increased the number of “lost to follow up” (LFU) cases in the State, as confirmed by The Hindu.
According to David B., coordinator for Sangama, a human rights NGO working with sexual minorities, even if you consider those who opt out to private practitioners and Ayurvedic treatment, the LFU figures are increasing rapidly in the State, as reported by The Hindu.
He alleged that the “atmosphere at ART centres” was also adding to the problem. Sometimes, patients are forced to make frequent visits to the centre either because the drugs are not available or because the laboratory has been closed for the day, another activist said.
KSAPS officials have not provided a year-wise break up of LFU figures, but an estimate shows that there are as many as 5,386 such cases over a period of last year (as compiled by KSAPS). 568 of them were brought back to ART centres after outreach by counsellors, the report said.
KSAPS project director S.G. Raveendra said a total of 9,978 LFU cases had been recorded in the State from 1998 till 2015. “Most of them could have dropped out because they would have started on alternative systems of medicine, or stopped treatment totally,” he said.
He added that KSAPS has now submitted a supplementary budget proposal for an additional Rs. 9 crore.
According to the World Health Organisation (WHO), more than half the people living with HIV are unaware of their status. Those who test, do so late when they have symptoms and their immune systems are already compromised. Only 36 per cent of people living with HIV are on treatment, and less than 30 per cent are able to get to the last point when HIV virus multiplication in their body is suppressed, which is essential to prevent further transmission.