Mihir, - my ties to India go back to infancy so I still feel kinship with the people of this vast continent. I was appalled by these facts. Apart from raising consciousness what can one do? Do organisations exist that need help other than in monetary terms? I am a writer and free-lance journalist. I am going to India in July/August. Can I meet with you or anyone from an AIDS agency? I am not prepared to publish personal contact details here but if you consider I can do anything to help I can authorise Graham to pass on my e.mail address.

I've had to learn a few things caring for some people with HIV.

The disturbing thing about this disparity Romany is this is not an isolated problem to India, nor with HIV treatments.

The crux of the problem is that multinational drug companies insist on pricing their drugs not on the cost of research, not on the cost of production, not even on the cost of the chemical and certainly not on the cost of circulation or marketing.

The cold and nasty fact comes back to the same unethical point. Drugs are priced not on the value of research and production but on the value of the drug has to the life and death value of the patient. The more likely the patient has to rely on the drug to survive, the more expensive the drugs are. That is why Fluconozol, an anti-fungal drug that cures many fatal fungal diseases including meningits, can cost more than A$3000 per month per patient. Without this drug, people die.

Some of the anti retrovirals that India uses are 20 years old now. This family includes AZT, DDI, DDC (do longer used) 3TC, D4T and a few others in Combavir. Their are at least 4 other families in HIV treatment. For any HIV treatment to work, a combination should include at least 2 or more families of HIV treatments whether they are anti retrovirals, protease inhibitor, non transcriptase protease inhibitors, immune boosters (Il 2), and Fuzeon inhibitors and a few new ones.

The problem is not just effecting India, it has an effect on Australia which is being pressured by new patent laws as part of the Free Trade Agreement. That is probably why we have a steep increase in our PBS scheme.

If India can make generic drugs for one family of treaments, surely they should have the ability to use the formulas to have generic versions of the four or so others. I agree that the situation is unfair and charity can only be a temporary remedy to the problem.

SF, yes, the situation re drug companies worldwide is appalling and I do know its not an isolated problem. The reason I think that I was so shaken was that I spent a few years in Africa in the '90's involved with the HIV question (As I am sure you are probably aware, the official figures which come out of Africa bear no relation to the actual figures concerning the percentage of the population affected) and a lot of the drugs there originated from India. But they were available, under some schemes, free. Of course not everyone was able to access them free, but through government health schemes a good majority could receive them at a nominal cost. I expect I was so gobsmacked because corruption and mismanagement can be an art form in some parts of Africa and yet the same drugs that could be distributed there government-subsidised, were not available to the people in the country of origin.

Respect to you, mate, that you know the horrors of this endemic and must have had to cope with the antipathy and horror-stories that attach to anyone who is either affected or even marginally involved.