After getting a rap from the Supreme Court, the Centre says doctors can’t deny care to HIV patients. The health ministry also wants to provide them free transport, jobs and ration cards entitling holders to subsidised rice, kerosene and sugar

Doctors or nurses who refuse to treat HIV/AIDS patients will be sternly dealt with, the Centre told the Supreme Court last week during the hearing of a public interest litigation (PIL) highlighting apathetic treatment and lack of facilities for HIV/AIDS patients across the country. 

The three-member apex court bench, headed by Chief Justice K G Balakrishnan, also observed that the government was not doing enough to improve the public healthcare system.  

In an attempt to convince the bench about ‘remedial’ measures being taken at the highest level to deal with instances of refusal to treat persons living with HIV/AIDS (PLHA) or non-availability of basic medicines and treatment for them, Additional Solicitor General Gopal Subramanium said the states had been asked to implement an office memorandum sent to them on August 26, 2008.  

The memorandum says: “All doctors, nurses and hospital staff, whether in the public or private sector, shall treat PLHAs in a professional and humane manner, treating them always with dignity and care. No doctor or nurse shall refuse to treat a PLHA on account of his/her positive status. In treating a PLHA there shall be no discrimination or stigma whatsoever.” It also suggests taking stringent action against doctors or nurses who refuse to treat HIV/AIDS patients.  

Subramanium informed the court that the government had recently instructed all state governments to improve their healthcare facilities, and that primary health centres were working satisfactorily in rural areas of Andhra Pradesh, Karnataka, Kerala and Tamil Nadu.  

But the bench shot back: “Go and check in any government hospital in Delhi, Bihar and Uttar Pradesh. In rural India there are hardly any doctors. Even in a 50-bed hospital, not a single doctor is available. It’s only on paper.” 

The government told the bench that all states, the Medical Council of India, the Dental Council and the Nursing Council would be asked to file compliance reports within six months.

  The National AIDS Control Organisation (NACO) has recently obtained Supreme Court approval for a scheme to step up medical facilities for PLHA. That was around the time the court directed the medical community not to deny treatment to PLHA.

  The Centre, in its fiat, said: “Doctors in the private sector, in particular, are directed to immediately familiarise themselves with the NACO comprehensive protocols and policies with regard to care and treatment. The NACO-approved antiretroviral treatment (ART) regimen has proven to be cost-effective and safe, and PLHA have shown good response to this regimen.”  

Meanwhile, health secretary Naresh Dayal has written to his counterparts in the ministries of railways, transport, food, and rural development seeking a slew of concessions for PLHA. His letter notes that though the government provides free treatment to HIV patients, it is not enough in itself to alleviate their problems.  

Their earning capacity might already have been hampered because of the disease, and they might find it difficult even to commute to ART centres for treatment. Under the circumstances, providing them with more concessions should be in order, says Dayal.

The health ministry also wants to extend wage and employment guarantees under the National Rural Employment Guarantee Scheme (NREGS) to PLHA. And provide them with ration cards, making their lives that much easier.  

Estimates show that there are around 2.5 million HIV-positive people in India.  

Source: The Hindu, October 2, 2008
            The Indian Express, October 2, 2008
            http://www.medindia.net, October 2008