Sarod player Amjad Ali Khan with model Padma Lakshmi at an awareness programme on AIDS day in Delhi. (PTI)

New Delhi, Dec. 1: The government today announced that it would next month begin offering expensive second-line drugs against HIV free to the poor who have lost their battle against the virus with first-line drugs.

The second-line drugs will be available free at two hospitals in Mumbai and Chennai to patients who are below the poverty line, officials said at an event to mark World AIDS Day, calling the initiative a cautious first step.

People in higher socio-economic groups who are detected HIV-positive may be asked to save money over several years for their own second-line drugs, a top health official said.

“We’re thinking about a medical savings scheme that people could use to pay for second-line therapy,” Sujatha Rao, the director-general of the National AIDS Control Organisation (Naco), said.

A patient would usually have about seven years after being detected HIV-positive before he or she would need to turn to second-line drugs. Savings during that period would help meet at least part of the second-line therapy expenses, she said.

Second-line drugs cost about Rs 50,000 to Rs 100,000 annually, about 5 to 10 times more than first-line drugs.

About 100,000 HIV-positive patients are receiving free first-line drugs from the government, but some are expected to have become resistant, and need to switch to second-line drugs. Officials estimate that the number currently requiring second-line drugs could be between 2,000 and 5,000.

Indian officials have been particularly concerned about the financial implications of introducing second-line therapy. They cite the plight of Brazil which had introduced second-line therapy and spends about 60 per cent of its anti-HIV drug funding in treating only 10 per cent of patients.

The Naco today also launched what it described as the world’s largest public outreach programme against HIV — through a special train that will touch 180 towns, travelling some 27,000km across the country over the next year.

The seven-coach Red Ribbon Express, flagged off by UPA chief Sonia Gandhi, will be used to promote safe behaviour and fight stigma and discrimination against people living with HIV through an exhibition in its coaches.

At each station, the train will disgorge 48 street-theatre troupes who will cycle into neighbouring villages carrying messages on how to avoid getting infected.