By Sreelatha Menon

The Indian Express 9 June 2001

New Delhi -- After defying MNCs to go ahead and sell its generic drugs in South Africa for HIV-positive patients -- is now promoting anti-retroviral drugs through an advertisement launched on STAR and ZEE last month. Though the advertisement claims that HIV-positive people need not lose hope because drugs are available, it is silent on the drugsí toxic nature.

The advertisement, which apparently refers to anti-retroviral drugs (ARVs), doesnít say that they donít cure either HIV or AIDS or they have side effects and donít suit everybody. In an e-mail to The Indian Express, Cipla said the drugs are not a cure and the advertisement nowhere claims that they are a cure. Ciplaís S. Radhakrishnan justified the advertisement and said it asks patients to consult a doctor on these drugs.

The advertisement had come days after Union Health Minister C.P. Thakur and his South African counterpart Tshabalala had appealed to the media not to send wrong messages on ARVsí efficiency. Both said the drugs were no solution and though cheap they were toxic, thus making administration under observation compulsory.

Radhakrishnan explained: "We have stressed that the line of treatment is not easy and the patient should necessarily consult their doctor for further details. We are making available alongside a complete booklet for patients giving details on the disease, its treatment, side effects."

According to Drug Controller of India Ashwini Kumar, Cipla and its advertisement canít be censured under the Cable TV Networks Regulation Act, 1995, because it does not mention the drug by name and so may not trigger self-medication. Though the argument is true, the mention of Cipla helps advertise the drug it makes. This is plausible after Ciplaís launch of cheaper generic drugs in developing countries against MNCsí resistance.

In fact, clause 5 of the networks regulation Act says: "No advertisement shall contain references that may lead the public to infer the product advertised or any of its ingredients has some special or miraculous or supernatural property or quality difficult to prove."

Radhakrishnan defended the advertisement and said it does not claim ARVs were a magical remedy, it simply holds out a picture, though incomplete, of hope to the infected.

A Health Ministry official said the matter will be examined in the light of Thakurís call.


What science says about ARVs

"Of 172 participants, 169 died on taking AZT, three on placebo. The results of Concorde donít encourage early use of zidovudine in symptom-free HIV-infected adults." -- Concorde Coordinating Committee Trial of Zidovudine in Symptom-Free HIV Infection, Lancet, April 9, 1994

"Zidovudine known to produce haemotological toxicity in vitro and in some patients... bone marrow changes in patients seem not to be readily reversed when drug is withdrawn... This has serious implications for drug use in HIV positive but symptom-free persons." -- Mir N, Costello C., Zidovudine and Bone Marrow, Lancet, November 19, 1998

A woman of 24 with a two-week history of progressive leg weakness in January 1998 was found HIV positive. Later, she developed pneumocystis carinii pneumonia. She was put on zidovudine and required three blood transfusions for white blood cell deficiency. Proximal weakness was detected but not wasting of limbs, tenderness of shoulders and thigh... Her gait was waddling and she was unable to rise without using her arms. Seven days after zidovudine withdrawal, her proximal weakness improved and muscle force became normal two months later. -- Gorard DA, Henry K, Guilodd RJ, Necrotising Myopathy and Zidovudine, Lancet, May 7, 1988