Health
Despite opposition from multiple sides because of its prohibitive cost, Sushma Swaraj forged ahead and kickstarted the national ART programme.
PTI photo

A wonderful person; courteous, humane and batting for women and their rights – this is how Dr Kuganantham remembers the late Sushma Swaraj, who passed away from a cardiac arrest on Wednesday night.

While most remember the former External Affairs Minister for her wit, social media savvy and approachable personality, Dr Kuganantham, former city health officer, Chennai, and presently a consultant at SIMS hospital in the city, also remembers her as the woman responsible for the Indian government’s antiretroviral therapy (ART) programme, announced in late 2003. It aimed at providing free treatment to one lakh affected by HIV-AIDS within a year.

From 1986 – when the first HIV case was detected in India, in Chennai – the number had grown to about six million in 2003. Given the expanse of India’s population and also those affected, introducing a government funded ART programme was considered cost prohibitive, and Sushma was advised against it. The antiretroviral drugs were expensive and had to be taken every day by patients. However, there was also a tendency for the virus to develop resistant strains.

Around that time, Dr Kuganantham, was the working with UNICEF as a consultant for prevention of transmission of the HIV from mother to child. He remembers a discussion Sushma was having in a room full of experts. “Every doctor and every administrator in that room was against the ART programme because of the cost it would incur. She listened to everyone, but at the end, she talked about the suffering of the women, families and children affected by HIV. She said if the drugs could prolong their lives, then they would manage the costs,” Dr Kuganantham tells TNM.

He adds that she was a political leader who had put people’s pain above all else. “The experts were more practical, but she had decided it should be done because of people were suffering because of the disease. She was able to see beyond the technicalities,” he says.

And so, Sushma Swaraj kickstarted the national ART programme, despite opposition from multiple sides, which may have included the World Health Organisation (WHO).

Dr Kuganantham also said that she negotiated the price of the ART drugs. “They cost Rs 8,000-10,000 initially, but she brought the price down to about half in the 2-3 years that followed. She knew they could save lives.”


Former Union Health Minister, Sushma Swaraj, with a HIV positive child, participating in "Walk for Life" on the eve of World AIDS Day in New Delhi on, December 1 2013. Photo: Journey of the ART Programme/naco.gov.in

He also recalled another noteworthy incident. As Dr Kuganantham was consulting for a UNICEF programme called Prevention of Mother to Child Transmission of HIV, Sushma insisted that the name be changed to Prevention of Parent to Child Transmission of HIV in India. “She pointed out that father is also be responsible for the child, and could be responsible for the HIV being transmitted to the woman as well. Why should the onus be squarely placed on the woman alone, she questioned,” he recalls.

Sushma Swaraj’s contribution to the national ART programme was also recounted by Aishwarya Rao for Firstpost. The then Union Health Minister had the file for the ART programme sitting on her desk for a year before she signed it. According to the story behind it, Sushma was in Kollam for a function in November 2003 when an aged man approached Sushma through her security. He pointed at his grandchildren Bency and Benson and asked what would happen to the kids when he was no more. “When are we going to get life saving drugs?” he asked her.

Moved by his plight, Sushma hugged the children, the photos of which were reportedly shared widely. The following day – December 1, or World AIDS Day – she quietly signed the file approving the ART programme, despite all the opposition on the grounds of cost.

The programme commenced on April 1, 2004. While it was reportedly a diluted version of Sushma’s original programme, it did prioritise the vulnerable – free drugs were given on priority to women already registered in the prevention of parent-to-child trasmission of HIV programme in the government antenatal clinics, children under 15, as well as those who were already being treated for advanced AIDS at eight selected hospitals at the time.