UPDATE: On August 23rd, 2016, six networks of people living with HIV sent a letter to Dr. Rajesh Deshmukh (Program Officer, TB/HIV with the National AIDS Control Organization) re. “Request for speedy implementation of Isoniazid preventive therapy (IPT) for People Living with HIV (PLHIV) in India.” Dr. Deshmukh responded on the same day with the points below, noting that countrywide implementation of IPT is scheduled for October 2016.
Isoniazid preventive therapy (IPT) prevents the progression of tuberculosis (TB) from infection to disease and helps reduce transmission in high TB incidence settings. The World Health Organization (WHO) has long recommended the provision of IPT for people living with HIV (PLHIV) and children under five years old who are household or close contacts of people with TB. Yet in India, where there are an estimated 2.1 million people living with HIV, this proven intervention is not widely accessible.
Under the National Framework for Joint HIV/TB Collaborative Activities in India, the National AIDS Control Organization (NACO) and Revised National TB Control Program (RNTCP) have been committed to the implementation of IPT for all PLHIV at least as far back as 2009. Yet the Government of India does not report IPT coverage for PLHIV to the WHO. And even in Indian states where there is a strong community demand for IPT, the well-documented lack of availability of isoniazid for IPT is an indicator of the Government of India’s failings to deliver this important TB preventive intervention for people affected by TB.
To take one example: in March 2016, Nagaland’s state division of the RNTCP responded to a Right to Information (RTI) request filed by the Nagaland Users Network (NUN) and reported procurement of 5,560 tablets of isoniazid (100 mg) for the provision of IPT for children—barely enough to treat 30 children with a six-month course—and stock outs of 300 mg tablets of isoniazid necessary for providing IPT for adults. The lack of implementation of IPT for PLHIV and children under five years old is not unique to Nagaland, and likely plagues most states in India.
 Ministry of Health and Family Welfare, Department of AIDS Control, India. National Framework for Joint HIV/TB Collaborative Activities. Government of India; November 2013.