Indian HIV patient Rekha has missed her daily dose of medicine several times over the last few months because the government distribution centre at New Delhi's Lok Nayak Hospital ran out of drugs.
"Sometimes they give it to me for one week, sometimes two weeks, but not more. They keep saying the drug has not arrived from NACO," said Rekha, referring to India's National AIDS Control Organisation (NACO), a part of the healthcare ministry.
The community motivator at an HIV/AIDS support group, who declined to give her surname, cannot afford to buy the drugs on the open market.
Like thousands of other HIV/AIDS sufferers, she relies on free antiretroviral drugs handed out at state-run healthcare providers supplied by NACO through a tender process.
But they are facing shortfalls that have been blamed on supply bottlenecks, late payments to drugmakers and at least one large Indian manufacturer boycotting the process.
Some drugmakers stopped participating in the government's tender process over the past year because of delays in getting paid, said Leena Menghaney, an activist with the medical charity Medecins Sans Frontieres (MSF).
India had the third largest number of people living with HIV in the world at the end of 2013 and accounts for about four out of 10 people living with HIV in the Asian region, according to the U.N. AIDS programme UNAIDS.
Out of 2.1 million HIV/AIDS patients in India, about 750,000 people depend on the free distribution of drugs through government-run centres, according to NACO.
CIPLA STOPS BIDDING - NACO
A senior official at the Maharashtra State AIDS Control Society, a government body, said the agency was facing a shortage of three HIV/AIDS drugs - two for treating children and one for adults.
The society, in the western Maharashtra state whose capital is Mumbai, is looking to get those drugs from other states where it is available, said the official, who declined to be named.
"There have been complaints, I won't deny that. But what they (NACO officials) say is that the situation is not as alarming as has been painted, so I have asked them to give me the facts," India's Health Secretary Lov Verma told Reuters.
"We are looking into that matter, we are trying to find out where the shortages exist and how we can address them."
Activists and A.S. Rathore, deputy director general of NACO, named Indian drugmaker Cipla Ltd as one of the firms that had stopped bidding in the tender process. Activists said delayed