The problem

PrEP prevents HIV before exposure; PEP can still prevent it if started within 72 hours. Both are manufactured in India and supplied to global procurement agencies at roughly US$3 to US$4 per month. The same molecules retail in India at around Rs 2,000 a month. India has a national PrEP guideline but no funded national PrEP programme, and roughly 7,000 people are estimated to have ever initiated PrEP in the country. The medicine is not the obstacle. The access system around it is.

What the platform does

Confidential risk self-assessment; linkage to anonymous testing through partner laboratories and the government ICTC network; PrEP and PEP information; a monitoring calendar built to national clinical guidelines; escalation when a review is missed; adherence support; and navigation to registered prescribers and licensed pharmacies.

The clinical contribution

The documented harm in PrEP is not a missed baseline test but a person who continues prophylaxis for weeks through an undiagnosed acute infection, which selects drug resistance. Published cohorts show two to four weeks of exposure is enough. That makes the one-month retest, not the first test, the real safety control, and it makes retention in monitoring a patient-safety function rather than an adherence metric. The platform is built around that calendar.

Boundaries

The platform does not supply, prescribe or dispense medicine. Prescribing is by registered medical practitioners and dispensing by licensed pharmacies only. Reporting to state programmes is aggregate and non-identifying by default, with separate consent for any linkage to government treatment services, consistent with the HIV and AIDS (Prevention and Control) Act 2017.

International applicability

The gap this addresses is global, not Indian. Roughly 40 million people live with HIV worldwide and about 1.3 million acquire it each year, against a target of ending AIDS as a public health threat by 2030. WHO recommends oral PrEP for anyone at substantial risk, and generic tenofovir-based prophylaxis is inexpensive almost everywhere. What is missing across most low- and middle-income countries is the same thing missing in Kerala: prescription pathways, affordable testing, monitoring retention and stigma-free collection. India supplies much of the world's generic antiretroviral volume, so a delivery model proven here is directly relevant to the countries already receiving Indian medicine. Injectable long-acting prophylaxis, expected from Indian manufacturers at around US$40 per patient-year, will need exactly this monitoring and delivery infrastructure. The platform is being architected for that: guideline-configurable clinical schedules, multi-language interfaces and aggregate reporting that can map onto any national programme.

Status

Prototype built. An anonymous public needs survey is running in Kerala, and a project proposal is being prepared for the Kerala State AIDS Control Society. Ethics committee review and licensing are being established before any service delivery.

The problem

Snakebite envenoming is a WHO-designated neglected tropical disease. Between 81,000 and 138,000 people die from it each year worldwide and roughly 4.5 million are bitten. India carries the largest single share, at about 58,000 deaths a year. In most of those deaths the antivenom existed somewhere in the system. The patient did not reach it in time.

What GARUD does

GARUD treats the emergency as a parallel process rather than a sequence. From the moment a call is received it simultaneously dispatches the nearest advanced ambulance, alerts community health workers and trained volunteers near the patient, opens a government teleconsultation channel so a clinician is engaged during transport, and selects the destination hospital on verified antivenom stock, ICU and ventilator availability rather than proximity alone. Public reporting of sightings and seasonal patterns feeds a risk map, and a free public training portal covers first aid and what not to do.

Access

Reachable by toll-free call as well as by app, because the people most at risk are the least likely to be carrying a smartphone.

Architecture

GARUD is an orchestration layer designed to sit above existing public health infrastructure rather than replace it, integrating with emergency ambulance services, state tele-health services and hospital systems through defined interfaces. That is what makes it portable.

International applicability

The failure mode GARUD addresses is delay, not drug shortage, and it is common to every high-burden country. WHO's 2019 strategy targets halving snakebite deaths and disability by 2030, and the countries carrying that burden across South and South-East Asia, sub-Saharan Africa and Latin America run the same fragmented chain of ambulance, clinician and antivenom stock. Because the platform is a coordination layer over national systems rather than a standalone service, the same architecture can be deployed in any of them. The emergency-orchestration model also generalises beyond snakebite to other time-critical presentations where the clock, not the medicine, decides the outcome.

Status

Web and mobile prototypes have been built and run on simulated data. Clinical governance, ethics review and pilot partnerships are being established before any live deployment.

ALIZON MedSim AI™ is an international-level AI-powered medical engineering and healthcare simulation platform that delivers immersive training in digital health, medical technology, clinical workflows, and AI-assisted healthcare systems. Our platform enables learners and institutions to experience real-world healthcare environments through virtual hospitals, AI-driven patient simulations, and advanced medical engineering technologies, creating a future-ready healthcare workforce for the global market.