The development of antiretroviral therapy has given a new hope for people living with acquired immuno deficiency syndrome. In the face of increased disease burden due to HIV the global and political commitment towards controlling the pandemic has received renewed thrust in recent times. The Government of India has initiated antiretroviral treatment as a part of national public health programme in the six high-prevalence states. The aim of the paper is to provide the programme planners and other stakeholders, information about the impact of initiating antiretroviral therapy programme in the country. The paper discusses the global commitment towards fighting the disease in the light of the development in affordability and accessibility of antiretroviral drugs therapy. The paper highlights the importance of infrastructure and logistic requirement for developing a comprehensive treatment programme for the affected population in India. Finally, the paper has drawn broad financial implications of the antiretroviral therapy under different treatment scenarios. The estimated financial requirement for treatment vary from Rs. 92 crores per annum if focusing on 400,000 HIV/AIDs cases to identify patients requiring ARV Therapy to 1008 crores per annum if all 4 million patients are screened for coverage. Against this NACO has allocated total of Rs. 113 crores for treatment part of the proposed intervention. Even under the most conservative estimate achieving the treatment target in India with the proposed programme budget will be a challenging task.