QUESTION : Discuss the progress made so far by the Government of India’s steps in this direction against AIDS in India and at the same time give key measures to tackle this virus further.
KEEPING ALIVE CONVERSATIONS ABOUT AIDS
India And HIV Infection
WHY IN NEWS ?
• The world has dealt with the Human Immunodeficiency Virus (HIV) infection for 40 years by implementing sound polices and robust measures.
o The devastating infection caused by the HIV in people with a weak immune system was first noted on June 5, 1981, in Los Angeles.
• Thus, there is need for collective experience of the past and learn lessons from the fighting against and apply relevant strategy in COVID-19 pandemic.
INDIA’S SUCCESS AGAINST HIV/AIDS :
• India had one of the biggest success in fighting HIV/AIDS between 1997 and 2010, after the infection hit the shores in 1986.
• The information and education campaigns of the 1990s helped to check the transmission of HIV infection through two routes: mother to child, and blood transfusions.
• Strict ante-natal protocols were established and blood banks were upgraded with superior testing facilities.
• Excellent intensive follow-up action plans led to significant decline in incidence.
• The nationalised AIDS treatment plan is a perfect example of how early detection, diagnosis and treatment saved many lives.
o It gave a head start to the National AIDS Control Programme (NACP) when every State and UT established its own AIDS control organisation.
INDIA’S FAILURE AGAINST HIV/AIDS :
• Between 2013 and 2019, the implementation of AIDS control programmes countrywide was not given enough attention.
o It is difficult to check progress on controlling it AIDS once enough attention is not given.
• The HIV infection diagnosis rate dropped from 60% in 2010 to 23% in 2019, the mortality rate doubled and new cases spiked five times more during the period.
• There were over 58,000 AIDS-related deaths and over 69,000 new HIV infections added to the pool of 2.3 million people living with HIV/AIDS, with 98% of new infections in the high-risk groups.
Global Failure against AIDS
• The aim of the World Health Organization was to ensure that 90% of the people living with HIV/AIDS are on anti-retroviral therapy by 2020. However, the target has been pushed by at least five years.
• UN Sustainable Development Goals aim to end AIDS by 2030. Given the current situation of world, this goal looks like it may take longer to achieve.
NATIONAL AIDS CONTROL ORGANIZATION (NACO):
• It is a division of the Ministry of Health and Family Welfare that provides leadership to HIV/AIDS control programmes in India through 35 HIV/AIDS Prevention and Control Societies.
• In 1986, following the detection of the first AIDS case in the country, the National AIDS Committee was constituted in the Ministry of Health and Family Welfare.
• In 1992 India’s first National AIDS Control Programme (1992-1999) was launched, and National AIDS Control Organisation (NACO) was constituted to implement the programme.
• The objective of NACP-I (1992-1999) was to control the spread of HIV infection.
• During NACP-II (1999-2006) a number of new initiatives were undertaken and the programme expanded in new areas like
o Targeted Interventions were started through NGOs, with a focus on High Risk Groups (HRGs) viz.
Commercial sex workers (CSWs),
Men who have sex with men (MSM),
Injecting drug users (IDUs), and
Bridge populations (truckers and migrants)
STEPS TAKEN BY GOVERNMENT OF INDIA AGAINST AIDS :
1. National AIDS Control Program (NACP):Shortly after reporting the first AIDS case in 1986, the Government of India established a National AIDS Control Program (NACP) which has now become the Department of AIDS under Ministry of Health and Family Welfare. Targeted interventions for the most at risk populations, preventive interventions among the general population, and involvement of NGOs and other sectors and departments, such as education, transport and police was made under it
2. National Helpline: It was launched to facilitate easy dissemination of information related to HIV/AIDS to general public, People Living with HIV/AIDS (PLHIV), High Risk Groups (HRG) and vulnerable population
3. Indian Medical Council Act(Professional Conduct, & Ethics) Regulations, 2002: It lays down certain duties on the part of doctors towards the HIV/AIDS patients.
4. Immoral Trafficking Prevention Act, 1986: It provides for conducting compulsory medical examination for detection of HIV/AIDS among the victims of trafficking.
5. HIV and AIDS (Prevention and Control) Act, 2017: The Act seeks to prevent and control the spread of HIV and AIDS.
• Prohibits discrimination against persons with HIV and AIDS.
• Provides for informed consent and confidentiality with regard to their treatment.
• Places obligations on establishments to safeguard their rights.
6. National strategic plan (2017-24): The Union Ministry of Health and Family Welfare launched the plan with aim to eradicating HIV/AIDS by 2030. In 2016, India commit at the UNs’ High-Level Meeting on AIDS towards the goal of ‘ending the AIDS epidemic as a public health threat by 2030.National Strategic Plan (2017-24) aims towards fast track strategy of ending the AIDS epidemic by 2030 and is expected to pave a roadmap for achieving the target of 90:90:90.
7. Mission SAMPARK: Its aim is to trace those who are Left to Follow Up and are to be brought under Antiretroviral Therapy (ART) services.“Community Based Testing” will be taken up for fast-tracking the identification of all who are HIV positive.
8. 90:90:90 Strategy: It is a new HIV treatment narrative of UNAIDS programme which has set targets of:
• 90% of all people living with HIV will know their HIV status (90% diagnosed)
• 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy (90% on HIV treatment) and
• 90% of all people receiving antiretroviral therapy will have viral suppression (90% suppressed).
9. Project Sunrise: It aims for prevention of AIDS specially among people injecting drugs in the 8North-Eastern states.
WAY FORWARD :
• There is need to give importance to long-term view of disease beyond the health sector and the socio-economic impacts of the epidemic.
• There is need to focus on the broad coalition of economists, scientists, doctors, researchers, technicians and civil society representatives to make policy decisions.
• Good data and information from scientific investigations have to be combined. Centre should provide resources to scale the research on AIDS.
• The existing workforce in 21,000 Integrated Counselling and Testing Centres (ICTC) can be used for COVID-19.
o ICTC can help in early detection of infections, provide basic information on modes of transmission, promote behavioural change, reduce vulnerability and link people with care and treatment services.
• By integrating education and awareness outreach programmes and re-allocating and releasing funds on time, new outbreak of OCVID-19 can be controlled.
• Emphasis on both prevention & control as well as care and support is needed.
• There is a need to invest in research to find cure for this epidemic.
• Focus on areas that have received little attention so far from government and other NGOs
• Targeted intervention should be adopted. As in Karnataka sensitising police personnel and educating female sex workers help to reduce HIV infection.
• More awareness should be generated to reduce stigma attached with the HIV infected people.
• A strong political leadership, financial support, advocacy and activism is needed to counter diseases like AIDS and COVID-19.
• Formula of supporting science-driven responses, good quality data and empirical evidence; and consolidating guidelines is the need of the hour.