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Nadda promises to end HIV; will policy follow suit?

Health Minister JP Nadda chose World AIDS Day (Dec. 1) to announce an end to HIV/AIDS in India by 2030; the government's reluctance to adopt new WHO guidelines, however, tells a different story
Health Minister JP Nadda chose World AIDS Day (Dec. 1) to announce an end to HIV/AIDS in India by 2030; the government’s reluctance to adopt new WHO guidelines, however, tells a different story

“We can now safely say that we can end the HIV/AIDS epidemic by 2030.”

Such were the bold words of Union Health Minister J. P. Nadda during an event to mark World AIDS Day on December 1. Nadda said that India had defied predictions from “around two decades ago” that it would be “the AIDS capital of the world.” Instead, Nadda claimed that the country had “arrested the epidemic successfully” and engineered “a 57% reduction of the incidences of new infection and 29% decline in the number of AIDS-related deaths.”

Between 2005 and 2013, new HIV infections in India declined by 19 percent, whilst AIDS related deaths declined by 38 percent. AIDS related deaths are believed to have fallen by 66 percent since the advent of the new millennium.

However, the fight against HIV and AIDS in India has often yielded mixed results over the course of its more than twenty-year history.

India recently celebrated its millionth person with HIV who was receiving antiretroviral therapy (ART).  However, a recent HIV/AIDS bill has proved controversial over its wording, particularly with regards to ART. Outlining some of the criticisms, Health Issues India wrote

“Since the bill was introduced in 2014, it has been amended to state that the focus will be on prevention rather than treatment – and that treatment will only be given “as far as possible”.

Some have taken this “as far as possible” comment to mean that free access to previously used anti-retroviral therapy (ART) is no longer guaranteed. ART has been available for over a decade and 869,000 patients currently receive first and second line ART, as well as diagnostics services also reliant on funding. Given the number of people who depend on these services, this is discouraging news.”

The World Health Organisation (WHO) recently recommended HIV self-testing in a landmark initiative. Approximately, 40 percent of HIV-positive people do not know they have the virus. The WHO have suggested that self-testing could be an effective way of rectifying this situation.

The Indian government’s response, however, was cool. The National AIDS Control Organisation (NACO) said that self-testing was “against Indian national treatment guidelines” and questioned the validity of the tests, though they are believed to be almost 100 percent accurate. Such attitudes are in spite of as many as 87 percent of Indians with HIV being unaware of their condition, according to the Times of India.

However, the TOI did further report that the Ministry of Health would consider the proposal, especially when considering groups that are deemed to be at high risk of transmitting HIV, such as sex workers and men who have sex with men.

Despite there being new legal protections afforded to those living with HIV, social stigma is still a significant challenge in India to helping those with the disease, many of whom are reluctant to seek treatment.

There is also an issue of accessibility of healthcare in a clinical setting. The majority of Indians live in rural areas where there is a poor quality of health infrastructure and a shortage of health workers. Whilst self-testing kits would not alleviate the problem of those who do test positive for HIV needing to seek further treatment, it would certainly be a starting point so that they may become aware of their condition and take appropriate measures to prevent infecting others.

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