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World AIDS Day 2018: The Indian perspective

2.1 million Indians live with HIV – the third largest HIV epidemic in the world. 

College students taking part in HIV/AIDS awareness campaign in Chandigarh.

Union Health Minister J. P. Nadda intends to make HIV/AIDS a thing of the past in India by 2030. On World AIDS Day 2018, we investigate how likely this is to come to pass.

Recent years have seen India make significant progress in its fight against HIV/AIDS, a disease which killed nearly a million people worldwide last year – including more than 90,000 Indians.

As Health Issues India reported earlier this year, new infections with HIV fell from 120,000 in 2010 to 88,000 in 2017. 2.1 million people were living with HIV last year, compared to 2.3 million the start of the decade.

This is no doubt encouraging news. However, huge obstacles remain in place which are likely to impede elimination efforts. 31 percent of HIV-positive Indians are unaware of their status. A mere 56 percent of Indians living with HIV receive treatment for the disease.

HIV/AIDS awareness banner in Patna, Bihar.

“It is clear, for all the progress India has made, there are still – as a UNAIDS report put it earlier this year – “miles to go”.”

Progress has clearly been made on the national scale. However, this is far from evenly dispersed across India’s states and union territories. In Manipur, one in every hundred people are HIV-positive. The northeast states of Meghalaya, Mizoram and Tripura are home to HIV hotspots – pockets where HIV incidence is much higher than the national average. Tamil Nadu, meanwhile, is recording a significant rise in HIV infections among young people.

It is clear that, for the progress India has made, there are still – as a UNAIDS report put it earlier this year – “miles to go”. Disallowing complacency will play a vital role in ensuring key momentum is not lost in the fight against HIV/AIDS. For example, while it can be acknowledged and celebrated that 200,000 fewer Indians are living with HIV, this must be tempered by experts’ projections that the world is not on course to reduce new HIV infections in-line with global targets of fewer than 500,000 by 2020.

 

India is home to the world’s third largest HIV epidemic. This is sobering news which should accelerate efforts, not allow momentum and commitment by policymakers, donors, and public health officials alike to plateau.

So what can be done?

Copyright: reddees / 123RF Stock Photo

“The importance of prevention measures in the fight against HIV/AIDS cannot be understated.”

The Centre is working through the National AIDS Control Programme to control the spread of HIV. It has taken substantial steps in recent years towards addressing the crisis.

Already India has enacted a bill aimed at fortifying the rights of persons living with HIV/AIDS. While the wording of this bill has proved controversial owing to its somewhat tempered commitment to expanding access to treatment, government efforts are underway to make sure more Indians can avail treatment for HIV. For example, ‘test and treat’ strategies screen for HIV and automatically offer antiretroviral therapy to those who test positive.

The aforementioned bill included an emphasis on prevention. The importance of prevention measures in the fight against HIV/AIDS cannot be understated. Expanding access to contraceptives and sex education, for example, could go some way to reducing the HIV/AIDS burden. This is particularly true of young people, who have displayed some aversion to the uptake of contraception in the past. This highlights the importance of initiatives such as youth outreach schemes educating young people about the importance of safe sex.

HIV/AIDS has long loomed in the forefront of public consciousness as a significant public health challenge. However, this awareness has not always translated into effective policy. At present, India is clearly making inroads in addressing HIV/AIDS. Sustaining and enhancing this proactive approach to engaging with the situation is vital if further progress is to be effected. As such, ensuring the public is informed about of HIV/AIDS and making commitments that sufferers can access the treatment they need is not something that should be limited to awareness days. It must be undertaken every day of the year.

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