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India has seen a significant decline in new HIV infections due to public policy intervention. But the road ahead still has significant hurdles.

New Delhi: Statistics have shown a fall in the number of new HIV positive cases in India and doctors say AIDS is no longer the same demon it was years ago, but the country’s agenda to eradicate AIDS is unfinished.

“Yes, we can say that AIDS is not as big a problem as it was 10 years ago. It has come down and the new infections happening have also reduced,” Dr Samiran Panda, director of National AIDS Research Institute (NARI), told ThePrint.

A National AIDS Control Organisation (NACO) estimations report released in September said India had around 2.14 million people living with HIV in 2017.

The report, prepared under the National AIDS Control programme, estimated that India saw around 87,580 new HIV infections in 2017 — an 85 per cent decline since the peak of 1995, and a 27 per cent fall between 2010-2017.

Panda, however, said there are some regions in the country that still need strong HIV prevention control.

The NACO report said annual new HIV infections are increasing in three states of the Northeast region — Assam, Mizoram and Meghalaya — and also in Uttarakhand. In Nagaland, Manipur, Delhi, Chhattisgarh and Jammu & Kashmir the decline has been less than 10% in the last 7 years.

On World AIDS Day, ThePrint takes a look at the measures taken to root out the disease as well as the challenges ahead for India.


Also read: India is winning the battle against HIV, but poor sex workers are slowing it down


Prevention programme

From safe blood transfusion to use of fresh needles and condoms, India has put in place several prevention control measures over the last two decades.

“While there are a number of things, the real agents of change in HIV prevention in India are the affected groups (Most At Risk Group). From transgenders to female sex workers and men who have sex with other men, all have contributed and guided the national programme for HIV and AIDS prevention,” said Panda.

He also gave credit to governments for their continued surveillance measures in rolling out the anti-HIV treatment.

“The big success story is that 1.2 million people with HIV positive are under medication. The right combination of drugs got their viral load suppressed,” he said.

“It is also prevention because when those infected with the virus are undertaking treatment, it is less likely to spread,” added Panda.

He further said that demonstration projects on pre-exposure prophylaxis (PrEP) — use of drugs to prevent disease in people who have not yet been exposed to the disease-causing agent — are also going on.

“They can play a great role as a strategy for the prevention of HIV/AIDS. The government wants to take two steps ahead. Once the demonstration is done, we will plan further,” he said.

In 2017, India developed a National Strategic Plan for HIV which emphasised AIDS eradication over the next seven years. In the same year, Health and Family Welfare Minister J.P. Nadda launched the ‘Test and Treat Policy for HIV’ for all men, women, adolescents and children who have been diagnosed as a HIV positive case.

In September this year, the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act, 2017, came into force. It aims to prevent and control the spread of HIV and AIDS in the country and provides for penalties for discrimination against those affected by the virus.


Also read: Huge drop in HIV infections in India due to sustained efforts: UN


Challenges

The road ahead for India, however, is still quite rocky.

A new UNAIDS report, Knowledge is Power, estimated that 79 per cent of people living with HIV in India were aware of their condition. Of the total cases, only 56 per cent were receiving treatment, said the report.

“Yes, there is unfinished agenda. Challenge is to reach out to the uncontacted groups,” Panda said.

“There are certain uncovered geographical areas where the government needs to reach. Targeted intervention projects to mainly people who inject drugs is also required,” he added.

He said the Northeast region is affected with dense HIV positive groups.

“HIV prevalence is high in Northeast and due to difficult geographical terrain, the coverage could be hindered. Thus, treatment has to be ensured and supply of medicines should not get interrupted,” he said.

Dr Atul Gogia, HIV specialist and vice-chairman of Department of Medicine at Sir Ganga Ram Hospital, said most patients get to know about their condition either when they get tested for an employment or before a surgery.

“Now, internationally, the tests for HIV are promoted like any other blood pressure or sugar test investigations,” he said.

The advent of high quality treatment has made HIV infections like any other chronic disease and continuing awareness to break stigmatisation would help the country get rid of it completely, added Gogia.

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