HIV challenge


The recent report of the United Nations Programme on HIV and AIDS (UNAIDS) does not paint a grim picture for the joint war of many countries against the killer virus. India also appears to have made progress in controlling the spread of HIV among the groups of people prone to getting infected with HIV and its spread in the country. The high incidence of HIV among the targeted groups has been under control during the past over one decade through a programme spearheaded to control the spread of this virus. Along with India, many other countries, as per the report, have made rapid progress in reducing HIV incidence and getting antiretroviral therapy to the patients. As of today, at least 3 out of four people i.e. 75% people with HIV know their status and 21.7 million get treatment across the world. It is no mean achievement so far as lack of awareness among the common masses in Asia, Eastern and Southern African countries are concerned. These are the areas on the planet where the largest number of people infected with this virus is living and the level of awareness has been quite low. But the only satisfaction is that the highest reduction in incidence came from these areas particularly Africa while Asia has also made some significant gains in this direction. India has, in particular, brought down the number of new cases and deaths by 27% and 56%, respectively, between 2010 and 2017. The UNAIDS report says, some satisfaction is warranted in view of the data available from these countries. This applies also to India, which has done a few things in the right direction. For example, tuberculosis is the biggest killer of HIV patients across the world. India is now able to treat over 90% of notified TB patients for HIV. Social stigma surrounding AIDS-infected people in India, while high, is declining slowly too. Survey data show that in the last decade, the number of people unwilling to buy vegetables from a person with HIV came down from over 30% to 27.6%. But even as India celebrates such progress, it is important to be mindful of the scale of the challenge posed in an orthodox society. With almost 2.1 million cases, accounting for almost 10% of HIV patients, India is among the largest burden countries in the world. And there are critical gaps in its strategy that has been devised to control HIV incidence. The UN report points out that a country’s laws can legitimise stigma and give licence to the harassment of groups at the highest risk of HIV. These include men who have sex with other men, people who inject drugs, and sex workers. Indian laws don’t do well on this count because of the fact that the rulers have not been sensitive to the efforts of those working in this field. The Immoral Traffic (Prevention) Act criminalises several aspects of sex work, while Section 377 of the IPC criminalises gay sex. The intervention of the highest court of India has also not made any difference to the government of the day. Studies show that fear of prosecution under such laws prevents homosexual men, drug-users and sex workers from seeking HIV screening and treatment. As a result, these groups lag behind average treatment rates, although their requirements are higher. According to a 2017 UNAIDS report, for example, awareness of their HIV status among men who have sex with other men was 41% in India; 52% of those who knew their status were receiving treatment, and of these, 83% had suppressed viral levels. These are troubling patterns under the existing system. If India is serious about tackling HIV, it must find ways to reach such groups with full preparation. The health scheme to reach the doorsteps of every household in the country has also not been able to track down the HIV patients because the scheme has been on papers only with many shortcomings on the ground. As the UNAIDS report emphasises, the right to health is universal and simple law in India does not suffice to reach all the patients. India has to take a serious note of this to ensure that no one is left behind in the fight against HIV.