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India needs to end HIV-related discrimination by realistically implementing the HIV/AIDS (Prevention and Control) Act 2017, said Dr Ishwar Gilada, president of AIDS Society of India and secretary general of Organised Medicine Academic Guild (OMAG).
Dr Gilada, who is also the Governing Council Member of International AIDS Society, was speaking on the sidelines of the14th National Conference of AIDS Society of India (ASICON), which started from March 17, 2023 in New Delhi and concluded on March 19, 2023 under the theme “Energize, Empathize, Equalize”.
As of today, only 15 states have made some progress towards appointing ombudsman, which is a mandatory provision in the Act after a gap of almost six years. India is yet to see a single prosecution under the provisions of this Act and it in no way connotes those violations have not happened. For example, PLHIV are denied “mediclaim” policies, as such policies still mention HIV in the exclusion criteria.
“Life insurances still have provision not to allow people living with HIV to take policies for an insured sum more than Rs. 10 lakhs and claims aren’t settled. Insurance Regulatory and Development Authority of India (IRDAI), after persuasion from the AIDS Society of India, recently warned insurance agencies against such discriminations,” Dr Ishwar Gilada informed.
He further added that all nations globally have promised to end AIDS by 2030 as part of the UN Sustainable Development Goals (SDGs) and domestic commitments. But why should we wait till 2030 if we can make #endAIDS a reality in the lives of PLHIV, today? The entire cascade of HIV care and support with lifesaving ART and monitoring viral load suppression keeps them away from HIV-related illnesses. Similarly, we can break the chain of HIV transmission with treatment as prevention (TasP) and other HIV combination prevention options. The price of inaction is heavy and unacceptable.
Since most nations could not meet the 2020 AIDS targets, now eyes are set on the 2030 goalpost of 95-95-95 targets (95% of people living with HIV to know their status, 95% of them should be on Antiretroviral Therapy (ART), and 95% of these be virally suppressed).
In 2021, globally, 85% of all People Living with HIV (PLHIV) knew their HIV status. Among those who knew their status, 88% were accessing treatment. And among people accessing treatment, 92% were virally suppressed, that translates to 75% were accessing treatment and 68% were virally suppressed. In India, as of March 2022, 77% of people living with HIV knew their status, 84% of them were on ART, and 85% of them had viral suppression. This translates into 55% of total PLHIV being virally suppressed.
India has made commendable progress since the World Health Day of 7th April 2004 when it began the rollout of lifesaving antiretroviral therapy (ART) for people living with HIV, but formidable challenges remain.
According to the Government of India’s National AIDS Control Organization 2022 report, annual new HIV infections and AIDS-related deaths continue to decline nationally. Between 2010 and 2021, new infections declined by 46% and AIDS-related mortality declined by 76%. The goal to reduce new HIV infections by 2025 is 80% and clearly, we need to do much more to turn the tide.
“While the overall adult prevalence remains low (0.21% in 2021), HIV prevalence among high-risk groups and the bridge population remains very high,” Dr Ishwar Gilada concluded.
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