[Answered] “AIDS is one of the biggest challenge for health policymakers all over the world including India”. Discuss. What should be done to reduce incidence of AIDS in India.

AIDS, acquired immune deficiency syndrome (AIDS) is a number of condition of weak immune system caused by infection with the human immunodeficiency virus (HIV). It is a headache for policymakers around the globe as it is not curable (but can be prevented). Data shows thatIn 2016, about 36.7 million people were living with HIV and it resulted in 1 million deaths.

Some Facts related to AIDS in India:

• In 2017, HIV prevalence among adults was an estimated 0.2% i.e 2.1 million people in India are living with HIV.Overall, India’s HIV epidemic is slowing down. Between 2010 and 2017 new infections declined by 27% and AIDS-related deaths more than halved, falling by 56%.

• The epidemic is concentrated among key affected populations especially sex workers and migrants. However, injecting drug use in the north and northeast of the country is also pushing HIV prevalence up.

Barriers to the HIV policies in India:

1. Stigma and discrimination: Although AIDS (prevention and control) Act 2014 criminalises discrimination against people with HIV and AIDS, people living with HIV face high levels of discrimination.Often people justify their attitude by saying that people who got HIV through sex or drugs got what they deserved.
2. Gender inequality: Women, particularly in rural areas, have little control or decision-making powers over important aspects of their lives. This means they are often unable to negotiate protection from risk of infection. Women living with HIV are reluctant to access health care for fear of discrimination and marginalisation.
3. Data issues: There is need for greater analysis related to HIV data.
   • Lack of integrated data systems limit its availability and use.
   • Also lack of HIV and accurate key population size estimates create hurdles.
   • Further inadequately trained staff to monitor the epidemicis an issue.
   • There are also challenges to track people under HIV treatment.
4. Infrastructural bottlenecks: In recent years, there have been issues in the
   • procurement, management and distribution of antiretroviral vaccines, HIV testing kits and other HIV commodities, mainly due to supply chain bottlenecks.
   • The operation of the drug procurementsystem, particularly in remote locations, needs to be strengthened. For example, slow internet speeds, late payments can disrupt the system.
5. Funding issues: Funding to tackle the HIV epidemic in India relied heavily on international funding. However, in 2012 India committed to financing 90% of its HIV and AIDS programmes.Mobilisation of resources for this is not easy.

What is needed to control AIDS in India?

1. Targeted Intervention: Targeted interventions for key affected groups and those at high risk of HIV transmission is needed.
   • This can be achievedthrough the HIV treatment plan, education, care and support.
   • Prevention of new HIV infections by reaching out key affected populations with targeted interventions is needed. For example, targeting interventions towards female sex workers.
2. Education: Increasing awareness among the general population and key affected populations about HIV prevention is needed.
   • A number of innovative programmes to increase awareness of HIV testing, prevention and treatment should be implemented. These include the use of folk media to reach people, particularly remote places.
   • Aneducation Programme in the schools to helpadolescents cope with negative peer pressure and improve awareness on sexual health and HIV should be employed.
3. Preventing mother-to-child transmission:HIV infections among children must be eliminated. Antiretroviral treatment for all pregnant and breastfeeding women living with HIV should be done.
4. Proper Counselling: For people who inject drugs in India
   • proper counselling and therapy should be promoted.
   • Sensitisation of youth through media, education, schools is needed.
   • A community-based effort should be made to keep vigil on children.
   • Interventions along with psychosocial support are needed.
5. Civil society’s role: Indian civil society should come together to shun stigma related to HIV in society through awareness programs and education.

Over the past decade, India has made significant progress in tackling its HIV epidemic, especially in comparison with other countries in the region. Although continued effective prevention programmes like National AIDS Control Programme Phase-IV (NACP-IV)must remain in place, focus should be on targeting vulnerable groups. A coordinated effort of government, civil society and various NGOs is must.