• UGI USER
  • Apr 01, 2024
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THE ART OF INDIA’S HIV/AIDS RESPONSE

Syllabus:

GS 3:

  • Science and Technology- developments and their applications and effects in everyday life.
  • Achievements of Indians in science & technology; indigenization of technology and developing new technology.
  • Awareness in the fields of IT, Space, Computers, robotics, nano-technology, bio-technology and issues relating to intellectual property rights.

Focus:

  • India commemorates the 20th anniversary of the launch of Free Antiretroviral Therapy (ART) for Persons living with HIV (PLHIV) on April 1, 2004.
Source:- HIVInfo

What is HIV/AIDS Disease?

  • Human Immunodeficiency Virus (HIV) is an infection that targets the body’s immune system.
  • Acquired Immunodeficiency Syndrome (AIDS) is the advanced stage of HIV infection, characterized by severe damage to the immune system.

Key Points:

  • HIV Infection:
    • HIV attacks the body’s immune system, specifically targeting CD4 cells, a type of white blood cell responsible for detecting anomalies and infections in the body.
    • Upon entering the body, HIV replicates and destroys CD4 cells, leading to a weakened immune system.
  • CD4 Cells Depletion:
    • HIV infection results in a significant reduction in CD4 cell count.
    • In a healthy individual, the CD4 count ranges between 500 to 1600 cells per cubic millimeter of blood, but in HIV-infected individuals, it can drop as low as 200 cells per cubic millimeter.
  • Progression to AIDS:
    • As HIV continues to multiply and destroy CD4 cells, the immune system becomes severely compromised.
    • When the CD4 count falls below a critical level, usually around 200 cells per cubic millimeter, the individual is diagnosed with AIDS.
  • Chronic Infection:
    • Once HIV enters the body, it cannot be completely eradicated.
    • Treatment aims to control the virus, prevent its progression, and manage symptoms, but it does not eliminate the virus entirely.
  • Impact on Immune System:
    • With a weakened immune system, individuals with HIV/AIDS become more susceptible to opportunistic infections and certain types of cancers.
    • Without proper treatment and care, HIV/AIDS can lead to serious illness and death.

Inception and Significance

  • The launch of Free Antiretroviral Therapy (ART) on April 1, 2001, marked a crucial milestone in India’s response to HIV/AIDS.
  • Providing free ART has been a cornerstone in combating the epidemic, significantly impacting the lives of Persons living with HIV (PLHIV).

Evolution towards Free ART

  • In the early 1980s, HIV/AIDS was associated with fear and stigma, exacerbated by limited access to antiretroviral drugs.
  • The establishment of the Global Fund to Fight AIDS, Tuberculosis, and Malaria in 2002 aimed to address the barriers to universal access to treatment.
  • By 2004, India had over 5.1 million PLHIV, with only a small fraction receiving ART due to cost constraints.

Key Milestones

  • Since November 2006, free ART has been available for children, significantly expanding access to treatment.
  • Over two decades, the number of ART centres has grown substantially, providing vital treatment to approximately 1.8 million PLHIV.
  • Notably, the prevalence of HIV in 15-49 year-olds decreased to 0.20% in 2023, indicative of the program’s impact.

Patient-Centric Approach

  • Complementary initiatives, including free diagnostic facilities and prevention of parent-to-child transmission of HIV (PPTCT) services, have played a pivotal role.
  • The ART program has evolved with a “Treat all” policy, ensuring universal access to treatment irrespective of CD4 count.
  • Patient-centric strategies such as providing multi-month prescriptions and rapid ART initiation have improved adherence and reduced healthcare burdens.

Ongoing Challenges and Future Directions

  • Challenges persist, including delayed enrolment, patient adherence, and ensuring sustained ART supply.
  • Addressing private sector engagement, continuous training, and integration with other health programs are crucial for overcoming these challenges.
  • The next phase of India’s National AIDS Control Programme aims to further reduce HIV infections and mortality, aligning with global targets.
  • Lessons from the ART initiative can guide other public health programs, such as launching a nationwide free hepatitis C treatment initiative.
India’s Efforts to Prevent HIV

  • HIV and AIDS (Prevention and Control) Act, 2017
    • Mandates the central and state governments to implement measures preventing the spread of HIV/AIDS.
  • Access to ART
    • India has ensured affordability and accessibility of Antiretroviral Therapy (ART) to over 90% of the world’s HIV-positive population.
  • Memorandum of Understanding (MoU)
    • Signed between the Ministry of Health and Family Welfare and the Ministry of Social Justice and Empowerment in 2019.
    • Aims to enhance HIV/AIDS outreach and reduce social stigma and discrimination against victims of drug abuse and Children and People Living with HIV/AIDS.
  • Project Sunrise
    • Launched by the Ministry of Health and Family Welfare in 2016.
    • Targets the increasing HIV prevalence in northeastern states, particularly among people injecting drugs.
  • Pre-Exposure Prophylaxis (PrEP)
    • Involves offering PrEP medications to individuals at high risk of HIV contraction.
    • Consistent intake of PrEP significantly reduces the chances of HIV infection.

Source:

https://www.thehindu.com/opinion/lead/the-art-of-indias-hivaids-response/article68013606.ece

Mains Practice Question:

Discuss the significance of India’s Free Antiretroviral Therapy (ART) initiative in the context of its response to the HIV/AIDS epidemic. Highlight the key milestones achieved since its inception in 2001 and analyze the impact of the program on reducing HIV prevalence and improving healthcare access for Persons living with HIV (PLHIV).