Fight against AIDS

Adarsh Bhardwaj
Though India’s fight against HIV/AIDS over the past decade has been a great success, India has the world’s third largest HIV/AIDS-affected population and the challenges the country faces to overcome the AIDS epidemic are enormous. HIV/AIDS has torn apart families leaving millions of orphans, many HIV positive themselves. HIV/AIDS has infected women and children in alarmingly disproportionate amounts as well leaving them to live in lives of illness, death, uncertainty, stigma, isolation and fear.
In India, AIDS is not only considered as a disease but it has been a matter of discrimination against the affected persons. People living with HIV have faced violent attacks, been rejected by families, spouses and communities, been refused medical treatment, and even, in some reported cases, denied the last rites before they die.
It is estimated that in India more than a million children under 15 have lost one or both parents to AIDS.  For children infected with the virus, survival is a struggle. Many contracted it from their infected parents.  Many orphanages reject HIV-positive children. Children from families afflicted with HIV are often denied an education, pushed onto the street or forced into child labor, putting them at a greater risk of contracting HIV themselves.
Some doctors refuse to treat or even touch HIV-positive children. Some schools expel or even segregate children because they or their parents are HIV-positive, activists and experts working in the field say.
While such strong reactions to HIV and AIDS exist, it is difficult to educate people about how they can avoid infection.
“I don’t think there has been enough sensitisation,” says Anjali Gopalan, founder of the Naz Foundation, while adding, “there is still huge stigma around HIV.”
Experts says that India’s battle against Aids is far from won. With an estimated 2.1m people still living with HIV, the Northeast is the worst-affected. In Assam, youngsters’ propensity to ignore AIDS awareness programmes, indulge in unprotected sex and drugabuse are the major factors responsible for rise in HIV cases. According to the Assam State AIDS Control Society (ASACS), 500 new cases have been detected in the first three months of this year alone, which has taken the total number of HIV and AIDS cases to 7500. Till May last year, the total number of such cases was 6500, which increased to 7000 at the end of the year.
Assam State Commission for Women and ASACS, additional project director of ASACS, Pabin Talukdar, says, “At present, the number of cases detected are among the youngsters because of unprotected sex, sex before marriage and more intake of drugs.”
In 1998 when the Arunachal Pradesh Aids Control Society was set up, only two HIV positive cases were reported in the entire state, but the figure rose to 202 as per the latest count made in December, 2012.
“People are still very casual in approach to the disease,” deputy director of Arunachal Pradesh Aids Control Society (APSACS), Tasor Pali, said. He adds that the actual number of AIDS positive cases would be much higher as the figures available with APSACS were only of those who voluntarily came for testing.
Somen Debnath, who has travelled to 72 countries by pedalling 93,800 km from India since 2004, says that the persistent message he has been hearing from people living with HIV/AIDS is that they need love, care and respect. In his view, while HIV/AIDS statistics indicate improvement, these statistics are not reflecting the quality of life aspect. “The need for affection and care has not improved much since 2004,” he says. His key message: “Prevention is better than Cure”.
Dr. Rajiv Shah, USAID administrator, is hopeful that an end of AIDS is possible. He stated that we have the tools, now we need to act by funding them. “The key to ending AIDS is through prevention.  It has been proven that early treatment of HIV positive people with antiretrovirals reduces the transmission by 96% meaning a possible end to AIDS is in sight.  Unless we cut back.”
However, AIDS funding is dwindling. Last year, the Bill and Melinda Gates Foundation announced that it would withdraw from HIV control efforts in India. The Gates Foundation, which has funded targeted HIV prevention programmes in India since 2003, hopes to hand over the responsibility of continuing these programmes to the NACO  by June next year, the foundation’s country director Ashok Alexander had earlier said. The announcement had kindled concerns that the government, already facing a gap in funding for AIDS control, may not be in a position to run the foundation’s activities.  Gates Foundation’s initiative Avahan-supported schemes used to reach nearly 2 lakh female sex workers and 80,000 patients in the MSM community and the transgender community.
UNAIDS statistics show India’s rate of new HIV infections fell by more than 50 percent between 2001-2009, the global rate dropped by 25 percent. With the union health minister GhulamNabi Azad recently stating that there has been no increase in the number of people living with HIV/AIDS in India, experts fear complacency setting in now that the crisis has been reigned in to an extent.
“I am worried about complacency and losing political drive,” says UNAIDS country coordinator, Professor Charles Gilks. “As soon as politicians think Aids is beaten, they will cut back.” Dr Gilks fears are not unfounded. The National Aids Control Organisation (NACO) funded community centres that provide free treatment and medicines to HIV positive people are being shut down one by one in different states across the country.
This dramatic shift in funding – combined with an apparent new aloofness, and change in priorities, by the NACO – has raised anxiety among many public health professionals, who fear India’s impressive gains against the virus are in danger of being lost. Gilks warned that India should not stop investment in AIDS awareness.
“The worry is that a country like India will prematurely declare victory and think that it can start to reduce the money it is investing in HIV prevention and treatment, and declare a premature victory. If that will happen, the virus will rebound,” Gilks said   [IFS]

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