Context: Every year, December 1st is observed as World AIDS Day.

• The theme of World AIDS Day 2020 is Ending the HIV/AIDS epidemic: resilience and impact.

Significance of the day

• It reminds the public and government that HIV has not gone away and there is still a vital need to raise money, increase awareness, fight prejudice and improve education.
• It is an opportunity to show solidarity with the millions of people living with HIV worldwide.

What is AIDS?

• HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system. If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome).
• HIV attacks a specific type of immune system cell called CD4 helper cell or T cell. When HIV destroys this cell, it becomes harder for the body to fight off other infections.
• People with HIV who get effective HIV treatment can live long, healthy lives and protect their partners.

Treatment

• There is currently no effective cure, it can only be controlled.
• The medicines that treat HIV are called antiretroviral drugs.
• There are more than two dozen of them, and they fall into six main types. Each drug fights the virus in your body in a slightly different way.
• A combination of drugs is the best way to control HIV and lower the chances that the virus will become resistant to treatment.
• Stem Cell Transplant has emerged as a new form of treatment.
• Recently, a patient appears to have been cured of HIV following a stem cell transplant procedure, which replaces unhealthy, infected cells, with healthy blood cell precursors.

Prevalence of AIDS in India

• India has the third-highest HIV burden with 2.35 million.
• There were 69,220 new HIV infections and 58,960 AIDS-related deaths reported in India in 2019.

The key populations most affected by HIV in India are

• Sex workers, with an HIV prevalence of 1.6%.
• Men who have sex with men, with an HIV prevalence of 2.7%.
• People who inject drugs, with an HIV prevalence of 6.3%.
• Transgender people, with an HIV prevalence of 3.1%.
• AIDS mortality was estimated at 4.43 per 100,000 population in 2019 at the national level, which peaked at around 25 during 2004/05 and then continued to decline.

As per the UNAIDS Report 2020

• Asia Pacific region saw a 12% decline in new HIV infections and a 29% decline in AIDS-related deaths over the last decade.
• But the maximum decline of 66% in new infections was in India.
• Around 30 per cent of Indians between 15-49 years of age reported discriminatory attitudes towards people living with HIV (PLHIV).
• 79 per cent of PLHIVs are aware of their HIV status, of which 71 per cent are on HIV treatment.

Government efforts

• The National AIDS Control Programme (NACP), launched in 1992, is being implemented as a comprehensive programme for prevention and control of HIV/ AIDS in India.
• Currently in Phase IV, which aims to accelerate the process of reversal and further strengthen the epidemic response in India through a cautious and well-defined integration process over the next five years.
• The 2017 National Health Policy and the UN Sustainable Development Goals aim to end AIDS by 2030.
• India adopted the test and treat strategy of the World Health Organisation as a national policy to achieve the target of 90:90:90 by 2020.
• Government of India had passed the HIV & AIDS (Prevention and Control) Act 2017.
• The act provides for notification of a ‘Model HIV and AIDS Policy’ by the Centre for establishing standards for safe workplaces, grievance redressal mechanisms, and informed consent for tests.

International Level Initiatives

• India is a signatory to the United Nations Sustainable Development Goals and has committed itself to achieve the target of ending the epidemic of AIDS by 2030.

The UNAIDS has identified 2020-specific fast-track targets, which include

• 75 per cent decline in new HIV infections from the 2010 baseline value.
• Attainment of 90-90-90 treatment goals (90 per cent of PLHIV are aware of their HIV status, of which 90 per cent are on HIV treatment, of which 90 per cent have suppressed their HIV load).
• Elimination of new HIV infections among children.
• Elimination of HIV/AIDS-related stigma and discrimination.

Challenges

• The COVID-19 pandemic had a severe impact on the prevention, diagnosis, and treatment of AIDS.
• The majority of the allocated budget is towards counselling, testing, and ART.

Suggestions

• Ensure life-saving anti-retroviral therapy reaches all those who are infected and that all persons living with HIV know their status.
• Treatment as prevention must be the norm.
• Increase budgetary allocations for Information, Education, and Communication (IEC) programs.