Headline : World AIDS Day: HIV still a threat, but rate of spread is down
- Since 1988, December 1 every year is observed as World AIDS day.
- Once contracted, Human Immunodeficiency Virus (HIV) has the potential to attack the body’s immune cells called CD4 (which help the body to respond to infection).
- After HIV attacks the CD4 cells, it starts replicating itself and destroys them, weakening the body’s immune system making it more prone to certain “opportunistic infections” that take advantage of the weak immune system. This susceptibility worsens if the syndrome progresses.
- AIDS or Acquired Immunodeficiency Syndrome applies to the advanced stages of the infection caused by the HIV. Typically, the time between HIV transmission and AIDS diagnosis is 10-15 years, although it may occur sooner.
- Without treatment, HIV can progress and, eventually, it will develop into AIDS in the vast majority of cases.
- The virus progresses in the absence of antiretroviral therapy (ART) – a drug therapy that slows or prevents the virus from developing.
- Sexual transmission — it can happen when there is contact with infected sexual fluids (rectal, genital, or oral mucous membranes). This can happen while having sex without a condom, including vaginal, oral, and anal sex, or sharing sex toys with someone who is HIV-positive.
- Perinatal transmission — a mother can transmit HIV to her child during childbirth, pregnancy, and also through breastfeeding.
- Blood transmission — the risk of transmitting HIV through blood transfusion is extremely low in developed countries, thanks to meticulous screening and precautions. However, among people who inject drugs, sharing and reusing syringes contaminated with HIV-infected blood is extremely hazardous.
- As of now, there is no cure for HIV.
- It can be managed by the administration of antiretroviral (ART) drugs that stop the virus from replicating itself. This means that, most people infected with HIV who use ART, do not develop AIDS.
- In 2018, 62 percent of the adults and 54 percent of the children living with HIV were receiving life-long ART.
Improved control of HIV infections:
- Through national and international efforts, between 2000 and 2018, new HIV infections fell by 37 percent.
- HIV related deaths fell by 45 percent, with over 13.6 million lives saved due to ART.
Prevalence of HIV
- According to the World Health Organisation (WHO), there were about 37.9 million affected by HIV by the end of 2018 and 1.7 million were newly infected by it in the same year.
- In 2018, 770,000 people died of HIV related causes and 500,000 new cases and deaths are expected by 2020.
- In India:
- As per NACO’s 14th India-HIV Estimations, 2017, Total number of People Living with HIV in India is 21.4 lakh with about 0.22% adult population (15-49 years) suffering from the disease.
- Nearly 88 thousand people were newly infected with HIV in 2017.
- Maharashtra has the highest prevalence of people living with HIV, with 15 per cent of the cases, followed by Andhra Pradesh, Karnataka, Telangana and Tamil Nadu.
India’s efforts to reduce AIDS
- In 1986, the first known case of HIV was diagnosed and by 1987 , about 135 more cases came to light.
- Soon after the first cases emerged in 1986, the Government of India established the National AIDS Committee within the Ministry of Health and Family Welfare.
- To control the spread of the virus, the Indian government set up the National AIDS Control Programme in 1987 to co-ordinate national responses such as blood screening and health education.
- In 1992, the government set up the National AIDS Control Organisation (NACO) to oversee policies and prevention and control programmes relating to HIV and AIDS and the National AIDS Control Programme (NACP) for HIV prevention.
- In 2009 India established a “National HIV and AIDS Policy and the World of Work“, which sought to end discrimination against workers on the basis of their real or perceived HIV status.
- Government passed the HIV and AIDS act in 2017 to provide for the prevention and control of the spread of HIV and AIDS and for the protection of human rights of persons affected by the said virus and syndrome and for matters connected therewith or incidental thereto.
- Prevention and Care, Support & Treatment (CST) form the two key pillars of all HIV/AIDS control efforts in India.
About National AIDS Control Organisation (NACO):
- NACO was established in 1992 as a division of India’s Ministry of Health and Family Welfare .
- It is the nodal organisation for formulation of policy and implementation of programs for prevention and control of HIV/AIDS in India.
- NACO also undertakes HIV estimations biennially(every 2 year) in collaboration with the Indian Council of Medical Research (ICMR) and National Institute of Medical Statistics (NIMS).
- The first round of HIV estimation in India was done in 1998, while the last round was done in 2017.
National AIDS Control Programme:
- 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.
- It is a 100% centrally sponsored scheme.
- Launched in 1992, it was followed by NACP-II in 1999, NACP-III in 2007 and NACP-IV in 2012 (which was later extended from April 2017 to March 2020)
- NACP-I (1992):
- Objective: Slowing down the spread of HIV infections so as to reduce morbidity, mortality and impact of AIDS in the country.
- National AIDS Control Board (NACB) was constituted and an autonomous National AIDS Control Organization (NACO) was set up to implement the project.
- Focus areas:
- Awareness generation
- Setting up surveillance system for monitoring HIV epidemic
- Measures to ensure access to safe blood
- Setting up surveillance system for monitoring HIV epidemic
- Preventive services for high risk group populations.
- NACP-II (1999):
- Two key objectives of NACP II:
- to reduce the spread of HIV infection in India
- to increase India’s capacity to respond to HIV/AIDS on a long-term basis.
- NACP- III (2007):
- Goal: Halting and Reversing the Epidemic over its five-year period.
- NACP-IV (2012):
- Aim: To accelerate the process of reversal and further strengthen the epidemic response in India through a cautious and well defined integration process.
- Achieving the seventy five percent (75%) reduction in new HIV infections
- 90-90-90 strategy
- It refers to the UNAIDS’ ambitious treatment target to help end the AIDS epidemic.
- It targets that 90% of those who are HIV positive in the country know their status and that 90% of those who know their status are on treatment and 90% of those who are on treatment experience effective viral load suppression).
- NACO is even trying to achieve 95-95-95 in this regard.
- Elimination of mother-to-child transmission of HIV and syphilis and elimination of discrimination and stigmatization of people living with HIV
- The programme has succeeded in reducing the estimated number of annual new HIV infections in adults by 57% during the last decade through scaled up prevention activities.