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World AIDS Day, observed annually on December 1 since 1988, serves as a global platform to unite people in raising awareness about HIV (Human Immunodeficiency Virus) /AIDS (Acquired Immune Deficiency Syndrome) and demonstrating solidarity against the pandemic. It is an opportunity for governments, organizations, and communities to reflect on the progress made in prevention, treatment, and care while highlighting the ongoing challenges. This day, recognized as one of the most significant international health observances, not only spreads awareness but also commemorates those who have lost their lives to AIDS and celebrates milestones such as expanded access to healthcare services. By fostering understanding about HIV as a critical public health issue, World AIDS Day underscores the integral connection between combating AIDS and achieving Universal Health Coverage and the Right to Health.
2024 Theme: “Take the rights path: My health, my right!”
The theme for World AIDS Day 2024, “Take the rights path: My health, my right!” emphasizes the importance of healthcare access and the empowerment of individuals in managing their health. It underscores the need to address systemic inequalities that prevent vulnerable populations from receiving essential HIV prevention and treatment services. This year’s theme highlights the role of human rights in ensuring that everyone, regardless of their background or circumstance, can exercise their right to health. By focusing on this rights-based approach, the 2024 campaign seeks to foster inclusivity, reduce stigma, and encourage global cooperation to eradicate AIDS as a public health threat.
The Current State of HIV/AIDS: A Global and National Perspective
As per the Global AIDS Update 2023 released by The Joint United Nations Programme on HIV/AIDS (UNAIDS), significant strides have been made globally in combating HIV/AIDS. New HIV infections have declined in countries like India, where a robust legal framework and increased financial investments have facilitated progress toward the goal of ending AIDS as a public health threat by 2030. India, in particular, has been acknowledged for strengthening laws to protect the rights of vulnerable populations.
On the national front, the India HIV Estimations 2023 report highlights that over 2.5 million people are living with HIV in India. Despite this, the country has made notable progress, with adult HIV prevalence recorded at 0.2% and annual new HIV infections estimated at 66,400, a 44% reduction since 2010. India has outperformed the global reduction rate of 39%, demonstrating the success of sustained interventions. The availability of free high-quality lifelong treatment for over 16.06 lakh people living with HIV (PLHIV) through 725 ART (Antiretroviral Therapy) centers (as on June 2023) and 12.30 lakh viral load tests conducted between 2022–2023 reflect India’s commitment to ensuring care for affected populations.
India’s Response to the HIV/AIDS Epidemic: A Comprehensive Approach
India’s battle against the HIV/AIDS epidemic began in 1985 with sero-surveillance to detect the virus in various population groups and geographic locations. The initial phase (1985-1991) focused on identifying HIV cases, ensuring blood safety before transfusions, and generating targeted awareness. The response gained momentum with the launch of the National AIDS and STD Control Programme (NACP) in 1992. This marked the beginning of a systematic and comprehensive approach to tackling HIV/AIDS in the country. Over 35 years, NACP has become one of the largest HIV/AIDS control programs in the world.
Evolution of the NACP Phases
The first phase of NACP (1992-1999) prioritized creating awareness and ensuring blood safety. With the launch of the second phase (1999-2007), direct interventions were introduced across prevention, detection, and treatment. States were also equipped with the capacity for effective program management. The third phase (2007-2012) saw a major scale-up of activities, with decentralized program management reaching district levels. The fourth phase (2012-2017) consolidated earlier efforts with increased government funding, ensuring the program’s sustainability.
The extended NACP Phase-IV (2017-2021) brought several landmark initiatives, including the passage of the HIV and AIDS (Prevention and Control) Act, 2017, which guarantees equal rights for HIV-positive individuals and prohibits discrimination against them. This act, which came into effect in September 2018, strengthened India’s legal framework to safeguard the rights of people living with HIV (PLHIV).
During this phase, the government also launched the ‘Test and Treat’ policy in 2017, ensuring that every individual diagnosed with HIV receives free Antiretroviral Therapy (ART) irrespective of their clinical stage. To re-engage PLHIV who had discontinued treatment, the ‘Mission Sampark’ initiative was implemented in 2017. The onset of the COVID-19 pandemic during 2020-2021 posed significant challenges to the program. However, the NACP leveraged information technology to enhance program review, coordination, and capacity-building efforts. Innovations like multi-month drug dispensation and community-based ART refills ensured the continuity of treatment services during the pandemic.
NACP Phase-V: Renewed Focus on Ending AIDS
Launched as a Central Sector Scheme for 2021-26 with an outlay of Rs. 15,471.94 crore, NACP Phase-V aims to build on past achievements and address persistent challenges. The NACP Phase-V aims to reduce annual new HIV infections and AIDS-related mortalities by 80% by 2025-26 from the baseline value of 2010. Additionally, the NACP Phase-V aims to attain dual elimination of vertical transmission, elimination of HIV/AIDS related stigma while promoting universal access to quality STI/RTI services to at-risk and vulnerable populations.
The NACP Phase-V is designed to achieve specific targets by focusing on eight guiding principles, including community-centered approaches, synergy building, technology integration, gender-sensitive responses, and fostering partnerships. Key collaborations are planned with public and private sectors, leveraging existing government schemes for cost-effective service delivery.
Key Objectives of NACP Phase-V
- HIV/AIDS Prevention and Control:
- Ensure 95% of high-risk individuals access comprehensive prevention services.
- Achieve 95-95-95 targets: 95% of HIV-positive individuals know their status, 95% of those diagnosed are on treatment, and 95% of those patients achieve viral suppression.
- Eliminate vertical transmission by ensuring 95% of pregnant women with HIV have suppressed viral loads.
- Less than 10% of people living with HIV and key populations experience stigma and discrimination
- STI (Sexually Transmitted Infection)/ RTI (Reproductive Tract Infection) Prevention and Control:
- Provide universal access to high-quality services for at-risk populations.
- Eliminate vertical transmission of syphilis
Conclusion
World AIDS Day 2024 serves as a reminder of the work that remains to be done to eliminate HIV/AIDS. Through the NACP Phase-V and its rights-based approach, India has made significant progress in prevention, treatment, and care. However, challenges like systemic inequalities and social stigma require continued focus. The theme “Take the Rights Path: My Health, My Right!” encapsulates the collective mission to foster inclusivity, uphold human rights, and ensure equitable healthcare access. As the world moves closer to achieving the goal of ending AIDS by 2030, India’s efforts exemplify the power of collaborative action, innovative strategies, and an unwavering commitment to health equity. By addressing the structural challenges and scaling up successful interventions, India is poised to lead the global fight against HIV/AIDS, ensuring a healthier, stigma-free future for all.
Source:PIB
