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4th December – Taking stock of the anti-AIDS fight

The Sustainable Development Goals (SDG), adopted by member countries of the United Nations in 2015, set a target of ending the epidemics of AIDS, Tuberculosis and Malaria by 2030 (SDG 3.3).

Indicators –

The key indicator chosen to track progress in achieving the target for HIV-AIDS is “the number of new HIV infections per 1,000 uninfected population, by sex, age and key populations”. In the terminology of HIV prevention and control, the phrase “key populations” refers to: men who have sex with men; people who use injected drugs; people in prisons and other closed settings; sex workers and their clients, and transgender persons.

Bridging gaps

  • An ambitious treatment target was also adopted through UNAIDS, called the “90-90-90” target  which states that by 2020, 90% of those living with HIV will know their HIV status, 90% of all people with diagnosed HIV infection will receive sustained anti-retroviral therapy and 90% of all people on such therapy will have viral suppression.
  • The gaps in detection, initiation of drug therapy and effective viral control were to be bridged to reduce infectivity, severe morbidity and deaths from undetected and inadequately treated persons already infected with HIV, even as prevention of new infections was targeted by SDG 3.3.

The achievements –

  • It is the confluence of those ingredients that made it possible for the world to achieve a reduction in new HIV infections by 37% between 2000 and 2018. HIV-related deaths fell by 45%, with 13.6 million lives saved due to Anti-Retroviral Therapy (ART).
  • A rush of public and private financing flowed forth in a world panicked by the pandemic. Ignorance and stigma were vigorously combated by coalitions of HIV-affected persons who were energetically supported by enlightened sections of civil society and the media.
  • Never before had the world of global health resonated so readily to the rallying cry for adopting a rights-based approach and assuring access to life-saving treatments.
  • According to a recent report by UNAIDS, of the 38 million persons now living with HIV, 24 million are receiving ART, as compared to only 7 million nine years ago.

The new concerns –

At the end of 2018, while 79% of all persons identified as being infected by HIV were aware of the fact, 62% were on treatment and only 53% had achieved viral suppression — falling short of the 90-90-90 target set for 2020. Due to gaps in service provision, 770,000 HIV-affected persons died in 2018 and 1.7 million persons were newly affected.

Need for vigil in India

  • HIV-related deaths declined by 71% between 2005 and 2017. HIV infection now affects 22 out of 10,000 Indians, compared to 38 out of 10,000 in 2001-03. India has an estimated 2.14 million persons living with HIV and records 87,000 estimated new infections and 69,000 AIDS-related deaths annually.
  • The total number of persons affected in India is estimated to be 21.40 lakh, with females accounting for 8.79 lakh. Assam, Mizoram, Meghalaya and Uttarakhand showed an increase in numbers of annual new infections.

What is required?

  • There has to be a fresh surge of high-level political commitment, financial support, health system thrust, public education, civil society engagement and advocacy by affected groups — all of which were part of the recipe for rapid progress in the early part of this century.
  • Success in our efforts to reach the 2030 target calls for resurrecting the combination of political will, professional skill and wide ranging pan-society partnerships that characterised the high tide of the global response in the early part of this century.

SourceThe Hindu

QUESTIONIt is argued that despite our best efforts, the fight against HIV-AIDS remains incomplete. Discuss the argument and suggest a way forward.

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