|
The most serious public health challenge that the country is facing today is of HIV/AIDS. AIDS is a global problem. The world’s second most populous country has one of the highest infection – and more than five million HIV/AIDS cases. HIV/AIDS presents major challenges to human survival, human rights and human development with implications far beyond the health sector. The social and economic consequences of the epidemic are perhaps the most serious threats to sustainable human development.
In order to prevent and control the spread of HIV/AIDS in the country, Government of India has launched a comprehensive National AIDS Control Programme, currently under implementation throughout the country as a centrally sponsored scheme. The components of scheme include preventive interventions for high-risk populations through targeted interventions adopting a multi-pronged strategy including peer counseling and behaviour change communication, Prevention of Parent to Child Transmission (PPTCT) and collaborative efforts to promote inter-sectoral programme activities including workplace interventions and public – private partnerships.
Law To End Discrimination
Recently, the Government has also announced that a law aimed at ending discrimination against HIV Positive cases at work places, treatment and education, will be enacted by this year-end. According to Union Health Minister Dr. Anbumani Ramdosss, the draft of the legislation is presently under consideration of the Law Ministry. .
According to UNAIDS, 36.1 million people are living with HIV/AIDS globally of which 47 per cent are women. In South and South East Asia region, 5.8 million people are living with HIV/AIDS of which 35 per cent are women with an adult prevalence rate of 0.5 per cent. The UN system has recognized the need for such a response in the creation of UNAIDS, which represents an innovative partnership of seven co-sponsors -- UNICEF, UNDP, UNDCP, UNFPA, WHO and the World Bank.
NACO is implementing India's National AIDS Control Programme (NACP) in partnership with Civil Society Organizations including NGOs, Corporate Sector, Academic institutions and networks. In India, six states ---Tamil Nadu, Maharasthra, Gujarat, Rajasthan, Himachal Pradesh and Delhi --have been jointly identified along with NACO for piloting this initiative.
Aids Scenario In India
The first case of HIV infection in India was diagnosed among commercial sex workers in Chennai, in 1986. By early 1987, efforts were made up to set up a national network of HIV screening centers in major urban areas. Globally India is second only to South African in terms of the overall number of people living with the disease. NACO estimated that the number of Indians living with HIV increased by 5 Lakh in 2003 to 5.1 million. Around 38 per cent of these people were women. The UN Population Division projects that India’s adult HIV prevalence will peak at 1.9 per cent in 2019. The world body estimates that there were 2.7 million AIDS deaths in India between 1980 and 2000. During 2000-2015, the UN projects 12.3 million AIDS deaths and 49.5 million deaths during 2015-2050. A 2002 report by the CIA’s National Intelligence Council predicted 20 million to 25 million AIDS cases in India by 2010, more than any other country in the world.
Spread Of Aids
Although HIV/AIDS is still largely concentrated in at-risk populations, including commercial sex workers, injecting drug users, and truck drivers, the surveillance data suggests that the epidemic is moving beyond these groups in some regions and into the general population. It is also moving from urban to rural districts. The majority of the reported AIDS cases have occurred in the sexually active and economically productive 15 to 44 age group. The predominant mode of HIV transmission is through heterosexual contact, the second most common mode being injecting drug use. Previously blood transfusion and blood product transfusion were also major causes, but blood safety measures are now in place to prevent such migration of economically productive sections of the population is a common phenomenon all over India. According to the 1993 National Sample Survey in India, 24.7 per cent of the population had migrated, either within India, to neighbouring countries or overseas. Applying this percentage to the mid-2003 population about 264 million Indians are mobile. Most of the migrant workers are highly mobile and often live in unhygienic conditions in urban slums. Long working hours, relative isolation from the family and geographical mobility may foster casual sexual relationships and make them highly vulnerable to Sexually Transmitted Diseases and HIV/AIDS. Migrant workers tend to have little access to HIV/STD information, voluntary counseling and testing and health services. Cultural and language barriers worsen their lack of access to such services as do exist. Returning or visiting migrants, many of who do not know their status, may infect their wives or other sex partners in the home community.
Social Reactions
In India the social reactions to people with AIDS have been overwhelmingly negative. Educating people about HIV/AIDS and prevention is complicated as India has many major languages and hundreds of different dialects. So, although some HIV/AIDS prevention and education can be done at the national level many of the efforts are best carried out at the state and local level. With the second phase of the National AIDS Control Programme (1999-2004), NACO has expanded its programme. It provides funds to State AIDS Control societies for targeted interventions, blood safety, voluntary testing and counselling and youth campaigns.
HIV/AIDS Vaccine
Upbeat at the successful completion of the clinical trial of HIV/AIDS vaccine on first 10 volunteers at Pune, India’s apex medical body – Indian Council of Medical Research (ICMR) says if things go right the antedote for the dreaded disease would be available in the market in the coming few years. According to ICMR, the Adeno Associated Vector Borne Vaccine (AV), which went into Phase-I trials in Pune, has been completed on 10 volunteers and their safety profile is very good. Trials are already on in Germany and Belgium and initial results have given excellent safety data. ICMR says number-wise the over 5 million AIDS cases in India is very large, although percentage wise India is no-where near the African countries. The vaccine tgAACO9, has been developed by an international partnership. In India, the trials are being conducted through a partnership between the government and the International AIDS Vaccine Initiative (IAVI).
If successful, the vaccine will go into its second and third stages of testing. This vaccine is aimed at fighting strain C of HIV, the sub-type most commonly found in the country. With no cure for HIV yet, prevention is seen as the only way of checking its rapid spread. Union Health and Family Welfare Minister Dr Anbumani Ramdoss says, India has started the first phase of clinical trials, but 85 per cent of the focus will be still be on prevention. Even if it is successful, the vaccine will take nearly eight to ten years to pass through all tests. The urgent need of the hour is a strong and determined policy supported by an effective timely action by political establishments to fight the killer disease before it takes on the whole humanity.
*Freelance Journalist
|
