0.1699
900 319 0030
x

Reassessing AIDS Measures

iasparliament Logo
December 01, 2018

What is the issue?

Observing December 1 as the World AIDS day, it should be taken note that after 2011, the decline in new infections had not been very impressive.

What are the global measures?

  • Specific themes are chosen every year to drive home the messages of prevention, treatment and fighting stigma and discrimination associated with AIDS.
  • This year's theme is ‘know your status’ which signifies universal testing followed by treatment of those who are tested positive.
  • In the last 30 years, no other disease control programme has attracted such global attention as AIDS.
  • Other initiatives and measures include
  1. a UN General Assembly Special Session (UNGASS) on AIDS in 2000
  2. a UN Security Council resolution treating AIDS as a security issue
  3. a special Global Fund to finance AIDS programme along with TB and Malaria (about $20 billion for AIDS programmes alone)
  • But the real game changer was the strong involvement of civil society.
  • This especially included marginalised communities like sex workers, transgender population, gay men, people who use drugs and people living with HIV/AIDS.

How did these benefit?

  • The cumulative effect was a greatly reduced mortality due to AIDS related illnesses.
  • From a high of 1.5 million in 2000, it was reduced to 9,40,000 in 2017.
  • The incidence of HIV, the new infections occurring every year, has also registered an impressive decrease.
  • It has come down from 0.49 per thousand adults in 2000 to 0.33 in 2010.
  • But instead of going forward and ensuring the reduction of new infections, the global programme lost direction around that time.

What happened thereafter?

  • Both prevention of new infections and saving lives of infected people should be twin priorities.
  • But the emphasis has decisively shifted to treatment alone.
  • An entire spectrum of anti-retroviral drugs came into the market.
  • Also, donors started investing in treatment programmes focussed on generalised epidemic countries in sub-Saharan Africa.
  • UNAIDS has kept 90-90-90 as their top priority focussing on testing, treatment and viral suppression.
  • [By 2020, diagnose 90% of all HIV-positive persons, provide antiretroviral therapy (ART) for 90% of those diagnosed, and achieve viral suppression for 90% of those treated]
  • But somewhere in this process, the agenda of reduction of new infections among key populations lost the needed attention.
  • More worryingly, the legal environment surrounding these populations has turned increasingly hostile.
  • E.g. Same sex relations, transgender identity and sex work have all come under increasing pressure of criminalisation.
  • But Global Commission on HIV and Law had emphasized that improving the legal environment alone could save up to 1 million new infections every year.
  • Moreover, access to affordable prevention devices like condoms, needles and syringes greatly suffered in the last six to seven years.
  • Funds for prevention programmes have dried up and the meagre amounts earmarked never reached the implementers.
  • Several civil society organisations that were doing well lost momentum for want of adequate financial support.
  • Resultantly, prevention interventions were left in the hands of inexperienced programme managers.

What was the result?

  • The rate of decrease of new infections started slowing down since 2011.
  • It has virtually stayed still in the last three to four years.
  • The cumulative decrease of new infections from 2010 to 2017 was just 18%, a little more than 2% per year.
  • Global HIV incidence still stands at high 1.8 million as revealed by UNAIDS in its latest estimate.
  • Certainly, it is hard to get to the global fast track targets of reduction of new infections by 85% by 2020.
  • Also, logically, the goal of ending AIDS by 2030 appears much farther away.

What does it call for?

  • The need of the hour is hard core programming for prevention, principally focussing on populations vulnerable to HIV.
  • Prevention messages on responsible sexual behaviour and harm reduction should be taken to the masses.
  • Global managers need to advocate equitable allocation of resources for preventing new infections and treatment of the affected.

 

Source: BusinessLine

Login or Register to Post Comments
There are no reviews yet. Be the first one to review.

ARCHIVES

MONTH/YEARWISE ARCHIVES

Free UPSC Interview Guidance Programme