India poised to end AIDS epidemic, says UNAIDS country director

Bridger’s remarks come in response to a new report released by UNAIDS titled ‘The Path that Ends AIDS’, which underscores the political and financial choices involved in ending AIDS and highlights the remarkable achievements of countries and leaders who have pursued this path.

The report revealed that several nations, including Botswana, Eswatini, Rwanda, the United Republic of Tanzania, and Zimbabwe, have attained the ambitious “95-95-95″ targets. These targets aim to ensure that 95% of people living with HIV are aware of their HIV status, 95% of those aware receive life-saving antiretroviral treatment, and 95% of people on treatment achieve viral suppression. Furthermore, 16 additional countries are in close proximity to reaching these targets.

Winnie Byanyima, executive director of UNAIDS, highlighted the significance of strong political leadership in successful HIV responses. Byanyima emphasized the need to rely on data, science, and evidence, address existing inequalities that hinder progress, empower communities and civil society organizations, and ensure equitable and sustainable funding.

The report also highlighted a fourfold increase in the number of people on antiretroviral treatment worldwide, rising from 7.7 million in 2010 to 29.8 million in 2022. However, it focussed on a somber statistic: AIDS claimed a life every minute in 2022. Approximately 9.2 million people, including 660,000 children living with HIV, still lack access to treatment.

Turning the focus to India, the 2022 HIV Estimates indicate that around 2.47 million people are living with HIV in the country, with an adult HIV prevalence of 0.2%. Although there were approximately 66,000 new HIV infections in 2022, there has been a decline of slightly over 42% since 2010, slightly exceeding the global average of 38%. AIDS-related deaths in 2022 stood at approximately 39,000, marking a significant decline of nearly 77% since 2010.

The Indian government has demonstrated its commitment and leadership in addressing the AIDS epidemic. Despite numerous competing health priorities during the COVID-19 recovery period, the fifth phase of the National AIDS and STI Control Programme (2021-2025) received a substantial budget allocation of approximately USD 1934 million. Notably, 95% of the overall budget for the program is financed domestically, exemplifying India’s dedication to combating the epidemic.

Efficient and effective utilization of resources, along with the availability of granular data from systems such as NACO’s Surveillance and Epidemiology Framework, are vital for achieving desired outcomes.

In 2022, India witnessed encouraging progress, with 79% of people living with HIV aware of their status. Of those aware, 86% of all people living with HIV are receiving antiretroviral treatment. Moreover, 93% of those on treatment who underwent viral load testing achieved viral suppression. A key priority for India is reaching individuals who are aware of their status but not on treatment. The concept of Undetectable=Untransmittable (U=U) reinforces the importance of achieving an undetectable viral load through antiretroviral therapy, rendering individuals unable to transmit the virus.

India’s strategic focus includes leveraging innovative solutions like pre-exposure prophylaxis (PrEP) and virtual interventions, removing barriers to access services, and implementing policy reforms that create an enabling environment. The planned establishment of welfare boards for transgender people in all states is a promising initiative that could be expanded to benefit other populations.

Bridger reiterated that achieving the end of the AIDS epidemic as a public health threat is well within India’s grasp. To accomplish this, he emphasized the need to enhance political will, prioritize essential financing, integrate health systems, scale up HIV prevention, testing, and treatment efforts in priority locations and among key populations, develop and enforce non-discriminatory laws, promote gender equality, and empower community networks.

Updated: 13 Jul 2023, 06:59 PM IST