A changing enemy

India's fight against AIDS is far from over

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Business Standard New Delhi
Last Updated : Jan 24 2013 | 2:10 AM IST

The latest report from the United Nations’ AIDS body notes that India has managed to bring down the count of people affected by HIV/AIDS by as much as 57 per cent. That’s an encouraging and creditable achievement. But it should not make the authorities overconfident. Slacking off in the campaign for the prevention and treatment of AIDS would quickly erode any gains made so far.

One particularly worrisome fact is that the prevalence of full-blown AIDS is still too high in the 15 to 49 age group; people belonging to this category are in the prime of their working life. Too much patting of India’s own back is also unwarranted because it is not alone in containing the spread of AIDS. The incidence of newly infected people is, in fact, falling the world over — the total number of new cases dropped by 20 per cent between 2001 and 2011. The number of AIDS-related deaths, too, has plummeted by 24 per cent. Moreover, many of the sharpest reductions in the rate of new AIDS cases have been recorded in 25 low- and middle-income countries, over half of them in Africa, the most infected continent. The countries reporting a sharper decline in AIDS than in India include Malawi (73 per cent), Botswana (71 per cent), Namibia (68 per cent) and Zambia (58 per cent). India’s achievement in lowering the incidence by 57 per cent, however, sparkles when viewed against that by some of its immediate neighbours like Bangladesh and Sri Lanka, where the incidence of the disease has actually surged by 25 per cent.

The success of India’s National AIDS Control Programme (NACP) can be attributed largely to the perceptible increase in the level of awareness about the perils of this disease, most importantly, among commercial sex workers. The decentralisation of the implementation of the NACP by involving the states’ AIDS control societies and voluntary organisations has contributed to this. So have innovative initiatives like “Hamsafar”, aimed at reaching out to thousands of truck drivers, who are also at risk. On the downside, scientists at a Bangalore-based research centre have reported that the most commonly found AIDs-causing virus, HIV type 1 (HIV-1), has been undergoing a process of evolution for the last 10 years — which may make AIDS control tougher. This has led to the emergence of five new strains of HIV-1, which have been found to be rapidly replacing the standard viral strain. Similar processes of viral progression have also been noticed in some other countries where the HIV-1 AIDS virus has been prevalent, notably South Africa, China and Brazil. The new strains, it is feared, may have a greater ability to infect and establish themselves in their hosts. This ominous development may require currently successful AIDS control strategies – especially the widespread and effective antiretroviral therapy – to be reviewed. The flow of funds towards research on AIDS control therapies cannot, therefore, slow down. In addition, work must continue on making cures and therapies accessible to patients.

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First Published: Dec 11 2012 | 12:17 AM IST