Getting to Zero Zero discrimination, zero new infections and zero AIDS-related deaths

Khamlianlal *

A painting at the World AIDS Day 2013 observation at MFDC Auditorium, Imphal on Dec 01, 2013 :: Pix - Ashok Ningthoujam

World AIDS Day, observed on 1st December every year, is dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV infection. Government and health officials observe the day, often with speeches or forums on the AIDS topics. This year the theme is "Getting to Zero": Zero Discrimination, Zero New Infections and Zero AIDS-related deaths.

It is estimated that nearly 40 million people around the world are living with HIV and AIDS. Amongst these people only one in ten have been tested and know their HIV status. With thousands of people becoming newly affected every day, including some 6000 young people, HIV and AIDS continues to be a devastating virus that affects the lives of people, families, communities and nations.

Today people living with HIV and AIDS often face many social, economic, and political challenges because of the historical stigma and fear associated with the illness. Today more than ever there is hope of a fulfilling life as an HIV or AIDS positive person. Due to the development of new and more effective antiretroviral drug treatments people living with HIV and AIDS are able to live longer and healthier lives than was possible even a decade ago.

In countries like the United States, Canada, and various countries in Europe, antiretroviral drugs are cheaper and more available; though the prices of treatment are still quite high. In many developing countries on the other hand, one of the main challenges is the issue of accessibility, distribution, and the high pricing of antiretroviral drugs which prevented those most in need from getting them.

Some of the challenges that people living with HIV faced in our societies: - Many of the people living with HIV and AIDS fall into vulnerable groups i.e. they are faced with various economic and social disadvantages. Increasingly, the populations of persons that are overrepresented in HIV and AIDS cases are women, persons of color, children, and other social groups who are disadvantaged by limited educational opportunities and financial resources amongst other factors iii. Furthermore, many of the people who are infected with HIV and AIDS may face other challenges like mental illness, substance abuse, and homelessness.

To improve the quality of life of people living with HIV and AIDS we need to facilitate and improve access to treatment for people living with HIV, Providing accurate and easily accessible information to people living with HIV, Actively promoting and protecting the human rights of people living with HIV, Promoting the involvement of people living with HIV in all levels of decision making within governments, NGOs, and communities/families. Promoting social acceptance of people living and to actively dispel stereotypes and Myths about the diseases and the people that are affected by it, and providing opportunities for networking among people living with HIV.

Here are five things we ought to know about HIV/AIDS in India:

2.4 million People are HIV positive in India: India has 2.4 million HIV positive people. It's estimated that out of these 61% are male, 39% are female and 3.5% are children. As of 2009, the adult prevalence is believed to be 0.31%. Despite, the huge number the prevalence of HIV is low when compared to our today population. On the other hand, HIV epidemic regions like South Africa have over 5 million cases with a prevalence of 18% in adults. {Source: AIDS Alliance}

India has reduced new HIV infections by 57% since 2001: The recently released UNAIDS Report 2013 claims that India has managed to reduce new HIV infections by a staggering 57% since 2001. To put this in perspective, in the same time frame, our neighbors Pakistan have seen an eight-fold increase in the number of cases. A major reason for this a concerted effort by the Central government to tackle the ailment head on through information dissemination, education and communication. Also there has never been a case of AIDS denialism in India like there was in other epidemic countries which prevented the disease from spreading far and wide.

Drug addicts, men who have sex with men (MSM) and female sex workers are the high risk groups: In India, HIV is mainly concentrated among high risk groups who are 15-30 times more likely to contract HIV than non-high risk groups. The main high risk groups are intravenous drug users, men who have sex with men and female sex workers. Getting treatment for high risk groups is even harder because of the stigma attached to each of the aforementioned activities. If we're to contain the spread of HIV, then we must figure out a way to help people from these groups find proper rehabilitation and drugs.

Not enough ART – anti-retroviral therapy: Less than 10% people getting drugs: The reason HIV has become a more manageable disease instead of a death knell is because of something called anti-retroviral therapy in which a cocktail of drugs are given to HIV positive people which helps them manage their condition and prevents HIV from becoming AIDS. In fact, a study in India showed that early treatment not only prevents HIV from becoming AIDS but also lowers the chance of transmitting the virus. This has been observed in HIV discordant couples (one positive, one negative) and also mother-to-child transmission. Sadly, not enough people are getting treatment. India remains one of the countries where less than 10% HIV positive people receive ART and there are frequent cases of drug shortage.

Still need to fight the stigma: The biggest challenge in India after the lack of drugs is the stigma attached to the ailment. When HIV was rife in the US, most people thought it was a disease that afflicted people who had it coming – the homosexuals, the drug users and the sex workers. While this view has changed over time, the stigma issue remains a problem in many parts of the world including India. We keep on coming across news items which talk about HIV positive families being ostracized, or an HIV positive people losing their jobs. It's been often said that stigma of the ailment makes it much harder to deal with than the ailment itself. We need strict laws to curb anti-HIV discrimination and need to provide sensitization to people to deal with people who suffer from the condition.

We pray and hope that all the governmental institutions, NGOs, religious and cultural organizations will all fight against stigmatization and administer more support, love and care to that people living with HIV/AIDS. This also applies to many developing countries in the world; I want to use this medium to urge all public health workers to do more in ameliorating the situation of people living with HIV/AIDS in our immediate communities.

"We can start today and our efforts can create a difference in our society".