The world has made enormous progress in reducing the impact of HIV over the last 15 years. Globally, 30.7 million people —77 per cent of those living with HIV— were on treatment in 2023, up from just 7.7 million in 2010. This has resulted in a dramatic decline in AIDS-related deaths, down by 51 per cent over the same period. India has also made significant progress in reducing AIDS-related deaths by 79 per cent since 2010, thanks to a strong partnership between government and community, driving free treatment scale-up and the Test and Treat programme under the National AIDS Control Organization (NACO).
Annual new HIV infections have also seen a 44 per cent decline, from 2010 to 2023. However, HIV prevention efforts will need acceleration if India is to close the gap and meet the Sustainable Development Goal of ending AIDS as a public health threat by 2030.
Although a range of effective treatment and prevention tools have been developed, the world is still not on track to end AIDS as a global health threat by 2030. In at least 28 countries, new HIV infections are on the rise.
So how do we protect the gains and make progress towards the vital 2030 goal?
A new UNAIDS report, ‘Take the Rights Path’, which will be released ahead of World AIDS Day on December 1, shows that upholding rights is the pathway to a robust and sustainable society.
The world can end AIDS as a public health threat if the human rights of all people living with and at risk of HIV are protected. Upholding the rights of women and girls is central to ending the AIDS pandemic.
Gender-based violence increases vulnerability to HIV. The denial of education and information puts people at risk. There is an urgent need to invest in girls’ education and to provide comprehensive sexuality education—a critical component of HIV prevention.
Barriers to accessing healthcare need to be dismantled. For example, more than half of countries have laws that prevent young people from being get tested to learn their HIV status unless they get parental permission, which scares young people away and leads many young people to remain unaware of whether they are living with HIV.
Last year there were an estimated 68,000 new HIV infections here in India. That means around 186 people are newly infected every day. The Global AIDS Strategy calls for 80 per cent of prevention services to be delivered by community-led organizations that are best placed to reach key at-risk populations. These organisations need the right space and sustainable resources to lead.
The criminalisation and marginalisation of groups of people, such as gay men, transgender people, sex workers and people who use drugs, in a number of countries, is undermining efforts to end AIDS. Increasing levels of stigma and discrimination drive people away from HIV treatment and prevention services.
To protect everyone’s health we need to protect everyone’s rights.
There is hope.
Across the world, a number of divisive laws that impede the delivery of public health services to vulnerable groups of people have been removed. Two thirds of countries now do not criminalise LGBTQ people. There is a clear trend also towards the removal of the counterproductive laws criminalizing HIV exposure, non-disclosure or transmission.
India has a long history of exceptional community leadership. The government of India has committed to achieving the 30-80-60 targets for community engagement in the HIV response as set out in the current Global AIDS Strategy.
This means communities should provide 30 per cent of testing and treatment services, 80 per cent of prevention services and 60 per cent of programmes to achieve the societal enablers. Communities must be at the centre of the formulation, budgeting, implementation, monitoring and evaluation of all plans, policies and programmes that affect them.The role of the community has been central to India’s HIV response. The partnership approach between government and community is one of the great lessons of the HIV response that can be applied across the health system.
The foundations of response are solid in India. The goal of ending AIDS as a public health threat by 2030 could be a reality in the country. The next three to five years will be crucial, accelerating HIV prevention efforts will be key. If India can end AIDS as a public health threat then the world can.
UNAIDS new report provides a clear roadmap: To end AIDS, take the rights path.
Written by David Bridger
Source: Indian Express, 29/11/24
