He explained that the first phase of Indian government's national AIDS control programme, which was launched in 1992 for prevention and control of HIV/AIDS in India, focussed on awareness and education. In its second phase the programme broadened its scope and added blood safety and targeted interventions to its strategy. The third phase focused on treatment with the introduction of free anti-retroviral treatment (ART) in 2004. Next came the test and treat policy and introduction of viral load testing, as well as reducing stigma through the HIV/AIDS Act 2017 that prohibits discrimination or unfair treatment of HIV-infected people.
However, during the last decade or so, the tempo of the awareness campaigns has dwindled and prevention activities have taken a back seat. "Children who were around 10 years old in 2005-2010 have become adults now, but unlike their predecessors, they have not seen or heard of any major primary HIV prevention campaigns. These young adults are the risk takers which is evident from the fact that currently most of the new infections are in the age group of 18-30 years. Our prevention campaigns are poor, targeted interventions have almost nullified, and HIV control programmes for sex workers programmes are not working well, more so due to the changing face of sex work and the arrival of dating Apps. Some of the youth are using pre-exposure prophylaxis (PrEP), but they do not know that it can prevent only HIV and not other sexually transmitted infections. So we are also seeing an emergence of herpes, venereal warts and syphilis", said Dr Gilada.
Dr Gilada rightly points out that when a disease has a high death rate, it attracts more attention. As soon as we start overcoming the problem, people's efforts to sustain its control diminish. This has happened with HIV/AIDS also. When HIV/AIDS was akin to a death sentence, people were ready to take all precautions and make all out efforts to prevent it. However, thanks to the untiring efforts of our scientists and researchers, today people living with HIV on treatment can lead a near normal life, reduce their viral load to undetectable levels within 3 months of treatment and become non-infectious, and they can give birth to HIV negative kids. As it is no longer a dreaded disease, it seems to have resulted in a "could not care-less" attitude, with the focus shifting from prevention to treatment.
And as Dr Marjolein Jacobs of UNAIDS said, while we have worked a lot on diagnosis, treatment and care of people living with HIV, and made good progress in these areas, we need to give much more importance to prevention if we have to deliver on the goal of ending HIV/AIDS by 2030.
While scientists charter newer territories for improved diagnostics and treatments of diseases, we cannot slacken our efforts to roll out primary prevention interventions, including safe sex practices and immunisations against vaccine preventable diseases, to safeguard human health.
Shobha Shukla - CNS (Citizen News Service)
(Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media). Follow her on Twitter @shobha1shukla or read her writings here www.bit.ly/ShobhaShukla)
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