Community treatment observatory process has been an empowering one for most affected communities. "People felt reassured that they can access Legal Aid Clinic to file legal complaints against human rights violations - which includes right to health. At the same time, we got an opportunity to raise awareness among the communities about their rights and responsibilities as per the National Viral Hepatitis Control Programme," shared Nalinikanta.
Dolutegravir-based antiretroviral therapy regimens for people with HIV are preferred choice in India too as per the guidelines. Community treatment observatory process was an opportunity to raise treatment literacy so that those who have not yet switched over from older regimen to dolutegravir-based regimens, may do so.
TB and HIV
Tuberculosis (TB) is not only the most common opportunistic infection among people living with HIV but also a major cause of death. That is why TB prevention needs to be centre-stage of TB response as well as of HIV programmes.
TB preventive therapy protects people who have latent TB (not active TB disease) from progressing towards active TB disease. But people with HIV (some of them may have hepatitis co-infection too) need to be fully aware of the importance to take TB preventive therapy when offered. This is another area where Nalinikanta feels he has been able to impact change.
"Bedaquiline and Delamanid stocks are available under the National TB Elimination Programme of government of India, but instead of giving these medicines they are giving the injectable medicine, Kanamycin, for those who require treatment for drug-resistant TB. The WHO has already recommended moving away from Kanamycin to non-injectable medicines-based regimen, but the National TB Elimination Programme is still giving out injectables-based therapy for those with multidrug-resistant TB," rues Nalinikanta.
Making integrated care accessible
In light of the scientific evidence for "same-day test and treat" model for hepatitis care, it is paramount for the National Viral Hepatitis Control Programme to not delay scaling this up so that same-day test and treat care is available everywhere in India. Not doing this will be counter-productive for the oft-chanted slogan of 'Health For All' as well as for sustainable development.
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