Daily News Analysis

World AIDS Day 2024:

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World AIDS Day 2024:

Context:
World AIDS Day is observed annually on
1st December to raise awareness about HIV (Human Immunodeficiency Virus) and AIDS (Acquired Immune Deficiency Syndrome). The day serves as a platform to reflect on the global progress made in the fight against HIV/AIDS, as well as the challenges that remain. It highlights ongoing efforts to eliminate the disease and emphasizes the importance of education, prevention, and access to treatment.

2024 Theme:

Take the rights path: My health, my right!”

The theme for World AIDS Day 2024 underscores the importance of human rights, advocating for access to healthcare and treatment for all people living with HIV. It calls for everyone to exercise their right to health, emphasizing empowerment and equality in the fight against HIV/AIDS.

What is AIDS?

AIDS is a chronic, life-threatening condition caused by HIV, which weakens the immune system by attacking CD4 cells, which are vital for immune function. Without treatment, HIV can progress to AIDS, significantly increasing the risk of infections and certain cancers.

  • Transmission: HIV is spread primarily through:

    • Unprotected sexual contact

    • Sharing of needles or contaminated blood

    • From mother to child during childbirth or breastfeeding

  • Treatment: Although there is no cure for HIV/AIDS, antiretroviral therapy (ART) can significantly reduce the virus' replication, help restore CD4 cells, and improve the quality of life for individuals living with HIV.

Global and National Progress:

  • Global Update: According to the Global AIDS Update 2023, there has been significant progress in reducing new HIV infections worldwide. The goal is to eliminate AIDS by 2030, with substantial improvements in access to prevention, care, and treatment.

  • India’s Progress:

    • Current Situation: In India, over 2.5 million people live with HIV.

    • New Infections: India has seen a 44% reduction in new HIV infections since 2010, a testament to the effectiveness of public health initiatives and awareness programs.

    • Challenges: Despite progress, India still faces challenges such as stigma, limited access to healthcare in certain regions, and the need for continued efforts to address the epidemic.

India’s Response to HIV/AIDS:

India’s response to the HIV/AIDS crisis is spearheaded by the National AIDS Control Programme (NACP), which has been implemented in multiple phases since its launch in 1992.

NACP Phase-V (2021-2026):

The NACP Phase-V focuses on achieving significant goals by 2026, including:

  • 80% reduction in new HIV infections and AIDS-related deaths (compared to the 2010 baseline).

  • Elimination of vertical transmission (prevention of mother-to-child transmission).

  • Combating stigma associated with HIV/AIDS and promoting inclusion.

Other Key Initiatives:

  • ART Rollout: The government has expanded access to antiretroviral therapy (ART), making it available to millions of people living with HIV.

  • Prevention and Awareness Programs: Awareness campaigns and education programs are crucial in reducing stigma and promoting safe practices to prevent transmission.

  • Targeted Interventions: Focused on high-risk populations, such as sex workers, men who have sex with men, and intravenous drug users, to reduce HIV transmission within these groups.

Key Takeaways:

  • Global Goal: The global target is to eliminate AIDS by 2030, with nations, including India, making significant progress in reducing HIV infections and improving the quality of life for those living with HIV.

  • India's Vision: India's NACP Phase-V sets ambitious goals, aiming to reduce new infections, eliminate mother-to-child transmission, and combat the stigma surrounding HIV/AIDS.

  • ART Treatment: Access to antiretroviral therapy (ART) remains the cornerstone of treatment for HIV, allowing those affected to live longer and healthier lives.

The 2024 UNAIDS Global AIDS Update, titled "The Urgency of Now: AIDS at a Crossroads," presents a critical overview of the HIV/AIDS epidemic, offering insights into the global progress and challenges in tackling the disease. The report emphasizes the urgency of addressing inequalities, expanding access to prevention and treatment, and ensuring sustainable resources to end AIDS as a public health threat by 2030.

Key Highlights of the Report:

1. Global Progress and Challenges:

  • 39% Reduction in New HIV Infections: There has been a 39% reduction in new HIV infections globally since 2010. Sub-Saharan Africa achieved the steepest decline, with a 56% decrease.

  • Decrease in AIDS-Related Deaths: AIDS-related deaths have dropped to their lowest levels since the peak in 2004, due to wider access to antiretroviral therapy (ART).

  • Access to ART: In 2023, approximately 31 million people globally were receiving ART.

  • Regional Disparities: While Sub-Saharan Africa has seen significant progress, regions such as Eastern Europe, Central Asia, Latin America, and the Middle East & North Africa have witnessed rising HIV infections. For the first time, more new HIV infections were reported outside Sub-Saharan Africa than within it.

2. Key Populations at Risk:

  • High-Risk Groups: Key populations, including sex workers, men who have sex with men, people who inject drugs, transgender people, and people in prisons, continue to face elevated risks due to inadequate prevention programs, stigma, and discrimination.

  • Community-Led Interventions: While community-led responses are crucial in addressing the needs of these populations, they are often underfunded and unrecognized.

3. Prevention and Treatment Gaps:

  • Prevention Deficiencies: HIV prevention efforts, such as pre-exposure prophylaxis (PrEP) and harm reduction strategies for people who inject drugs, are lacking in many regions.

  • Access to ART: Approximately 9.3 million people living with HIV are not receiving ART, with children and adolescents being particularly affected.

What is HIV/AIDS?

  • HIV (Human Immunodeficiency Virus) attacks the immune system, particularly the CD4 cells (T cells), which help the body fight infections. Without treatment, HIV can progress to AIDS (Acquired Immune Deficiency Syndrome), the final and most severe stage of HIV infection, when the immune system is severely weakened.

  • Transmission: HIV is transmitted through infected bodily fluids, including blood, semen, vaginal fluids, rectal fluids, and breast milk. It can be spread through:

    • Unprotected sexual contact

    • Sharing needles or syringes

    • From mother to child during childbirth or breastfeeding

  • Symptoms of AIDS: Symptoms include rapid weight loss, unexplained fever, night sweats, extreme tiredness, and persistent infections. Early stages may not show symptoms, or they may be mild.

India's Response to HIV/AIDS:

1. National HIV/AIDS Policy:

India has implemented several programs and policies to curb the spread of HIV:

  • HIV and AIDS (Prevention and Control) Act, 2017: This act mandates prevention, treatment, and care, and protects individuals from discrimination based on their HIV status.

  • Access to ART: India has made significant strides in providing free ART to those living with HIV. Over 1 million people in India are receiving ART.

2. Project Sunrise:

Launched in 2016, Project Sunrise focuses on tackling the rise of HIV in the northeastern states, particularly among people who inject drugs. The project aims to reduce HIV prevalence and increase access to treatment and prevention services.

3. UNAIDS Targets:

India has set ambitious targets in line with the global UNAIDS 90-90-90 goal:

  • 90% of HIV-positive individuals diagnosed

  • 90% of diagnosed individuals on ART

  • 90% of those on ART achieving sustained viral suppression

India's government is aiming to achieve these goals and end AIDS by 2030.

International Initiatives:

  • UNAIDS: Since 1996, UNAIDS has been at the forefront of the global fight against HIV/AIDS, leading efforts to end AIDS as a public health threat by 2030. UNAIDS advocates for zero new HIV infections, zero discrimination, and zero AIDS-related deaths.

  • WHO’s “Treat All” Guidance (2015): The World Health Organization recommended universal ART for all HIV-positive individuals, regardless of CD4 count. The aim is to reduce viral loads to undetectable levels, preventing transmission.

Key Suggestions from the UNAIDS Report:

1. Accelerating HIV Prevention:

  • Expand Access to Prevention: Special focus on key populations like sex workers, men who have sex with men, and people who inject drugs.

  • Condom Programs: Reinstating and funding condom programs for safe sex, particularly in regions where their use has declined.

  • Increase PrEP Access: Aim for 21.2 million people on PrEP by 2025 to reduce HIV transmission risk.

2. Enhancing Treatment and Care:

  • Improve ART Access: Ensure 95% of people living with HIV are on ART by 2025.

  • Focus on Children and Adolescents: Only 48% of children living with HIV are on ART. This gap needs to be addressed to ensure equitable treatment access.

3. Addressing Inequalities and Stigma:

  • Remove Harmful Laws: Eliminate laws that criminalize HIV transmission and exposure and those targeting key populations.

  • Stigma Reduction: Strengthen programs to reduce stigma and discrimination in healthcare and community settings.

4. Community-Led Responses:

  • Support Community Organizations: Empower community-led organizations to deliver more testing, treatment, and prevention services, especially for high-risk populations.

5. Sustainable Financing:

  • Increase Funding: There is a USD 9.5 billion shortfall in funding for HIV programs. New funding mechanisms are needed, especially in low- and middle-income countries.

Way Forward:

To achieve the goal of ending AIDS as a public health threat by 2030, there is an urgent need for:

  • Enhanced prevention efforts, especially for key populations.

  • Wider access to treatment, ensuring no one is left behind.

  • Increased funding and sustainable financing for global HIV programs.

India’s continued commitment, along with international cooperation, is essential in addressing the HIV/AIDS epidemic and moving towards the global vision of Zero New HIV Infections, Zero Discrimination, and Zero AIDS-related Deaths.


 

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