Prevention of HIV:
Educating people with HIV/AIDS and how it can be prevented is complicated in India, as a number of major languages and hundreds of different dialects are spoken within its population. This means that, although some HIV/AIDS prevention and education can be done at the national level, many of the efforts are best carried out at the state and local level.
Each state has its own AIDS Prevention and Control Society, which carries out local initiatives with guidance from NACO. Under the second stage of the government’s National AIDS Control Programme (NACP-II), which finished in March 2006, state AIDS control societies were granted funding for youth campaigns, blood safety checks, and HIV testing, among other things. Various public platforms were used to raise awareness of the epidemic – concerts, radio dramas, a voluntary blood donation day and TV spots with a popular Indian film-star. Messages were also conveyed to young people through schools. Teachers and peer educators were trained to teach about the subject, and students were educated through active learning sessions, including debates and role-play.
The third stage of the National AIDS Control Programme (NACP-III), was launched in July 2007 and runs until 2012.The programme has a budget of around $2.6 billion, two thirds of which is for prevention and one sixth for treatment. Aside from the government, this money will come from non-governmental organizations, companies, and international agencies, such as the World Bank and the Bill and Melinda Gates Foundation.
As part of its focus on prevention, the government has supported the installation of over 11,000 condom vending machines in colleges, road-side restaurants, stations, gas stations and hospitals. With support from the United States Agency for International Development (USAID), the government has also initiated a campaign called ‘Condom Bindas Bol!’ (Condom-Just say it!), which involves advertising, public events and celebrity endorsements. It aims to break the taboo that currently surrounds condom use in India, and to persuade people that they should not be embarrassed to buy them.
By the end of 2009 there were 5135 ICTCs in India, compared to just 62 in 1997. By 2009 these centre’s tested had tested 13.4 million people for HIV, an increase from 4 million in 2006. Although voluntary testing is officially supported in India, some states have tried to implement policies that would force people to be tested for HIV against their will. In Goa and Andhra Pradesh the state governments proposed a bill in 2006 to make HIV tests compulsory before marriage, and in Punjab it has been proposed that all people wishing to obtain or retain a driver’s license should be tested for HIV.Neither of these plans have come to pass, but they have concerned activists, who argue that HIV testing should never be imposed on people against their wishes.
Unfortunately, cases of people being tested without their consent or knowledge are common in Indian hospitals. In one 2002 study, it was suggested that over 95% of patients listed for surgical procedures are tested against their will, often resulting in their surgery being cancelled. Hospital staff and health professionals, much like the rest of the Indian population, are often unaware of the facts about HIV.
Treatment for people living with HIV:
Unfortunately, as in many resource-poor areas, access to this treatment is limited in India; an estimated 300,000 adults (aged 15 and above) were receiving free ARVs by April 2010. This represents less than half of the adults estimated to be in need of antiretroviral treatment in India.
While the coverage of treatment remains unacceptably low, improvements are being made. The government has started to expand access to ARVs in a number of areas; by November 2009 there were 266 reported sites providing antiretroviral therapy. Increasing access to ARVs also means that an increasing number of people living with HIV in India are developing drug resistance. When HIV becomes resistant to the ARVs the treatment regimen needs to be changed to ‘second-line’ ARVs. As with many other parts of the world, second-line treatment in India is far more expensive than first-line treatment.
In 2008, NACO began to roll out government funded second-line antiretroviral treatment in two centres in Mumbai and Chennai. By 2009 second-line therapy was available in a total of eight states but treatment remains very limited. Of the 3,000 who need to be on second line treatment, about 970 were receiving it as of January 2010. One reason for this is expense; second line ARV drugs, unlike first line ARVs, are not produced on a large scale in India due to patent issues that control drug pricing and can be more than 10 times more expensive than first line ARVs. Another reason why coverage is so limited is the eligibility requirements imposed on second line ARVs; only those ‘living below the poverty line, widows and children’ and those who have received first-line ARVs from a government centre for at least two years are eligible.
- Saffron, Asgandh, Ailwa, Murmuqi, and Sandal, each same in quantity and make powder. Use this powder in capsule form 500 mg alternate day with honey 20 ml. This formulation is very effective in HIV/ AIDS patients.
- Decoction of Zanjabeel, Amla, Inderjo talkh, Gul Anar, Zaravant, Filfil siyah, Hurmal, Beejband, Ustookhudoos, chiraita and Chobchini. Each 3 gm, make decoction in 500 ml of water. When water remails 250 ml, filtrate the solution and mix with Arq Gau zaban 50 ml, Arq Baid musk 70 ml. use this decoction two times daily.