Syllabus– General Studies 2 (Governance)
Issues relating to quality of life: livelihood, poverty, hunger, disease and social inclusiveness.
The lessons to draw from chronic epidemics such as HIV/AIDS to prevent the COVID-19 pandemic.
- Four decades ago, on June 5, 1981, the Centers for Disease Control and Prevention reported an unusual fungal infection of the lungs (pneumocystis carinii pneumonia) in five gay men in Los Angeles.
- That was the first time the world learnt about the devastating infection caused by the Human Immunodeficiency Virus (HIV) in people with a weak immune system.
- Clio Epidemiology is the study of information from past epidemics for advice about the present.
- We have dealt with HIV infection for 40 years.
- Non completion of Targets:
- India scripted one of the biggest success stories in fighting HIV/AIDS between 1997 and 2010, after the infection hit the shores in 1986.
- The achievement of “controlling AIDS” was flagged by the Centre in 2012 as a small victory in the long journey of accepting, understanding and fighting the disease. But soon it fell short of the following targets:
- The aim of the World Health Organization, of which India is a member, was to ensure that 90% of the people living with HIV/AIDS are on anti-retroviral therapy by 2020.The target has been pushed by at least five years.
- The 2017 National Health Policy and the UN Sustainable Development Goals aim to end AIDS by 2030.This goal too looks like it may take longer to achieve.
- When the COVID-19 outbreak shook the world in 2020, transferring the blame for unmet targets got easy.
But AIDS had actually fallen off the radar long before.
- If it is further flushed out of public memory, it will be difficult to check progress on controlling it.
- Cause for underachievement of target:
The information and education campaigns of the 1990s helped to check the transmission of HIV infection through two routes: mother to child, and blood transfusions.Strict ante-natal protocols were established and blood banks were upgraded with superior testing facilities.The sale of blood was banned. Excellent awareness programmes and intensive follow-up action plans led to significant decline in incidence.
But the reduced visibility of the disease led to plateauing of efforts.
- The politics let AIDS slip from being priority health news.
- The arrogance and complacency of governments between 2013 and 2019 slackened the implementation of AIDS control programmes countrywide.
- Post 2014 the HIV infection diagnosis rate dropped from 60% in 2010 to 23% in 2019, the mortality rate doubled and new cases spiked five times more during the period.
- According to National AIDS Control Organization (NACO’s) annual HIV Estimates report of 2019, there were over 58,000 AIDS-related deaths and over 69,000 new HIV infections added to the pool of 2.3 million people living with HIV/AIDS, with 98% of new infections in the high-risk groups.
- This happened because the campaign to educate and empower the vulnerable communities — MSM (men who have sex with men), IDUs (Injecting Drug Users), migrant and sex workers, and truck drivers — was losing steam.
- An entire new generation had grown up on Internet knowledge. They were downloading dating apps and hooking up with no awareness of AIDS.
- Natural desires and sexual behaviour cannot be changed; yet discussions with adolescents on safe sex were buried.
- The need for a multi-sectoral and multi-pronged strategy to contain AIDS by a broad coalition of economists, scientists, doctors, researchers, technicians, civil society representatives and policymakers.
- To fight any medical crisis, we can trust the same formula of supporting
- Science-driven responses,
- Good quality data and empirical evidence and
- Consolidating guidelines.
- There is a road map for reducing new HIV infections by 2030.
- Good data and information from scientific investigations have to be combined and the Centre needs to provide resources to scale.
- E.g., The nationalized AIDS treatment plan:
- It is a perfect example of how early detection, diagnosis and treatment saved many lives.
- It gave a head start to the National AIDS Control Programme (NACP) when every State and Union Territory established its own AIDS control organisation.
- They were given a free hand and funds to monitor the epidemic and work on integrated action plans under NACO’s supervision.
- The existing workforce in 21,000 Integrated Counselling and Testing Centres (ICTC) is well-equipped.
They can help in:
- Early detection of infections,
- Provide basic information on modes of transmission,
- Promote behavioural change,
- Reduce vulnerability and
- Link people with care and treatment services.
- A majority of the ICTCs have an excellent outreach in the interiors. The staff can also be easily utilised for dealing with COVID-19 now.
- At the core of every exit strategy is a strong surveillance system.
- The government needs to rearrange its priorities and re-energise the ICTCs along with the 32,000-plus primary and urban health centres to uphold the right to treatment and the dignity of individuals affected by diseases — AIDS, COVID-19 or any other.
- By integrating education and awareness outreach programmes and re-allocating and releasing funds on time, any chronic (TB/HIV/malaria), acute (cholera/plague) or new outbreak becomes easier to deal with.
There is no scarcity of experiences to draw from if only we are inclined to learn from our past, rather than forget and be condemned to repeat it.
Question- Lessons from fight against HIV-AIDS can help in countering present and future Pandemics. Comment.