By Ashima Makhija
Today marks the 21st World AIDS Vaccine Day, also commonly referred to as the HIV Vaccine Awareness Day. This day commemorates the efforts of thousands of researchers, community workers, volunteers, health professionals and scientists who have contributed to the process of finding a safe and effective AIDS vaccine. It also serves as a reminder to the international community to invest greater financial and technological resources towards building an effective AIDS vaccine.
This tradition started with a moving speech made by the then US President Bill Clinton at Morgan University on May 18, 1997. He said, My fellow Americans, if the 21st century is to be the century of biology, let us make an AIDS vaccine its first great triumph. He emphasised on the need to use technological and scientific advances for the development of an AIDS vaccine to truly end the pandemic.
Every year, the HIV Vaccine Awareness Day recognises the progress in the search of an AIDS vaccine. Volunteers generate awareness and sensitivity about this stigmatised disease and bring attention to the ways in which ordinary people can be a part of the international effort to stem HIV/AIDS.
Indias entry into a global battle
There are an estimated 4.2 million people living with HIV/AIDS in Asia, 90% of whom are concentrated in India, China and Thailand. Indias battle with AIDS began in 1986, when the disease was detected among sex workers in Chennai. By the end of the 1980s, the spread of HIV was observed among injecting drug users in Manipur, Mizoram and Nagaland. As more cases began to be detected, a National AIDS Committee was set up under the Union Ministry of Health and Family Welfare in 1986, the objective of which was to control the spread of the infection and promote community and family-based care to people with HIV/AIDS.
Soon, the need for a nationwide policy and programme was recognised. Thus, in 1992, India embarked on its battle against AIDS with the setting up of the National AIDS Control Organisation (NACO), under the health ministry. The organisation was constituted to implement Indias first National AIDS Control Policy (NACP) from 1992-1999.
The role played by the NACPs
The first NACP (1992-99) was launched with International Development Association credit of $84 million and with the objective of spreading awareness, controlling transmission through blood, and reducing mortality. During this period, 685 blood banks and 504 STD clinics were established. NGOs across the nation were involved in prevention interventions as well as awareness generation. HIV sentinel surveillance system was also initiated. The creation of State AIDS cells in the Directorate of Health Services in states and union territories enhanced Indias capacity to respond more effectively to the disease.
NACP-II was launched for the period of 1999-2006, with World Bank credit support of $191 million. One of the most effective features of this program was targeted intervention. It focused on High Risk Groups such as commercial sex workers, men who have sex with men, injecting drug users, and bridge populations (truckers and migrants). This program was implemented through NGOs and community-based organisations, which provide services on behaviour change communication, condom use promotion, STI care, needle syringe exchange program, opioid substitution therapy and referrals for HIV testing and linking positives to antiretroviral therapy. A revised strategy was also launched to provide HIV prevention services to migrants.
An essential aspect of the NACP-II was the rollout of the antiretroviral therapy (ART) in 2004. Free ART was commenced in selected hospitals across the country. Indian pharma companies developed innovative methods for manufacturing complex pharmaceutical products and marketed these at very low costs, which played an important role in ensuring universal access of ART at affordable prices. Now, India supplies nearly 80% of drugs for AIDS and is the worlds largest supplier.
With the success of the NCAP-II, NCAP-III was rolled out in 2007, with the ambitious target to halt and reverse the epidemic, to be achieved over a period of five years (2007- 2012) by scaling up prevention efforts and integrating them with care, support and treatment services. The capacities of State AIDS Control Societies and District AIDS Prevention and Control Units were strengthened. Technical Support Units were established at the national and state level to assist in the programme monitoring and technical areas.
NCAP-IV, which is also a five-year program, was launched in 2012 and seeks to scale up coverage of targeted interventions among high risk groups, and emphasises comprehensive care, support and treatment. It also hopes to expand information, education and communication services for the general population and high risk groups with a focus on behaviour change and demand generation.
Indias success
The Indian battle against HIV/AIDS is widely regarded as a success story. There are several unique features of the Indian mission that helped it to combat the spread of HIV/AIDS.
Firstly, the idea of targeted intervention helped the program focus its resources on the parts of the population in which the incidence of HIV/AIDS was higher. This helped in prevention, intervention, and even in providing easier access to medication.
NACOs emphasis on information dissemination, education and communication has played a crucial role in this mission. Red Ribbon Express is the worlds largest mass mobilisation campaign on HIV/AIDS. It is a special exhibition train which travels across the country disseminating messages on HIV/AIDS prevention and general health in rural and remote areas of the country. NACOs communication strategy has moved from creating general awareness to behaviour change communication. It aims to motivate behavioural change among at risk populations, raise awareness and risk perception among general population, particularly youth and women. In 2010, NACO introduced the TeachAIDS curriculum, which represented the education of HIV/AIDS without being coupled with sex education.
As the world marks the 21st World AIDS Vaccine Day, it is important for every individual to strengthen their resolve to contribute to the global battle against HIV/AIDS and the stigma and misinformation associated with it. The HIV Vaccine Awareness Day also provides us an opportunity to commemorate the immense efforts of NACO, which allowed India to tackle the massive challenge posed by the pandemic with much success.
Ashima Makhija is a writing analyst at Qrius