HIV/AIDS treatment and control in India and the millennium development goals

Abstract

India has a large HIV burden, with a concentrated type of epidemic in high-risk groups distributed unevenly in different parts of India. The advent of the “3 by 5” program for specific antiretroviral treatment (ART) during 2003–2005 provided the experience and a trigger for a quantum leap in the treatment program under a 5-year NACP (National AIDS Control Program) III beginning 2006. ART is provided free of charge at about 292 ART Centers and additional Link ART Centers, which people living with AIDS (PLHA) in need can access. A well-coordinated system of pre-ART registration of PLHA and their periodic checkup enables identifying those who need to be initiated in ART. Response to treatment and adherence is satisfactory, with an average of about 80 % of patients initiated on ART available and continuing treatment beyond 12 months. By the end of December 2010, about 387,205 PLHA had been enrolled for treatment. During 2010, about 8,000 patients were inducted to the ART program in India each month. While updated data are not yet available, continued enrollment at the same rate each month would mean about 500,000 patients would have been enrolled by the end of 2011. Lifelong treatment and increased life expectancy in PLHAs require the provision of health care services to an ever-increasing number of PLHA on ART in successive years. Health manpower development, infrastructure facilities, associated laboratory backup, and the increased quantity of drugs required need to be built into the planning for the next phase—NACP IV during 2012–2016. With the political determination exhibited so far and with the determination, dedication, and concerted efforts of health care planners and providers and with active participation and cooperation of patients, the challenges of AIDS Control leading to the realization of the Millennium Development Goals are likely to be largely met in India.