Fighting HIV/AIDS in India

In India today more than four million people are infected with HIV/AIDS— which represents nearly 10 percent of the global burden for this disease. Experts warn that many more could already be HIV positive and that current trends could lead to 25 million Indians living with HIV by 2010 if programs for prevention and treatment are not substantially enhanced and implemented over the short term.

Six states account for 90 percent of all infections in the country. In four of these states heterosexual sex drives transmission; in the others, it is fueled by the use of intravenous drugs. In addition, an estimated 170,000 children under the age of 15 are living with HIV, which has indicated a need to expand the national program on the prevention of mother-to-child transmission.

Support from the Global Fund of US$26 million will underwrite programs to both prevent and treat HIV/AIDS throughout India. HIV prevention will be integral to a comprehensive package of services that includes voluntary counseling and testing, antiretroviral prophylaxis for prevention of mother-to-child transmission, counseling on infant feeding, family planning and the treatment of sexually transmitted infections — which increase the risk of HIV transmission.

The availability of these services will expand from 125 centers today to 450 within two years, to include medical colleges, district hospitals, and antenatal and private clinics — 80 percent of these in the six high-prevalence states. The program intends to reach seven million women.

A public-private partnership will provide antiretroviral treatment to 15,000 people living with HIV. The Ministry of Health will work with four sites, both public and private, in Bangalore, Chennai, Hyderabad and Mumbai to provide treatment. Nearly 200 non-governmental organizations will ensure the continuity of care and follow-up in the communities of those being treated. Pharmaceutical companies will help to subsidize prices so that free drugs are available to the poorest patients.

To enable these services, some 2,200 health-care workers will receive training to provide HIV/AIDS patients with necessary services of care, treatment and prevention. While the National AIDS Coordinating Organization is poised to be the Principal Recipient of funds, the government will absorb only 15 percent of grant monies. Sixty percent of funds are destined to nongovernmental organizations, more than 20 percent to the private sector and academic organizations and the remainder directly to people living with HIV/AIDS. This program is designed to be decentralized, with state AIDS control societies coordinating local implementation.