13 months left to deliver on 90:90:90 promises of 2020

[हिंदी] Despite promise of governments to end AIDS by 2030 and considerable progress on putting people living with HIV on antiretroviral therapy (ART) along with reduction in AIDS deaths, the decline in new HIV infections has stalled over the past 8 years in Asia Pacific.

“2020 target is to achieve reduction in new HIV infections and AIDS deaths to below 500,000 in a year. But in 2018, we had 1,700,000 newly infected people with HIV, and 770,000 AIDS deaths worldwide. There are 37,900,000 people living with HIV at the end of 2018 globally. In India, we have 2.14 million people living with HIV out of which 1.345 million are receiving life-saving antiretroviral therapy. 88000 new HIV infections and 69,000 AIDS related deaths were reported in a year in India” said Dr Ishwar Gilada, President of AIDS Society of India (ASI) and Governing Council member of International AIDS Society (IAS).

World AIDS Day theme underlines that communities are a unique force behind the success of the HIV response. But we need to accelerate progress on every evidence-based intervention for HIV prevention, treatment, care and support.

2020 targets of 90-90-90 are to ensure 90% of people living with HIV know their status, 90% of these are on ART, and 90% of those on ART are virally suppressed. “Of the 37.9 million people living with HIV at the end of 2018, 79% received testing, 62% received treatment, and 53% had achieved suppression of the HIV virus with reduced risk of infecting others globally. In India, 79% of all people living with HIV were aware of their status, of these 71% were on ART (that is 55% of all people living with HIV), and number of those who are virally suppressed is also increasing, although lagging behind from the 90-90-90 target” said Dr Ishwar Gilada.

“India’s National Health Policy (NHP 2017) as well as the UN Sustainable Development Goals (SDGs) both promise to end AIDS by 2030. Only 133 months are left to meet these targets. To end AIDS, we need to make U=U (undetectable equals untransmittable) a reality in the life of every person living with HIV. This means that 100% of the people living with HIV must know their status, 100% of them should be on life-saving antiretroviral therapy (ART), and 100% of them should be virally suppressed. We need to achieve zero new transmission of HIV if we are to deliver on the promise of ending AIDS in the next 11 years” said Dr N Kumarasamy, Secretary General of ASI, and the Chief & Director of Infectious Diseases Medical Centre at Voluntary Health Services (VHS) Hospital in Chennai.

After India adopted WHO‘s Test & Treat strategy as a national policy, the entire machinery has been gearing up to achieve the target of 90:90:90 by 2020. But we need to aspire to scale up the HIV care to reach not just 90% but 100% of people living with HIV. Several new Antiretroviral (ARV) molecules and ART combinations are available in current times, and this is changing the entire treatment paradigm. Treatment as prevention must be a norm, so that all people living with HIV get ART, due to which amount of virus in their blood will get reduced to undetectable levels, and their risk of transmitting HIV becomes negligible, making U=U (Undetectable = Untransmittable) a reality.

Dr Gilada shared that ASI had advocated for a strong policy to combat HIV stigma. The HIV/AIDS (Prevention and Control) Act 2017 is an important milestone, as the law has several provisions to strengthen HIV care for people living with HIV and prevent their discrimination and human rights violations. But a lot more progress needs to happen on law enforcement to advance HIV care with dignity.

India is the third-highest HIV burden country in the world (2.14 million) after South Africa (7.1 million) and Nigeria (3.2 million).

28 November 2019