New Perspectives and Trends in Countering HIV/AIDS – A Global and National View

Introduction

Acquired ImmunoDeficiency Syndrome (AIDS) also called as slim disease is a life threatening condition as immune system is compromised. HIV/AIDS is called as modern pandemic as it affects both the developed and developing nations. The historical development of HIV/ AIDS dates back to 1981, when first five clinical cases were confirmed and reported in New York Native, a gay newspaper in USA. The global statistics related to HIV/ AIDS is given below (Figure 1)

The first case of HIV/AIDS was detected in India, in the year 1986, among the female sex workers at Chennai.³ From then till date India has become the second most burdened country in the world with a record of 23.19 lakh people living with HIV/AIDS in 2020. Nationally, the prevalence is highest in Maharashtra followed by Andhra and Karnataka.⁴ Till date only two individuals i.e. Berlin patient and London patient have been cured of HIV/AIDS. In this regard, National Institute of Health & Gates foundation have incorporated themselves in rigorous research for discovering or developing universal cure for HIV/AIDS.¹

New perspectives and trends in dealing with HIV/ AIDS

In India and across the globe, collaborated strategies and strategies apt to a country or region are designed, developed and are put into action to halt HIV/AIDS. Some of the strategies are as follows:

1. Integrated and coordinated efforts among partners and stake holders in countering HIV/AIDS

2. 90:90:90 target⁵

3. Getting to zero

4. Joint United Nations programme on HIV/AIDS2022.26

5. Cluster of health interventions 

Integrated and coordinated efforts among partners and stake holders in countering HIV/AIDS The integrated and coordinated efforts among partners and stake holders in countering HIV/AIDS calls for multi sectoral approach and inter sectoral co-ordination to make progress towards countering HIV/AIDS in terms of preventing occurrence of new HIV infections, improving quality of life of people living with HIV / AIDS, reducing social and psychological disparity. This new perspective is adopted by National HIV/AIDS Strategy (NHAS), USA, to reenergise whole of nation against the global epidemic of HIV/AIDS. The goal of this strategy is to enhance and sustain a focus on Quality of Life of People Living with Human Immune Virus.⁶

90:90:90 target 90-90-90 is an ambitious treatment target to help end the AIDS epidemic. A Joint United Nations Programme on HIV/AIDS expert’s panel/advisory panel incepted the concept of 90-90-90 which indicates:

- By year 2020, 90% of PHLIV will know their HIV status.

- By year 2020, 90% of all the people diagnosed with HIV infection will receive Anti Retroviral Therapy continuously.

- By year 2020, 90% of all the people receiving ART treatment will have reduced or decreased viral load/ suppression.⁷

Getting to zero The foundation of Joint United Nations programme on HIV/AIDS-2022.26 & Interventional packageis laid down on a five year plan i.e. “GETTING TO ZERO” as proposed during World AIDS day 2011 to 2015. This strategy was devised after rigorous consultation with people living with HIV/AIDS. The core components of this strategy were “ZERO new HIV infection”, “ZERO discrimination” “Zero AIDS related deaths.” In some countries/regions, zero new infection might be of prime importance while other regions may considerzero discrimination as priority. This perspective has opened everybody’s imagination to realise that “getting to zero” is a mandate for better healthy future.⁸

Joint United Nations programme on HIV/AIDS2022.26 The hallmark of Joint United Nations programme is the global AIDS strategy. Unified Budget, Results & Accountability Framework (UBRAF) which is a part of Joint United Nations programme gives a feasible roadmap to realise the slogan “End inequalities, End AIDS.”⁹

Cluster of health interventions

A new trend targeted to improve the quality of life of people living with HIV/AIDS makes way for cluster intervention.¹⁰ One single intervention may not be fruitful in countering HIV/AIDS.Therefore, a new perspective of multi-dimensional intervention or a package of intervention also called as cluster of intervention based on available evidences could be suggested. India has used extensive data related to HIV/AIDS to plan programmes & monitor the its effectiveness in HIV prevention & care interventions.¹¹ Following are some health interventions based on principles of dimensions of comprehensive care to be part of cluster intervention they are - Physical interventions, Pharmacological interventions, Psycho-behavioural interventions, Social interventions, Vocational intervention and Economic intervention.¹² 

Conclusion

HIV/AIDS has been a dreadful, stigmatic and lethal infectious condition since 1981. International, national and regional health agencies have collaborated to fight against HIV/AIDS. The concept of public private partnership and emphasis on prevention than control of disease has been fruitful. The promotion in use of condoms and protective measures have been effective but then the complete treatment to cure or vaccine to prevent HIV/AIDS is not available. Gates foundation and UNAIDS & other agencies are continuously conducting research to find a treatment or vaccine. Until the permanent solution to this disease is available, may the cluster of interventions become trend to counter HIV/AIDS. 

Conflict of interest

No conflict of interest among authors