Missed opportunities affecting AIDS control: Dr Ishwar Gilada

An array of “missed opportunities‟ is plaguing the AIDS response worldwide and there is need to progress on every SDG goal, says Dr Ishwar Gilada, the first person to raise the alarm against AIDS in India and to start the first AIDS clinic.

“Factors like lack of accountability, sub-optimal programme effectiveness, and complacency are slowing us down from reaching the goal of an AIDS-free world. Covid-19 pandemic did play spoilsports, but we cannot use it as an excuse towards non-achievement of goals,” said Dr Gilada, the Secretary General of Peoples Health Organisation, President of AIDS Society of India (ASI), and Governing Council member of International AIDS Society (IAS).

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Gilada’s statement comes on the eve of World AIDS Day on December 1.

“An astonishing 1.5 million people became newly infected with HIV in 2021, around 4,000 new infections every day. The number of people onHIV treatment increased by only 1.47 million in 2021, compared to net increases of more than 2 million people in previous years. Globally, 85 per cent of all people living with HIV knew their HIV status in 2021.

Among people who knew their status, 88 per cent were accessing treatment. And among people accessing treatment, 92 per cent were virally suppressed. In other words of all people living with HIV 85 per cent knew their status, 75 per cent were accessing treatment and 68 per cent were virally suppressed in 2021,” Dr Gilada said in a press statement.

According to him, globally the data for 2021 shows that 38.4 million people were living with HIV out of which 1.7 million were children. 54 per cent of all people living with HIV were women and girls. In 2021, 650,000 people died of AIDS-related causes - one every minute, despite effective HIV treatment and tools to prevent, detect and treat opportunistic infections such as cryptococcal meningitis and TB.

UN SDGs as well as National Health Policy of India promised that by 2020, 90 per cent of people living with HIV will know their status, 90 per cent of these will have access to ART and 90 per cent of those on ART will have viral suppression.

“Most countries were not able to deliver on 2020 HIV targets of 90-90-90 but made commendable progress. Conveniently shifting goal posts will not help end AIDS.We can end AIDS by 2030 but the curve will not bend by itself. We need to remember that we could have achieved these goals had we succeeded in eliminating ‘missed opportunities‟ in the AIDS response. We should have ensured that the full HIV combination prevention spectrum and complete range of diagnostics, treatment, care and support services were reaching everyone, especially those among the key populations. We should have worked with a heightened sense of purpose and urgency to help prevent HIV infection transmission and avert AIDS deaths. Ending AIDS is one of the targets of UN SDGs. Unless we progress on all SDG goals and targets, we will not be able to progress towards ending AIDS as we should,” said Dr Gilada.

India‟s capacity to produce generic HIV medicines and supply them worldwide did result in major successes for the global AIDS fight as over 90 per cent of antiretrovirals consumed globally were from India. “We have the time-tested and proven capacity to manufacture HIV diagnostics, medicines and robust supply chain mechanisms to deliver them worldwide sustainably. But are HIV programmes worldwide strong enough to ensure that HIV prevention, diagnostics, treatment, care and support services are reaching every person in need – without any further delay,” he said.