The number of new HIV infections in India has recorded a considerable drop over the past decade. But the fight against its spread is far from won, and HIV-related stigma in society continues to remain rampant.
India's fight against HIV/AIDS has taken a turn for the better. According to communities, NGOs, and individuals working in this area, there has been a steady decline in the number of new HIV infections, with the "India HIV Estimation 2015" report showing 86,000 new HIV infections and 68,000 deaths last year.
At the end of 2015, there were an estimated 2.1 million people living with HIV in the South Asian nation. The number didn't change much from the figure a year earlier, as fewer people got infected and fewer died due to the increased availability of free antiretroviral therapy (ART).
Globally, there are roughly 36.7 million people living with HIV. And since 2001, new HIV infections among children have declined by more than 70 percent, according to the latest UNAIDS report, released ahead of the World Aids Day on December 1.
"Considering the huge size of India's population and the evolution of the epidemic, the country has done well for long-term commitment to AIDS response. But there are certain areas that can be scaled up such as prevention and treatment," UNAIDS country director Oussama Tawail told DW.
Despite the progress made, many NGOs working in the sector believe these areas need to be addressed urgently. They also call on the government to put in place effective measures to tackle the social stigma faced by those infected by the virus.
'Prevention is essential'
Given the country's geographical expanse and heterogeneity, the AIDS epidemic has never been evenly distributed across India. Some states, particularly the northeastern ones, have long suffered from high infection rates.
The National AIDS Control Organization (NACO), a government body set up in 1992 for formulation of policy and implementation of programs for prevention and control of HIV/AIDS, has spearheaded the fight against HIV. NACO also runs an elaborate network of rural clinics that addresses the need for prevention of sexually transmitted infections.
"We work closely with NACO and have made a dent in targeting identified groups at the local level. But somehow prevention in some states has been slowed and that needs to be ramped up," Sonal Mehta, chief executive of India HIV/AIDS Alliance, told DW. Her organization works with civil society, government and communities to support rights of those affected.
"What's more, there has to be more emphasis on targeting key affected populations like the LGBT population and transgenders," added Mehta.
Tawail also concurs, emphasizing that "prevention is essential" and more needs to be done in this area.
Removing stigma is essential
To address the question of stigma, Prime Minister Narendra Modi's government last month approved the amended HIV and AIDS (Prevention and Control) Bill, 2014. The matter is still before parliament but once the bill becomes law, discrimination against people with HIV or AIDS may lead to a jail term of up to two years, and a maximum penalty of 100,000 rupees (1,300 euros).
It will then become illegal to deny, terminate, discontinue or treat HIV/AIDS patients in an unjust manner at work, in educational establishments, healthcare services, while they are renting property, or by denying them medical insurance, among others.
But activists have a problem with some of the provisions of the bill.
"If we have to tackle stigma, the bill does not talk anywhere of providing compulsory medical treatment to those infected. There has to be a continuous campaign and there is no mention of this aspect at all," says Anjali Gopalan, founder of the Naz Foundation, an NGO that focuses on prevention and treatment.
Both Tawail and Mehta also agree, pointing out that it's imperative on central and state governments to provide ART to people with HIV/AIDS.
"Amendments have to be incorporated as otherwise you are effectively killing a legislation," said Mehta.
ART consists of a combination of antiretroviral (ARV) drugs to maximally suppress the HIV virus, and stop progression of the disease. According to various estimates, the proportion of people who do not have access to such treatment nationwide is close to 64 percent.
While steps have been taken to reduce prevalence and spread awareness of the infection, health experts stress that India's health system needs to respond more robustly to deal with the problems.
"At some point, we would like to see its alignment with the public health system as this will sharpen focus and increase its coverage in the future," points out Tawail.
It is clear that the overall numbers of people infected with HIV are falling globally. Studies show that early use of antiretroviral therapies has helped people live longer and healthier lives.
If the same can be put into practice effectively in India it will go a long way to reduce the risk of transmission of the virus.