The Indian Council of Medical Research (ICMR) is getting ready to launch an HIV-AIDS research study to help the government develop intervention strategies to achieve the global target of “90-90-90” by 2020. The initiative, under the National AIDS Control Programme, aims at getting researchers from India’s top health institutes and advocacy groups involved in the fight against the global pandemic.
The research project is expected to help prioritise key sub-populations in epidemiologically critical states, develop holistic intervention packages to check HIV infection among transgender, spot currently ‘invisible’ key sub-populations, assess the feasibility of viral load testing and propose cost-effective approaches to enhance access to HIV testing.
The Council’s bid to rope in scientists from elite institutes for HIV research assumes significance as India’s National Health Policy 2017 seeks to achieve the global target of “90-90-90” for HIV/AIDS by 2020. The aim is to diagnose 90 per cent of all HIV-positive persons, provide antiretroviral therapy (ART) for 90 per cent of those diagnosed, and achieve viral suppression for 90 per cent of those treated by 2020.
While accepting that more research and data are imperative for the speedy roll-out of evidence-based anti-AIDS measures, many patient advocacy groups stress the need for concrete action on the ground. “Translation of research outputs into programmatic action and policy formulation is the key. We are seriously lacking in this area,” said an activist associated with a non-profit group.
The health ministry implemented the provisions of Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome Act of 2017 on September 10. “But the implementation of the HIV/AIDS Act hasn’t produced any real, tangible results as far as treatment support is concerned. Drug shortages and stock out at ART centres are still a major problem for patients,” Paul Lhungdim, president of Delhi Network of Positive People, told Pharmabiz. The group is active in efforts protect HIV patients’ rights and to ensure access to critical medicines.
Official data reveals that in India, 67 per cent of People Living With HIV (PLHIV) or around 21 lakh know their status. However, only about 12 lakh PLHIV are getting free treatment from more than 530 ART centres. Despite the World Health Organisation (WHO) guidelines to “test and treat all”, less than 50 per cent in the country are on ART.
The research initiative of ICMR would try to assess the feasibility of viral load testing and propose cost-effective approaches to HIV testing. The study data will be crucial as the WHO guidelines term viral load testing as the gold standard in HIV treatment monitoring.
The ART centres in India regularly face shortage of viral load monitoring kits for AIDS. According to health activists, the government’s tender for manufacture and distribution of kits fails to attract bidders because of price issues and the resultant shortage seriously impedes efforts to control the disease. The National Strategic Plan for HIV 2017-24 puts the government’s testing capacity at around 15,000 patients, though the country currently has more than a million patients on ART.