In a post-2015 development world, what really stands out is the early realisation of the stakeholders that HIV is not just a medical issue.
Having followed the evolution of HIV response globally for over a decade, what stands out is the early realisation of the stakeholders that HIV is not just a medical issue, but also involves behavioural, social and economic factors. This realisation has led countries to think differently in their responses to the epidemic and has necessitated a multi-sectoral approach.
In India and across the world, remarkable progress has been made towards combating HIV and AIDS over the past two decades. The number of people infected with HIV and cases of AIDS-related deaths have reduced and there is a significant increase in the number of people seeking and receiving treatment.
More than three decades of experience in responding to an epidemic have taught us that HIV cannot be prevented and managed by the health sector response alone. We need to strengthen governance, institutional capacities, partnerships, community engagement and civil society as a whole.
India identified its first HIV case in 1986. Since then, much has changed. The country has shown strong political will, commitment and urgency in addressing the problem, leading to the evolution of one of the most comprehensive AIDS control programmes in the world. The National AIDS Control Programme in India has gone beyond just generating an HIV response—it has paved the way for some of the most successful experiments in social sector response. As a result of strong leadership and the consistent support of Government of India, the annual incidence of HIV infection among adults has fallen by about 57 per-cent between 2000 and 2011.
There are many reasons for the programme’s success in India. Evidence-backed planning, robust systems and timely policy creation really pushed the envelope.
A significant investment in technical quality and programme design led to widespread community participation and ownership. India’s experience in HIV prevention and control, presents us with many important lessons for the next phase of the global AIDS response and for health and development as a whole.
The proposed Sustainable Development Goals (SDGs) embody bold aspirations of the international community to end the tyranny of poverty, ensure a life of dignity for all and secure the planet for future generations. To deliver these ambitious, interconnected goals, we need to think and act differently.
For example, reducing gender inequality and gender-based violence can help women and girls to negotiate safe sex and to protect themselves from HIV. The inclusion of men who have sex with men (MSM), transgender people, sex workers and people who use drugs has accelerated the progress of HIV prevention and control. Addressing economic inequalities through social protection and economic empowerment can reduce poverty, vulnerability to HIV and help keep people living with HIV healthy and contributing to their communities.
The lessons are clear. Now it falls upon us to apply them if we want to realise the vision of the SDG — a more prosperous, fair and sustainable world, one free from the scourges of discrimination and AIDS.