Dear Honourable
Members of Parliament and Legislators,
As part of the nationwide
AIDS Momentum Campaign, we bring to your notice the grave concern of civil
society members about the Government of India’s recent approach to our
country’s HIV/AIDS prevention and care programme.
More than 150 organisations across
the country are of the strong view that any move by the government towards
shrinking organisational and budgetary support to the AIDS response will lead
to a reversal and upsurge of the epidemic among the most vulnerable groups and
beyond.
India has the third largest
number of people living with HIV in the world – 2.1 million [1.7 million–2.7
million] at the end of 2013 – and our country accounts for about 4 out of 10
people living with HIV in the Asia-Pacific region.
With these points in mind,
we would like to raise ten questions that are key to the future control of
HIV/AIDS in India:
TEN QUESTIONS
1. The
current fourth phase of the National AIDS Control Programme of Government of
India will come to end in 2017. What are the Government’s plans to design the fifth
phase of the national programme which is absolutely critical to ensure that
there is no resurgence in the epidemic?
2. 6
out of 10 People living with HIV are still not receiving HIV treatment, among
them pregnant mothers.
This is a threat to their fundamental rights and needs to be addressed
urgently. Half of all AIDS-related deaths in Asia occur in India. What is the
Government’s long-term plan in this regard especially after 2017 when the
current phase of the National AIDS Programme ends?
3. HIV
testing is the critical entry point into HIV prevention and care, but it
remains inadequate.
Punitive laws, policies and practices increase the vulnerability of people
living with HIV and affect their ability to access voluntary testing and
treatment. Evidence shows that fear of stigma and discrimination discourages
and delays a person seeking an HIV test. What is the Government of India’s own
assessment of these issues and what are its long-term plans to address them?
How has the Government involved people who are most at risk and most affected
by these issues in the design and implementation of the National AIDS Programme
and its future?
4. Increasing
the participation of men and their uptake of HIV services is essential to
protecting them and, in turn, their loved ones. The consequences of lower male uptake
of HIV prevention, testing and treatment services are more severe for women who
are reluctant to get tested or to access treatment services and often face
violence, stigma and discrimination when they reveal their HIV status to their
male partners. Especially in view of the sterilisation deaths in Chhattisgarh,
what are the Government of India’s long-term plans to involve men more directly
in sexual health programmes with specific emphasis on HIV treatment and care?
5. The
level of stigma and discrimination against people living with HIV, against sex
workers, sexual minorities and injecting drug users have not reduced,
especially in government health facilities. As a result, people who are marginalised
and at risk are unable to access vital services at government facilities. What are the government’s plans to address
this major problem? New HIV and sexually
transmitted infections are on the rise in many parts of India despite a decade
long AIDS programme by the Government. What information and data does the
Ministry of Health have on this issue? What are the plans to address this issue
urgently?
6. HIV
prevalence among people who have migrated from rural to urban areas is
estimated at 0.9%, almost four times the national prevalence average of 0.27%. In certain states in India,
nearly 90% of newly diagnosed HIV infections were among wives with a migrant
husband. Does the Government of India have a long-term comprehensive strategy
to address this sensitive issue?
7. Estimated
population size of sex workers in India is 868,000. Of them, it is estimated
that 2.8% are HIV positive.
However, in Mumbai, HIV prevalence among sex workers was 22% and 19% in
Vishakhapatnam. Given the transient
nature of sex work, national averages mask in-country differences. While
national HIV prevalence among female sex workers declined, it increased in the
states of Assam, Bihar and Madhya Pradesh. Is the Government of India making
long-term plans to address this issue in a comprehensive way? Are sex workers
themselves being consulted in the design of interventions and in the long-term
strategy?
8. In
India, HIV prevalence for gay men and other men who have sex with men is
estimated at 4.43%, more than 15-times higher than that of the general
population. In Chhattisgarh state alone, HIV prevalence among gay men and other
men who have sex with men is 15%. While precise measures for this population are not easily
available, the high levels of HIV prevalence among gay men and other men who
have sex with men must not be ignored, and HIV services must be made available.
Does the Government of India have a long-term plan to ensure that this
marginalised group is able to access HIV and other sexual health services in a
stigma-free environment?
9. Worldwide
16 million people are estimated to inject drugs, and three million of them are
living with HIV. In India, HIV prevalence in this group is 24-times that of the
general population.
Though progress has been made, the HIV epidemic continues to be fueled by the
stigma and discrimination often experienced by drug users. In India, the lack
of access to services can effectively be a death sentence for people who inject
drugs. While some parts of the country, especially the Northeast, have developed
a range of services for this vulnerable population, most other states have few
if any such services. Even in places where basic services exist, it remains
difficult for beneficiaries to access them. What is the Government of India’s
long-term plans to address this issue?
10. The
Census of India puts the number of transgender people in India at 4.9 lakh,
though field activists say the numbers are six to seven times higher. A large
proportion of transgender people also sell sex, and HIV prevalence in this population
is estimated to be as more than 8%. In 2014, the Supreme Court of India
issued a landmark judgement directing the Government of India to recognize
transgender people as a third gender and to formulate special health and
welfare programmes to support their needs. What are the Government of India’s
long-term plan to ensure that this extremely marginalised group is able to
consistently access HIV prevention and care services?
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