New Delhi: As the world marks AIDS Day on December 1, with an aim to unite communities globally to fight against the human immunodeficiency virus (HIV), show support for people living with the infection, and commemorate those who have died from the illness. David Bridger, Country Director India, Joint United Nations Programme on HIV/AIDS (UNAIDS) spoke to NDTV-Banega Swasth India team about the significance of the day.
NDTV: Speaking of World AIDS Day 2022 theme ‘Equalize’, how can we end inequalities which perpetuate the AIDS pandemic in the Indian perspective?
David Bridger: If we look at AIDS-related deaths globally, they run along the frontlines of inequality. That is why this year’s theme holds great significance. It is a call to action for all of us to look at how we can equalise access to services for people living with HIV, including prevention, testing, treatment, and care. The theme also focuses on how we equalise people’s access by looking at laws or policies that stigmatise and discriminate against people with HIV.
NDTV: Nationally 24 lakh people are estimated to be living with HIV, but, only 19 lakh people living with HIV know their status. Similarly, 16 lakh people living with HIV are on antiretroviral therapy (ART). How can we bridge this testing and treatment cascade?
David Bridger: It comes back to this year’s theme, which aims to address the issue of inequality: how do we accelerate our action to address some of these issues that are causing the response to fall behind? We have seen progress in access to treatment, but we now need to see progress in the power of a community, as it will help us find the people living with HIV but unaware of its status and get them the right treatment.
NDTV: Is it possible to bring down new HIV infections to zero? If yes, how can India do it?
David Bridger: Getting to zero is unquestionably a vision that we all aspire to achieve. But when it comes to ending AIDS, the public health threat, we are talking about severely reducing infections and AIDS-related deaths. We may not reach zero, but the aim is to get there.
NDTV: What have been some of the wins in fighting the HIV epidemic globally?
David Bridger: Some of the big wins in the past 20 years have been leadership-related. We’ve had tremendous success in galvanising leadership, be it through political, business, or faith-based organisations. The biggest win has been the engagement and involvement of communities. Their voices have held the leadership accountable in terms of mounting and launching a response regarding HIV/AIDS. The status of treatment over the past 10–15 years against the infection has been enormously successful, and the uptake of treatment has saved several lives. We estimate that over the last 10–12 years, around 13 million people have been saved.
NDTV: What has been the impact of COVID-19 pandemic on people living with HIV?
David Bridger: COVID-19 has had a massive impact on people living with HIV globally. We have seen people be fearful of accessing treatment, of being able to visit clinics, and of losing their way of life. But we have also seen a range of responses, especially community intervention, that have helped people access the treatment. So, the last two years have been a combination of setbacks and victories.
NDTV: In India, there has been an increasing trend in annual new infections seen in the northeast states. Whereas, the southern states have the largest number of people living with HIV. How policy interventions need to vary to tackle regional realities?
David Bridger: For India, we see both national and state-level data related to HIV/AIDS. We have seen an elevated level of HIV/AIDS prevalence in the northeast region, which clearly indicates that we need to pay more attention to ‘prevention’. But it also means that we need to pay attention to ‘treatment’, because in preventing HIV, we must ensure that we identify people living with the infection and link them to treatment and care. Conversely, in central and southern India, we are perhaps seeing a mature epidemic, where large numbers of people living with HIV are starting to show other issues that we need to get on top of. People who are living longer with treatment and have other issues to do with aging that we all face, but had not anticipated that people infected with HIV will be able to see such long years of their lives, which is a welcoming thing, but there is a lot more work to be done regarding HIV/AIDS.
NDTV: What is the globally strategy of UNAIDS to tackle HIV/AIDS?
David Bridger: The global strategy we are embarking on is a five-year plan that focuses on addressing inequality. The plan uses the inequality lens to frame the response going forward over the next 4–5 years. We know how to prevent and treat HIV; the big challenge now is to address some of the inequalities that are causing new infections and related deaths.
You can listen to the full Banega Swasth India podcast discussion by hitting the play button on the Spotify player embedded above.
NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.