The increasing shortage of key HIV drugs in India, coupled with the prevalence of the disease, has highlighted both the risks and the need for mitigating measures. Unaddressed, this situation could escalate into a significant public health issue.
Understanding Human Immunodeficiency Virus (HIV)
HIV is a pathogen that primarily targets CD4 white blood cells (T cells) in the human body’s immune system. These T cells move around the body, detecting anomalies and infections in cells. When the HIV virus enters a body, it multiplies rapidly and destroys these CD4 cells, thereby wreaking severe damage on the immune system. It’s noteworthy that once the virus enters the body, it can never be eliminated. As a result, an individual’s CD4 count drops drastically – from a healthy range of 500-1600 to as low as 200 in infected bodies. Eventually, if left untreated, HIV can lead to acquired immunodeficiency syndrome (AIDS).
The Impact of Drug Shortages
Access to a combination of drugs known as antiretroviral therapy is vital for individuals living with HIV. This treatment suppresses the virus, helping individuals maintain their health and reducing the risk of transmitting the virus to others. Continuous consumption is critical to keep the virus suppressed. However, shortages of these crucial drugs are on the rise. The reason? A failing pooled procurement mechanism that has seen bureaucratic delays in 2014, 2017, and now again in 2022. While not in acute shortage, medicine supplies are dwindling, with some stocks due to expire soon. The knock-on effects are far-reaching, with medical professionals being forced to compromise in ways such as portioning adult medication for children.
The Implications of Untreated HIV/AIDS
If the drug shortage isn’t addressed promptly, there’s a strong likelihood of a significant public health crisis. According to the National AIDS Control Organisation (NACO), irregularities in following the prescribed regimen can lead to resistance to HIV drugs, which can diminish or nullify their effect. If the antiretroviral therapy isn’t taken daily, the probability of infection build-up in the body increases, making the individual unwell and infectious. These consequences threaten to undo India’s hard-earned progress against HIV/AIDS and further derail global progress, which already isn’t on track to meet the goal of ending AIDS by 2030.
The Current State of HIV/AIDS in India
As per the government’s HIV Estimation 2021 report, there are about 24.01 lakh People Living with HIV (PLHIV) recorded in India. The number of new HIV infections annually has declined by 46% since 2010. Data indicates that while Maharashtra registers the maximum numbers, Andhra Pradesh and Karnataka follow suit. The adult prevalence (15-49 yrs.) rate of HIV is highest in Mizoram (2.37%), followed by Nagaland and Manipur. Specifically, the prevalence of HIV/AIDS in Mizoram is ten times higher than the national average of 0.22%.
Way Forward
For the situation to improve, the Ministry of Health needs to exhibit political will and take definitive measures to ensure drug shortages do not recur. Ignoring these issues could potentially negatively impact the right to health and drive drug resistance, which is a significant public health challenge for the country. Government programmes, such as those for HIV and TB, must be prioritized and given the requisite resources to prevent such crises in the future.
UPSC Civil Services Examination Previous Year Question (PYQ)
This section comprises questions from previous years’ UPSC civil service examinations, providing readers with a glimpse into the kind of questions typically asked, along with the correct responses. The examples supplied range from information about Hepatitis B and C to queries on diseases transmitted through tattooing to a discussion question on the Millennium Development Goals related to health.