Improving access to HIV/AIDS care in India

August 12, 2002

[TuPeG5640] Improving access to HIV/AIDS care in India.

Abstract: XIV International AIDS conference 2002. Barcelona July 7-12

S.K. Hira1, J.V.R. Prasada Rao 2 1 AIDS Research & Control Centre

(ARCON) & The University of Texas-Houston, Houston, United States; 2

National AIDS Control Organisation, Ministry of Health & Family

Welfare, Govt of India, New Delhi, India

Issues: Access to care in developing countries is <25% of estimated

need. With an estimated 3.9 million people infected in India, India

finds itself at a major crossroads.

Description:India has upscaled the concept of Continuum of Care to

that of Access to Care comprising of most effective components:

1. Uniform availability of voluntary counselling and testing

services. Over 200 VCTs are established at state/district levels to

provide proper assessment of an individual's HIV status.

2. Scaling up of MTCT prevention programs. India has embarked on

possibly the world's largest and most ambitious PMTCT program such

that by end of 2002, all 620 districts will be PMTCT compliant

providing coverage to over 27 million pregnant women annually.

3. Opportunistic infections (OI) prophylaxis and treatment. India has

introduced this at all hospitals up to district level at pro-rated

annual cost of $30.

4. Improving access to ARV. India has an estimated 1 million HIV-

infected persons who are eligible for ARV therapy. However, estimated

5-7% is currently able to access it. The access can be expanded

through intersectoral partnerships.

5. Psychosocial support. A large cadre of psychologists is needed to

address depression and other emotional illnesses and to nurture hope.

6. Operational research. There is need to identify most relevant and

cost-effective ways to deliver and monitor ARV therapy.

Lessons Learned: Access to care improved credibility of the national

program, improved acceptability of preventive activities, and reduced

stigma and discrimination.

Recommendations: While a demand-driven, participatory, and

decentralised approach will help broaden health care services in

India, a national capacity is also needed for protecting people's

rights, promoting price reduction for HIV/AIDS drugs and services,

quality control of services, monitoring and evaluation. The greatest

challenge is of scaling up care, treatment, and support.

Presenting Author: Subhash Hira,

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