India specific guidelines for HIV/AIDs By ASI-NACO

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India specific guidelines for HIV/AIDs on the anvil

Sapna Dogra - New Delhi

In a new initiative of its sorts, the AIDS Society of India (ASI)-

an affiliate of the International Aids Society (IAS)- in

collaboration with the National Aids Control Organisation (NACO) and

the US Mission is drafting HIV/AIDS treatment guidelines tailormade

to Indian milieu and conditions.

The protocols to be referred as NACO-ASI guidelines would chart the

ways to contain physical management of HIV/AIDS patients, including

their counselling, drug combinations and side effects. NACO, which

has welcomed this initiative will help implement these guidelines

across the country. The US mission will facilitate the movement of

experts from India to the US and vice-versa.

To be compiled in the form of a booklet, the guidelines aim to

contribute to improved national and regional responses. The

guidelines will be circulated among specialists, as well as general

practitioners.

According to Dr Suniti , president, ASI and director, YRG

Care in Chennai, the guidelines are being prepared with the help of

international experts, like Bartlett and Gallent from

s Hopkins University.

But in the presence of WHO guidelines on the management and

treatment of HIV/AIDS, do we need separate guidelines for

India? " WHO guidelines are meant for SEARO region and African

countries. However, India has certain infections that are region-

specific and the disease pattern for HIV/AIDS is also very unique,

calling for distinctive guidelines for India, " says Dr .

Agrees Anjali Gopalan, founder, Naz Foundation, an HIV/AIDS and

sexual health agency working in South Asia, " Parts of WHO guidelines

are not very relevant to Indian scenario. If ASI comes up with

specific and precise guidelines for the management of Indian

HIV/AIDS, it would usher in rational treatment. "

She suggests that NACO-ASI guidelines should guide doctors about the

right time to start ARV treatment for paediatrics. " Another problem

that needs to be addressed is the start of the treatment when the

CD4 count is around 300-350. Most doctors in the country start

treatment when the CD4 is below 200, " Dr Gopalan said.

Further, vis-à-vis the A4 sized WHO guidelines which are cumbersome

to carry, the ASI guidelines would be a pocket guide, convenient for

doctors to carry in coat pockets for quick reference, informs Dr

.

HIV/AIDS has assumed epidemic proportions in most parts of the South

East Asia Region, which now accounts for the second highest burden

of the disease after Sub-Saharan Africa. And India, with its 5.1

million HIV positive people needs effective strategies for the

prevention and control of this pandemic.

Says Dr I S Gilada, secretary general, ASI and consultant in HIV

medicine, adding, " " We need simple guidelines which should enable

all doctors to get involved in HIV treatment management. " According

to him, India is neither a fully developed country nor it is an

underdeveloped country therefore, it is imperative that we have

special guidelines as per the conditions prevalent in India.

According to Dr P C Bhatnagar, director-community health, Voluntary

health Association of India (VHAI), though NACO-AS guideline is an

excellent initiative, he cautions against the possible misuse of

pocket-sized guidelines by quacks and unqualified practitioners

giving rise to irrational use of drugs.

— sapna.dogra@...

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