Skip to main content

Targeted treatment (.hindu)

Lakhs of HIV deaths can be averted as India follows WHO’s recommendations

Two years after the World Health Organisation (WHO) recommended that antiretroviral therapy (ART) be initiated in people living with HIV irrespective of the CD4 (a type of white-blood cell) counts, India has aligned its policy with the guideline. In a major shift, Union Health Minister J.P. Nadda had recently said that any person who tests positive for HIV will be provided ART “as soon as possible and irrespective of the CD count or clinical stage”. Nearly 4.5 lakh deaths can be averted through this move.

It was in 2002 that the WHO first issued its ART guidelines. In the absence of AIDS-defining illnesses, the WHO set CD4 count less than 200 cells per cubic millimetre as the threshold to begin ART treatment. Over time, it changed its guidelines and, in 2013

,

increased the threshold to CD4 count less than 500 cells per cu. mm.

Change in WHO guidelines


The recommendation was based on the evidence that an earlier initiation of ART will help people with HIV live longer, remain healthier and “substantially reduce” the risk of them transmitting the virus to others. The availability of safer, affordable and easy-to-manage medicines that could help to lower the amount of virus in the blood played a key role in the WHO’s decision. Earlier initiation could avert an “additional three million deaths and prevent 3.5 million more new HIV infections between 2013 and 2025,” noted the WHO in 2013.

In 2015, the WHO once again changed its guidelines. Based on evidence from clinical trials and observational studies since 2013, it became clear that an earlier use of ART, irrespective of the CD4 count, results in better clinical outcomes. Accordingly, it recommended that ART be initiated in HIV-positive people at any CD4 cell count.

As per 2015 estimates, India has 2.1 million HIV-positive people, of which only 1.6 million have been diagnosed and about a million are on treatment. But over half a million people are not even aware of their HIV status.

With the government changing its treatment guidelines, the 0.6 million who have been diagnosed but not been on treatment are now eligible for treatment. Of the 0.6 million, about 0.25 million have been enrolled for pre-ART care and can be started on treatment almost immediately. But the biggest challenge will be to identify the 0.35 million who have been diagnosed but not on treatment and the 0.5 million who have been infected but have not been diagnosed. Also, nearly 80,000 people get infected each year.

Even as efforts are on to expand the 1,600 treatment delivery sites that are currently operational, there should be greater focus now on identifying people with HIV. The government has plans to start community-based testing to bring it closer to those in need, and target special groups that are more vulnerable to infection such as partners of people who are HIV-positive.

Popular posts from this blog

SC asks Centre to strike a balance on Rohingya issue (.hindu)

Supreme Court orally indicates that the government should not deport Rohingya “now” as the Centre prevails over it to not record any such views in its formal order, citing “international ramifications”.

The Supreme Court on Friday came close to ordering the government not to deport the Rohingya.

It finally settled on merely observing that a balance should be struck between humanitarian concern for the community and the country's national security and economic interests.

The court was hearing a bunch of petitions, one filed by persons within the Rohingya community, against a proposed move to deport over 40,000 Rohingya refugees. A three-judge Bench, led by Chief Justice of India Dipak Misra, began by orally indicating that the government should not deport Rohingya “now”, but the government prevailed on the court to not pass any formal order, citing “international ramifications”. With this, the status quo continues even though the court gave the community liberty to approach it in …

Khar’s experimentation with Himalayan nettle brings recognition (downtoearth)

Nature never fails to surprise us. In many parts of the world, natural resources are the only source of livelihood opportunities available to people. They can be in the form of wild shrubs like Daphne papyracea and Daphne bholua (paper plant) that are used to make paper or Gossypium spp (cotton) that forms the backbone of the textile industry.

Nothing can compete with the dynamism of biological resources. Recently, Girardinia diversifolia (Himalayan nettle), a fibre-yielding plant, has become an important livelihood option for people living in the remote mountainous villages of the Hindu Kush Himalaya.

There is a community in Khar, a hamlet in Darchula district in far-western Nepal, which produces fabrics from Himalayan nettle. The fabric and the things made from it are sold in local as well as national and international markets as high-end products.

A Himalayan nettle value chain development initiative implemented by the Kailash Sacred Landscape Conservation and Development Initiati…

The Chipko movement as it stands today

The idea behind the Chipko movement originated in early 1970s from Mandal, a village in Chamoli district of Uttarakhand. Forty-three years later, Down To Earth travelled to Chamoli and Tehri Garhwal and spoke to the participants of this movement about its relevance today