Explained: The HIV/AIDS situation in India, and how the new Bill will protect victims

Indian Express explains the coming slew of protective measures — and the one important catch.

Written by Abantika Ghosh | Updated: October 7, 2016 7:56 am
HIV aids bill, HIV bill, Aids Bill, hiv/aids bill, hiv aids bill cleared, HIV patients prevention and control bill, hiv/aids bill, antiretroviral treatment, antiretroviral treatment legal right, antiretroviral therapy, hiv tests, hiv, hiv aids, aids cure, hiv india, aids medicine, aids treatment, hiv causes, india hiv, hiv aids, indian expres At a protest to urge China, Japan and Germany to step up contributions to the fight against AIDS, tuberculosis and malaria in New Delhi in May 2016. (Express Photo: Oinam Anand/Archive)

More than two years after it was introduced in Rajya Sabha, a revised draft of the HIV and AIDS (Prevention and Control) Bill, 2014, which makes discriminating against a person living with HIV/AIDS a punishable offence, was cleared by the Union Cabinet on Wednesday. How will it change things in India’s HIV/AIDS situation?

Why was the Bill needed?

The Bill seeks to give a legislative framework to existing norms of non-discrimination against people living with HIV/AIDS — most crucially, making it a legally punishable offence to deny such a person health insurance on the ground of the infection that causes lowering of immunity. The Bill incorporates feedback from stakeholders, and also recommendations of the Parliamentary Standing Committee on Health and Family Welfare to which it was referred after being introduced in Rajya Sabha in February 2014.

What was until now achieved through executive orders will, once Parliament passes the Bill, be laid down in statute. After the Standing Committee submitted its report, a Group of Ministers headed by Finance Minister Arun Jaitley finalised the draft that was sent to the Cabinet. Apart from insurance, the protection from discrimination mandated in the Bill extends to the fields of employment, healthcare services, educational services, public facilities, property rights, holding public office etc. It also recognises the right of a person living with HIV/AIDS to keep his/her health status confidential. Institutions are obliged to keep all such information confidential and reveal them only with the informed consent of the PLHIV (person living with HIV).

So, how many people are living with HIV/AIDS in India currently?

Approximately 21 lakh, as per government estimates. The adult prevalence is in the range of 0.3%, of which around 40% are women. Some states have more people living with HIV/AIDS than others. Four high-prevalence states of Andhra Pradesh, Maharashtra, Karnataka and Tamil Nadu account for about 55% of the total cases in the country. The prevalence of HIV has been decreasing over the past decade.

How will the proposed law help in the treatment of AIDS?

The Bill will bring a rights-based approach to AIDS treatment, making it imperative for both the central and state governments to provide treatment “as far as possible”. However, it is in these four words that a catch lies. Though the Bill lays down that treatment is the right of the patient, it stops short of making it a legal right — and therefore, a patient who is denied ART treatment cannot ordinarily drag any government to court. Last year, the Health Ministry had finalised revised norms for ART [antiretroviral therapy (ART) consists of a combination of antiretroviral (ARV) drugs to maximally suppress the HIV virus, and stop progression of the disease] that made all patients with a CD4 count of 500 eligible for ART against the earlier norm of 350. This brought an estimated 1 lakh additional PLHIVs under the ART umbrella, taking the number of Indians currently under the regime to approximately 12 lakh.

The CD4 count measures the number of CD4 T lymphocytes in blood, and is the most important laboratory indicator of how well the immune system is working in people with HIV. Employing the ART regime at a higher CD4 count means starting therapy earlier. Recent evidence suggests that earlier ART also reduces mortality (deaths) and morbidity (disease), and the incidence of opportunistic infections like tuberculosis.

What happens to an insurer that denies insurance to a PLHIV?

The Bill provides for the appointment of an ombudsman. The company would have to pay a fine of Rs 10,000 up front and a further Rs 5,000 per day until it agrees to give cover. The Standing Committee had said that “all HIV positive people should be provided insurance cover without any discrimination preferably at normal rate of premium or they may be charged slightly higher rate… but in no case exorbitant rate… should be charged… for providing insurance cover for both life and health insurance”. The government should “pursue the matter with the IRDA (Insurance Regulatory and Development Authority, the statutory insurance and re-insurance regulator) for providing insurance cover to all the HIV positive people without any discrimination”.

Has the HIV/AIDS funding situation changed after international organisations withdrew?

Not by much, if Health Minister J P Nadda is to be believed. In 2013-14, Rs 1,500 crore had been allotted, of which Rs 1,464 crore was spent; the corresponding numbers in 2014-15 and 2015-16 were Rs 1,300 crore and Rs 1,200 crore, and Rs 1,615 crore and Rs 1,603 crore respectively. All of this is domestic funding.

What is the Bill’s “guardianship clause”?

Recognising that HIV/AIDS often causes children to be orphaned, and extended families are reluctant to shoulder their responsibility, the Bill says that any person aged between 12 and 18 years with “sufficient maturity in understanding and managing the affairs of his HIV or AIDS affected family” can act as a guardian of another sibling below 18 years of age to be applicable in the matters relating to admission to educational establishments, operating bank accounts, managing property, care and treatment etc.

For all the latest Explained News, download Indian Express App

  1. T
    Trần Văn
    Oct 7, 2016 at 1:47 pm
    Neu muon ca the gioi noi chung va viet nam noi rieng khong co nguoi nhiem Hiv nua va nguoi bi nhiem Hiv bat buoc dieu tri thuoc Arv de chuyen qua AIDS thi chung ta phai lam sao de nguoi ta phai manh dan dung ra ma dieu tri.Vd nhu cai nay khong muon nguoi khac ki thi thi nguoi dung dau bo may nha nuoc phai tuyen bo khong ki thi voi nguoi bi nhiem Hiv,lam nhu vay no se tot va 100% so nguoi bi nhiem nguoi ta moi dam dieu tri con tuyen truyen hay cai khac chi la 1 phan trong do roi nguoi ta cung ki thi xa lanh nhung nguoi nhiem Hiv de rui nguoi ta vo tinh lay nhiem cho nguoi khac ma dai dich nay no tang len khong lau nua neu khong co vac xin chua tri thi dai dich nay no se giet chet het loai nguoi.Boi vay chi co nguoi dung dau nha nuoc dung ra tuyen truyen de nguoi ta bo qua mac cam ma chua tri,cung la con nguoi ca neu khong bit qui trong mang song hay nhan loai nay thi co song thi cung bang chet a vi dai dich nay gio chua co gi nhung no se giet het tat ca neu chua co vac xin
    1. G
      Geroge irabor
      Oct 14, 2016 at 8:11 am
      My name is George Irabor I live in new York city,. . It a pleasure for me to write this testimony about how i got syphilis disease cured 6 months ago. i have been reading so many comments of some people who were cured of syphilis by Dr,Ebhodaghe but i never believed them I was hurt and depressed so I was too curious and wanted to try DR,Ebhodaghe then i contacted him on his email , when i contacted him, he ured me 100% that he will heal me, i pleaded with him to help me out My treatment was a great success, he healed me just as he promised. He sent me his medication and ask me to go for check up after 3 weeks of taking his herbal medication, and went for check up after one month, to my greatest surprise my result was negative after the treatment, i am really happy that i am cured and healthy again. I have waited for 5 months to be very sure i was completely healed before writing this testimony. I did another blood test 2 weeks ago and it was still syphilis negative, so i guess its time i tell anyone out there with Herpes- or HSV-2, HIV, HPV, Hepais B, Diabetes, intestinal parasites, Spanish flu, hanta virus, cra, tuberculosis, seasonal flu, bubonic plague, small pox etc contact Dr,Ebhodaghe on email : have his number 234816183407, He is also on whatsapp. 2348162834017,lt;br/gt;I completely understand how skeptical you may feel about this because it happened to me, it might be expensive for you, but i am telling you right now that there is a cure to these deadly disease and i am a firsthand living witness distance is not a barrel
      1. A
        Amit Patel
        Oct 7, 2016 at 4:45 am
        Root cause to p HIV/AIDS Bill to increase sell of condom and garbh-nirodhak ya and injection of Foreign Companies.
        1. V
          Oct 9, 2016 at 3:52 pm
          tu laga le apne uspe.