The revival of the HIV and AIDS (Prevention and Control) Bill, 2014, and the Union Cabinet’s approval for provisions that make discrimination against people living with the virus punishable, are positive steps.
Such laws, however, can only deliver benefits within the overall constraints imposed by an underfunded public health system. Where the legislation can make some difference, with active monitoring by HIV/AIDS support groups, is in ensuring that acquiring the infection does not mean an end to education, employment, access to housing and healthcare due to discrimination.
The success of the anti-discrimination aspects hinges on the readiness of governments to accept the inquiry findings of ombudsmen, to be appointed under the law, and provide relief. Since the new law is intended to both stop the spread of the disease and help those who have become infected get antiretroviral therapy as well as equal opportunity, it will take a high degree of commitment to provide effective drugs to all those in need.
In August, the Ministry of Health and Family Welfare put the number of people getting free treatment nationally at 9,65,000, of which 53,400 are children. This must be viewed against the most recent estimate last year, that 21 lakhs people live with HIV in India, of whom 7,90,000 are women. Regional variations in access to diagnosis and treatment must be addressed.
The legislation and the structure of complaints redress that it proposes should provide some relief to thousands of families that face discrimination in admitting children to school, an infected individual getting a job, or treatment in hospital.
Unlike many other diseases, however, HIV/AIDS has received global attention and funding, thus building up pressure on governments to come up with supportive policies. Communities will now have the opportunity to ensure that the strongest element of the prospective law, assuring confidentiality of HIV status, is enforced.
A breach could invite imprisonment and a fine. Yet, the proposals approved by the Cabinet fail on one important count: the insurance industry is allowed to use actuarial calculations to limit access to products to people with HIV.
National AIDS Control Organisation data for 2015 indicate that while there is an overall decline in HIV prevalence among visitors to antenatal clinics, there was a rise in nine States. The government must get down to business and close such gaps.