“If you think you’re leading and no one is following you, then you’re only taking a walk.” ― Afghan Proverb” 


EDITORIAL 14 : “Taking stock of the anti-AIDS fight”


K. Srinath Reddy

President, Public Health Foundation of India


Taking stock of the anti-AIDS fight

The slowdown, which places targets out of reach, calls for a renewal of political commitment, finances and engagement

Fighting HIV-AIDS is still a half won battle . Setting up a target of winding up AIDS by 2030 is still a dream. Comment -(GS 1)

GS 1:SOCIAL ISSUES:Social stigma attached with HIV

In this article you will learn the present turnovers of the HIV AIDS. Article has been written in most simple language and with perfection for UPSC 😉

The Sustainable Development Goals (SDG), adopted by member countries of the United Nations in 2015, set a target of ending the epidemics of AIDS, Tuberculosis and Malaria by 2030 (SDG 3.3).
The key indicator chosen to track progress in achieving the target for HIV-AIDS is “the number of new HIV infections per 1,000 uninfected population, by sex, age and key populations”.

In the terminology of HIV prevention and control, the phrase “key populations” refers to: men who have sex with men; people who use injected drugs; people in prisons and other closed settings; sex workers and their clients, and transgender persons.





INFUSE ENERGY AND URGENCY : The global efforts to combat HIV-AIDS and complement the prevention target set by the SDGs, an ambitious treatment target was also adopted through UNAIDS, the lead UN agency that coordinates the battle against HIV.

“90-90-90” TARGET: The “90-90-90” target stated that by 2020,

  • 90% of those living with HIV will know their HIV status,
  • 90% of all people with diagnosed HIV infection will receive sustained anti-retroviral therapy and
  • 90% of all people on such therapy will have viral suppression.


ATTENTION TO GAPS: The gaps in detection, initiation of drug therapy and effective viral control were to be bridged to reduce infectivity, severe morbidity and deaths from undetected and inadequately treated persons already infected with HIV, even as prevention of new infections was targeted by SDG 3.3.


[i2pc pros_icon=”icon icon-check-1″ cons_icon=”icon icon-cancle” show_title=”true” title=”HIGH AND LOW ” show_button=”false” pros_title=”HIGH” cons_title=”LOW” heading_pros_icon=”icon icon-thumbs-up” heading_cons_icon=”icon icon-thumbs-down” ][i2pros]It is the confluence of those ingredients that made it possible for the world to achieve a reduction in new HIV infections by 37% between 2000 and 2018.

HIV-related deaths fell by 45%, with 13.6 million lives saved due to Anti-Retroviral Therapy (ART).

Not only were effective drugs developed to combat a disease earlier viewed as an inescapable agent of death but they also became widely available due to generic versions generously made available by Indian generic manufacturers, led by the intrepid Yusuf Hamied.

A rush of public and private financing flowed forth in a world panicked by the pandemic. Ignorance and stigma were vigorously combated by coalitions of HIV-affected persons who were energetically supported by enlightened sections of civil society and the media.

Never before had the world of global health resonated so readily to the rallying cry for adopting a rights-based approach and assuring access to life-saving treatments.

According to a recent report by UNAIDS, of the 38 million persons now living with HIV, 24 million are receiving ART, as compared to only 7 million nine years ago.

Why then the concern now? At the end of 2018, while 79% of all persons identified as being infected by HIV were aware of the fact, 62% were on treatment and only 53% had achieved viral suppression — falling short of the 90-90-90 target set for 2020.

[/i2pros][i2cons]Due to gaps in service provision, 770,000 HIV-affected persons died in 2018 and 1.7 million persons were newly affected.

There are worryingly high rates of new infection in several parts of the world, especially among young persons.

Only 19 countries are on track to reach the 2030 target.

While improvements have been noted in eastern and southern Africa, central Asia and eastern Europe have had a setback, with more than 95% of the new infections in those regions occurring among the ‘key populations’.

Risk of acquiring HIV infection is 22 times higher in homosexual men and intravenous drug users, 21 times higher in in sex workers and 12 times more in  .[/i2cons][/i2pc]


  • ASSUMPTION OF A CONCLUSIVE VICTORY: The success achieved in the early part of this century, through a determined global thrust against the global threat, led to a complacent assumption of a conclusive victory.
  • MORTALITY RATES : Improved survival rates reduced the fear of what was seen earlier as dreaded death and pushed the disease out of the headlines.
  • BEHAVIOUR:The information dissemination blitz that successfully elevated public awareness on HIV prevention did not continue to pass on the risk-related knowledge and strong messaging on prevention-oriented behaviours to a new generation of young persons.



  • Risk factors for cardiovascular disease are high among survivors as they age
  • with anti-retroviral drugs increasing the risk of atherosclerosis.
  • Other infectious diseases, such as tuberculosis can co-exist and cannot be addressed by a siloed programme.
  • Mental health disorders are a challenge in persons who are on lifelong therapy for a serious disease that requires constant monitoring and often carries stigma.


HIV-related deaths declined by 71% between 2005 and 2017. HIV infection now affects 22 out of 10,000 Indians, compared to 38 out of 10,000 in 2001-03.

India has an estimated 2.14 million persons living with HIV and records 87,000 estimated new infections and 69,000 AIDS-related deaths annually.


  • Nine States have rates higher than the national prevalence figure.
  • Mizoram leads with 204 out of 10,000 persons affected.
  • The total number of persons affected in India is estimated to be 21.40 lakh, with females accounting for 8.79 lakh. Assam, Mizoram, Meghalaya and Uttarakhand showed an increase in numbers of annual new infections.
  • The strength of India’s well established National AIDS Control Programme, with a cogent combination of prevention and case management strategies, must be preserved.
  • Drug treatment of HIV is now well founded with an array of established and new anti-viral drugs.
  • The success of drug treatment to prevent mother-to-child transmission, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), and male circumcision, especially among MSM population, is well-documented.
  • Given the wide diversity of the HIV virus strains, development of a vaccine has been highly challenging but a couple of candidates are in early stage trials.


The theme of the World AIDS day this year (“Ending the HIV/AIDS Epidemic: Community by Community) is a timely reminder that community wide coalitions are needed even as highly vulnerable sections of the community are targeted for protection in the next phase of the global response.


       IASbhai  Windup:  

There has to be a fresh surge of high-level political commitment, financial support, health system thrust, public education, civil society engagement and advocacy by affected groups — all of which were part of the recipe for rapid progress in the early part of this century.

However, mere technical innovations will not win the battle against HIV-AIDS. Success in our efforts to reach the 2030 target calls for resurrecting the combination of political will, professional skill and wide ranging pan-society partnerships that characterised the high tide of the global response in the early part of this century.


Muhammad Khan is an advocate; Jairam Ramesh is a Rajya Sabha MP;


The dubious legal case for an NRIC

The provisions that empower the government to carry out such an exercise smack of arbitrariness

Preparation of National Register of Indian Citizens (NRIC) has not at all been a easy task . Critically Comment-(GS 3)

GS 2:Citizenship

There are some glitches in the preparation of NRIC mentioned below . Article just mentions cons of NRC .


“Preparation of National Register of Indian Citizens (NRIC) is governed by the provisions of Section 14A of The Citizenship Act, 1955 and The Citizenship (Registration of Citizens and Issue of National Identity Cards) Rules 2003.

Section 14A of the Citizenship Act, 1955 provides for compulsory registration of every citizen of India and maintenance of NRIC.


The procedure to prepare and maintain NRIC is specified in The Citizenship (Registration of Citizens and Issue of National Identity Cards) Rules, 2003.”


  • This answer is mischievously misleading inasmuch as it suggests that a nationwide NRIC is mandated by law. Section 14A in the Citizenship Act of 1955 provides in sub-section (1) that “The Central Government may compulsorily register every citizen of India and issue national identity card to him”.
  • The word “may” implies a discretion contingent on other factors that is at odds with the supposed “compulsory” nature envisaged immediately thereafter.
  • A statute which issues a compulsory command must necessarily use the word “shall” and not the suggestive “may”.


Three Rules are of particular interest, Rules 11, 6 and 4, which seem to grant some vague sort of authority for a nationwide NRIC.

  • Rule 11 states that the “Registrar General of Citizen Registration shall cause to maintain the National Register of Indian Citizen in electronic or some other form which shall entail its continuous updating on the basis of extracts from various registers specified under the Registration of Births and Deaths Act, 1969 and the [Citizenship] Act [1955].”
  • It, therefore, confines the Registrar General’s responsibility to a periodic revision of the National Register by updating it with the information available with the Registrar of Births and Deaths.
  • No action or duty is enjoined upon the citizens to apply for (or prove) their citizenship afresh.
  • Rule 4 places the responsibility to carry out a census-like exercise on the Central government and not on citizens.
  • This deals with the “Preparation of the National Register of Indian Citizens” which provides that the Central Government shall carry out a “house-to-house enumeration for collection for particulars related to each family and Individual including the citizenship status”.
  • This is a distinctly passive process compared to the gruelling exercise that was forced upon citizens in Assam.
  • Rule 6 provides that every individual must get himself/herself registered with the Local Registrar of Citizen Registrations during the period of initialisation (the period specified as the start date of the NRIC).

What this means is that this rule is circumscribed by the other clauses in the Act.

  • Rule 11, which says that updating the NRIC entails updating the information available with ‘Registrar of Births and Deaths’ with no de novo process envisaged.
  • Then, we have Rule 4, which says that a census-like exercise shall be carried out and, if the Central government wants to exclude a citizen, it will give him/her a hearing.
  •  Rule 6, which says that a citizen shall have to get himself/herself registered once a start period is specified. These Rules are in direct contradiction with one another, and smack of non-application of mind and arbitrariness.



  •  NRIC exercise is mandatory and inescapable is ‘no’.
  • The rules, as currently drafted, do envisage other less destructive scenarios to register “citizens” (not “residents”) which, one can argue, are redundant in the wake of the Aadhaar Act and not mandatory.
  • This ambiguity is also clear from the answer given in Parliament which, in a typically too-clever-by-half fashion, does not cite the exact rules that empower the Central government to carry out this exercise.


  • Under the Foreigners Act of 1946, the burden of proving whether an individual is a citizen or not, lies upon the individual applicant and not on the state (Section 9).
  • Will the proposed NRIC strip bona fide citizens of basic legal protections by inverting the burden of proof just to satisfy the nefarious political agenda of the ruling establishment?

The NRIC exercise promises to inflict a long period of insecurity on well over a billion people.


       IASbhai  Windup:  

The individuals most likely to suffer are those at the very margins of poverty, who risk being rendered stateless and worse, being incarcerated in detention camps which are truly a blot on our democracy.

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