The first case of HIV/AIDS in India was detected in Chennai sex workers in 1986, triggering shocked disbelief among health professionals which ultimately transformed into panic and then hopeless resignation.

“We never thought that HIV would ever visit India and take us on,” said Dr Ramesh Paranjape, Director of the National AIDS Research Institute, Indian Council of Medical Research. “At that time HIV was considered to be a disease of the western world and we had nothing to do with it. But slowly with more and more cases testing positive for the virus, it became a grave concern for us too.”

India HIV

A young Indian boy carries a sign as he marches with others during a rally calling for funding for programs for workers with HIV/AIDS, in New Delhi, India in 2010. Pic: AP.

Today, with an estimated 2.39 million HIV infections (of which 39 percent are female and 4.4 percent are children) India is home to the second largest population of people living with HIV – an epidemic which is concentrated in high-risk populations such as sex workers and their clients, gay men, transgenders and injecting drug users.

The 20 years from 1986 to 2006 saw the development of safe and effective therapeutic agents which could block each known stage in HIV replication in the human lymphocyte. By 2000 the triple drug cocktail had been developed which was the most exciting thing that happened for HIV treatment. Combinations of anti-retrovirals create multiple obstacles to HIV replication to keep the number of viral offspring low and reduce the possibility of a superior mutation. If a mutation that conveys resistance to one of the drugs being taken arises, the other drugs continue to suppress reproduction of that mutation.

India has played a significant role in combating the disease by way of manufacturing generic drugs used in treatment, bringing down the cost of medicines to affordable levels. Today it supplies 85 percent of low-cost HIV drugs to the developing world. Also, over the past few years we have seen a lot of advocacy for HIV control programs at different levels – NGOs, government and networks of people living with the disease themselves. In 1992 the National AIDS Control Organization was created.

This has helped to improve the understanding of the complex epidemic in India, with the focus shifting from raising awareness to behavior changes; from a nationalized response to a more decentralized one. The estimated number of new annual HIV infections has declined by more than 50 percent over the past decade. India had approximately 120,000 new HIV infections in 2009 against 270,000 in 2008. The trend of annual AIDS deaths has declined steadily since the rollout of free anti-retro viral therapy program in India in 2004.

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