HIV: ‘Dip in cases, but systems complacency is dangerous’

Dr Samiran Panda recently took charge of the Pune-based National AIDS Research Institute (NARI). In an interview with My Medical Mantra, he said that, while the curve of HIV incidence is reducing, complacency setting in the system would be dangerous. His immediate focus would be HIV prevention program for injecting drug users (IDUs) and Men who have Sex with Men (MSM)

HIV: ‘Dip in cases, but systems complacency is dangerous’
On the right, Dr Samiran Panda

Q: What would your immediate focus be?

A: We would like to work towards not only reducing new infections in children but to improve quality of life of around 1 lakh children who are living with HIV. Also, there are orphan children whose parents had HIV and who need to be given more attention.

The highest HIV prevalence is witnessed among injecting drug users and transgenders. Around ten per cent of injecting drug users are affected with HIV and in some of the pockets of Uttar Pradesh and Punjab, the prevalence is even more. We should have in depth focus and research.

Also, it is necessary that people with HIV should be able to live in society with equal rights. A society without discrimination should be created. For that we would also like to do some research in community. In the distant future, we are also planning to expand the mandate of the NARI.

Q: India has promised for the elimination of HIV by 2030 according to UN Sustainable Goals. Can this be realistically achieved?

A: It is certainly an ambitious target. We just have 12 years to achieve this. In these 12 years, we need to ensure that there are zero new infections. For this all the HIV mothers should know effective anti-HIV combination therapy.

This also means that injecting drug users should be given oral substitution therapy so that I do not they do not suffer from withdrawal symptoms.

The main challenge is screening and diagnosing HIV affected people and putting them on anti-HIV therapy. We should be able to offer all this.

Q: What are the loopholes in its implementation?

A: Creating a non-stigmatised environment is essential. Only then people would be encouraged to come forward and take a test. We should focus on making the process user-friendly. If people are not adhering to treatment, then there is risk of the virus not getting suppressed and so adherence to treatment is of utmost importance.

Q: With the overall incidence rate going down, funding is also decreasing. Do we need to worry about decrease in funding?

A: It is one country, but epidemic is not one. It is concentrated in some pockets. We need to utilise our finances smartly. Also, there should be an effort to finding resources from other ministries.

Q: Do you see any complacency setting in? If yes, is it a cause for worry?

A: Since the last four years, there has been a dip in HIV cases. However, the systems complacency can be dangerous. If not altered, you have gains reversed. This is a critical time to ensure continuation of this downward trend.

Q: Is there anything that we are researching on which goes beyond the plasma viral load testing method, which is used to check present of HIV viral load estimation?

A: This method has some limitations and so we are in the process of validating the method called dried blood spots. They are easy to collect and test. With this regular screening and diagnosis would be easy.