Indian states lag behind in treatment, diagnosis of AIDS

About a dozen states, including Uttar Pradesh, Madhya Pradesh and Haryana, lag behind in the treatment and diagnosis of HIV/AIDS as well as the handling of tuberculosis, which is the foremost cause of death among people living with the virus.

A recent review meeting of the Health and Family Welfare Ministry on collaborative efforts to tackle HIV and TB unveiled a gloomy picture of the treatment and diagnosis of the diseases. The state of affairs is particularly dismal in states neighbouring the national capital like Uttar Pradesh and Haryana.

According to Central government guidelines, each district should have an Integrated Counseling and Testing Centre (ICTC) for HIV and a District Medical Centre (DMCs) for treating AIDS and TB. However, only 35 per cent of the districts in Uttar Pradesh have both facilities.

The gaps

There are 1,535 DMCs in Uttar Pradesh without HIV testing facilities. Only 38 per cent of TB patients know their HIV status and there is a scarcity of refrigerators for storing key medicines, said the minutes of the review meeting accessed by Mail Today.

"Training of the staff of Department of AIDS Control (DAC) and Revised National Tuberculosis Programme (RNTCP) is pending. The state TB-HIV coordinator post is vacant. Joint HIVTB review meetings are not happening in districts regularly," said a senior official.

The minutes of the review meeting further said: "Considering the critical issues seen during the presentation, the panel observed that there is a necessity of a joint review to identify the gaps in TB/HIV collaborations in the state with recommendations and action plan with timelines to fill the observed gaps."

Realising that TB is the commonest opportunistic infection among people living with HIV, the Centre, in order to mitigate the effect of the dual burden of HIV and TB infections, started collaborative efforts through the department of AIDS control and Central TB Division in 2001. The Centre recently asked the states to submit the status report of activities on HIV.

The scenario was no different in Haryana. During the review meeting, authorities found that 50 per cent of patients with both HIV and TB had not been started on Anti-Retroviral Therapy (ART). Rohtak Medical College, which caters to patients from Punjab, Chandigarh and Delhi, has not shared its data with the Haryana State TB Cell (STC) and State AIDS Control Society (SACS).

In Madhya Pradesh, ignorance rate among patients was classified as high with only 54 per cent of knowing their HIV status. "Almost 50 per cent of the districts reported zero reporting for initiation of TB treatment.

Coordination

It was noticed that the State TB HIV coordination committee meeting was not held for past one year and District Coordination Committee (DCC) meetings were not held in most of the districts for last quarter," said the minutes of the meeting.

Dr Jagdish Prasad, Director General of Health Services (DGHS) in the Health Ministry, said: "The northern states need to work harder for improving HIV screening among TB patients. Co-morbidities like diabetes among these co-infected patients is also a concern and efforts should be made to address this issue."