HIV and Law in India: Need for an Act of Parliament to Protect the Vulnerable and Related Issues

Introduction

This essay focuses on HIV law. First it presents the broad scenario of HIV/AIDS in India and its possible social and economic impacts. Then it describes the HIV policy in India and its limitations. At the end it deals with some legal controversies on the matter and gives suggestions to be considered in enacting the HIV law. It argues that the HIV laws must aim at protecting both people living with HIV/AIDS (PLHA) and those at risk, from stigma and discrimination. The law must, however, be supported by a fight against misconceptions, greater sensitivity to religion and culture, and strengthening of health facilities.

HIV situation in India

In terms of numbers, India is now the first country in the world with a maximum number of HIV positive persons that surpasses Africa where the HIV/AIDS epidemic has proved to be the most serious public health failure. As per the 2006 Report of the Global AIDS Epidemic, in India the prevalence rate among the adults, 15 - 49 years, is between 0.5 to 1.5 percent. From the global standards this is not a high rate as such, but the matter of concern is that this rate has constantly been rising for last several years. All those concerned, the planners, academicians and activists think that this is the time to act. If the AIDS virus is not checked in time it may lead to catastrophic results for the society and economy.

Historically speaking, the year 2006 marked a 20 year presence in India of the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS). The first serological evidence of infection was found among the female sex workers in Tamil Nadu in 1986 although it is believed that the HIV first appeared in India among the intravenous drug users in the northeast states. Initially the cases of HIV/AIDS were reported from commercial sex workers in Mumbai and Chennai and intravenous drug users in Manipur State (NACO, 2003). Now the infection has spread to all parts of the country and to all groups; it is no longer confined to high risk groups. The Sentinel Surveillance conducted during August-October, 2003 revealed that the prevalence rate of HIV had crossed the one percent level in the urban areas of seven states. This means that if urgent steps are not taken at this stage the number of HIV positive people may grow exponentially and develop into a serious public health problem. Less than two decades ago the African countries were in the same situation in which India finds itself today.

India has a large population and even a decimal change in the rates and ratios produces significant changes in numbers. According to the UNAIDS, 2006 Report on the Global AIDS Epidemic, the estimated number of people living with HIV is 5.7 million. The interval estimate is from 3.4 million to 9.4 million. Thus from a few thousands in 1990s the number of people with HIV/AIDS has gone up to 57 lakh (Radhika, 2006). According to the UNAIDS estimates again between 2.7 lakh to 6.8 lakh people (with a point estimate of more than four lakh) died of HIV AIDS last year (IBNLive.com., 2006). HIV is increasing faster than any other disease in India and there are estimates that 40 percent of all deaths due to infectious diseases in India in 2033 will be from AIDS only (Over, et al. 2004).

In India data on HIV are obtained from sexually transmitted diseases (STD), ante natal care (ANC) and injecting drug users (IDU) sites. For some places, namely, Goa, Mumbai and Tamil Nadu, MSM sites are also observed. There are some interesting trends. Andhra Pradesh, Goa, Karnataka and Maharashtra including Mumbai are the States/UTs where STD surveillance centres produce the prevalence rate above 10 percent. Although at most places, particularly where HIV prevalence had been high in the past, the rates are declining, the virus is spreading from high risk groups to the general population. Also in some groups the...