Context:

During the national ceremony held on the occasion of World AIDS Day, the Union Minister of Health and Family Welfare highlighted significant achievements related to India’s HIV/AIDS response. The country has witnessed a remarkable reduction of 32 percent in new HIV infections and 69 percent in AIDS-related deaths. This progress has been made possible through better diagnostic services, affordable medicines and the expansion of Antiretroviral Therapy (ART) centres across the country. Under the Test and Treat policy, every infected individual receives lifelong and free treatment, resulting in a sharp decline in mortality rates. India continues to strengthen nationwide awareness through extensive campaigns, community participation and initiatives led by the National AIDS Control Organisation (NACO).

• • Initiated by the World Health Organization in 1988, World AIDS Day is observed every year on 1 December with the aim of raising global awareness about HIV/AIDS, paying tribute to those who lost their lives to AIDS, and promoting sensitivity and support for people living with HIV. This year’s theme, ‘Overcoming disruption, transforming the AIDS response’,emphasises the urgent need to rebuild HIV/AIDS programmes that have weakened due to pandemics, conflicts, inequalities and disruptions in health systems.

India’s AIDS Control Programme:

• • India’s AIDS control programme is recognised globally as a successful public health model. From identifying early HIV cases to building a decentralised, community-driven programme, India has made remarkable progress over the past four decades.
  • Between 1985 and 1991, India focused on case detection, safe blood transfusion and targeted awareness campaigns. With the establishment of the National AIDS Control Organisation (NACO) and the National AIDS Control Programme (NACP) in 1992, India adopted a structured, multisectoral strategy involving health, education, women and child development, labour, and several social sectors.
  • Over time, the NACP transitioned from a centralised policy approach to a community-based and decentralised model, prioritising the involvement of NGOs and networks of people living with HIV (PLHIV).
  • India’s achievements are not merely policy-driven; they are also evident in practical outcomes. The decline from 1.73 lakh annual deaths in 2010 to 32,200 in 2024, amounting to an 81 percent reduction, reflects the nation’s strong commitment. Universal and free access to Antiretroviral Therapy (ART), 94 percent ART retention and 97 percent viral suppression have positioned India as a global leader.
  • India’s contribution to global AIDS deaths in 2024 is only 5 percent, compared to the global figure of 6.3 lakh. This reflects India's significant role in international health due to its affordable generic drug production, which supplies about 70 percent of global ART. India’s progress aligns with the UNAIDS 95-95-95 targets, reinforcing the goal of ending AIDS as a public health threat by 2030.

National AIDS Control Programme:

1. NACP-I (1992–1999): Laying the Foundation

The objective of this phase was to slow down the spread of HIV/AIDS and reduce morbidity and overall impact. The focus was on safe blood supply, awareness and basic prevention initiatives.

2. NACP-II (1999–2006): Building Institutional Capacity

• Reducing HIV transmission in India.
• Developing long-term national capacity to respond to HIV/AIDS.

This phase prioritised strengthening health systems, training and behaviour change communication (BCC).

3. NACP-III (2007–2012): Goal of Reversing the Epidemic

Its objective was to bring down the infection rate by 2012.
• Targeted interventions for High-Risk Groups (HRGs)
• Integration of prevention, care, support and treatment services

A key initiative during this period was the establishment of District AIDS Prevention and Control Units (DAPCU), strengthening decentralised monitoring and stigma-reporting systems.

4. NACP-IV (2012–2017)

• Goal: Accelerating the reversal of the epidemic and ensuring an integrated response.
• Objectives:
o 50 percent reduction in new infections (compared to the 2007 baseline).
o Comprehensive care, support and treatment for all PLHIV.

This phase was extended up to 2030 to advance the goal of ending AIDS.

Key initiatives during the extension:
• HIV/AIDS (Prevention and Control) Act, 2017 – prohibits discrimination against PLHIV, ensures confidentiality and mandates informed consent for testing and treatment.
• Mission SAMPARK – aimed at bringing back PLHIV who had discontinued ART.

5. NACP-V (2021–2026)

Launched as a central sector scheme with an outlay of ₹15,471.94 crore, this phase aims to build on past achievements and address persisting challenges. It supports SDG 3.3 by strengthening prevention, testing and treatment services to eliminate HIV/AIDS as a public health threat by 2030.

Government Efforts in Awareness and Prevention:

HIV/AIDS awareness in India is based on a multi-layered strategy.

1. Nationwide Awareness Campaigns

NACO uses television, radio, social media, digital platforms and print media to disseminate messages widely, especially targeting youth.

2. Outdoor Outreach and Community Dialogue

Hoardings, bus panels, folk performances and mobile IEC vans help spread awareness across remote regions.

3. Involvement of Grassroots Institutions

Self-help groups, Anganwadi workers, ASHA workers and Panchayati Raj Institutions play an important role in behavioural change, encouraging testing and reducing stigma.

4. Targeted Interventions for High-Risk Groups

By July 2025, 1,619 targeted intervention projects were operational to ensure equitable access to prevention and treatment services.

5. Campaigns Against Stigma and Discrimination

Since discrimination hinders access to treatment, thematic campaigns are conducted in workplaces, schools, hospitals and communities.

6. Appointment of Ombudsmen in States/UTs

Under the HIV/AIDS Act, 2017, the appointment of ombudsmen has strengthened the protection of PLHIV rights.

Challenges and the Road Ahead:

Despite major achievements, several challenges demand policy and health system attention:

1.       Hidden Epidemic: Social stigma prevents individuals from getting tested.

2.      High infection rates in Northeast India and urban slums – requiring targeted strategies.

3.      Vulnerability of women and adolescent girls due to gender-based inequalities.

4.     Migrant and mobile populations – difficulty in ensuring continuity of treatment.

5.     Digital health literacy gaps – limiting access to new digital platforms.

To achieve the 2030 target, India must strengthen prevention-focused strategies, community partnerships, gender-sensitive health services and stigma eradication efforts.

Conclusion:

India’s HIV/AIDS journey reflects how a nation transformed a crisis into an opportunity by aligning health policy, science, community participation and governance toward a shared goal. This journey extends beyond understanding transmission to establishing a rights-based health ecosystem. Progress from NACP-I to NACP-V, laws safeguarding PLHIV dignity, community-based initiatives and extensive awareness campaigns highlight India’s leadership in public health. The decline in mortality beyond the global average and alignment with UNAIDS targets show that India is on course to end AIDS as a public health threat by 2030, provided the current pace and commitment continue. The fight against HIV/AIDS in India is not merely a health struggle but a broader journey of human rights, social justice and community empowerment—reflecting collective will and effective policy implementation.