The HIV and AIDS (Prevention and Control) Bill passed by Parliament does not guarantee access to anti-retroviral drugs and treatment for opportunistic infections, but there is no denying that it is a good base for an active health rights movement to build upon. Understandably, HIV-positive people in the country, estimated at over 21 lakh, are disappointed that the Centre’s commitment to take all measures necessary to prevent the spread of HIV or AIDS is not reflected in the Bill, in the form of the right to treatment. The law only enjoins the States to provide access “as far as possible”. Beyond this flaw, though, the legislation empowers those who have contracted the infection in a variety of ways: such as protecting against discrimination in employment, education, health-care services, getting insurance and renting property. It is now for the States to show strong political commitment, and appoint one or more ombudsmen to go into complaints of violations and submit reports as mandated by the law. Here again, State rules should prescribe a reasonable time limit for inquiries into complaints, something highlighted by the Standing Committee on Health and Family Welfare that scrutinised the legislation.
Access to insurance for persons with HIV is an important part of the Bill, and is best handled by the government. The numbers are not extraordinarily large and new cases are on the decline, according to the Health Ministry. Data for 2015 published by the Ministry show that two-thirds of HIV-positive cases are confined to seven States, while three others have more than one lakh cases each. Viewed against the national commitment to Goal 3 of the UN Sustainable Development Goals — to “end the epidemic of AIDS” (among others) by 2030 — a rapid scaling up of interventions to prevent new cases and to offer free universal treatment is critical. Publicly funded insurance can easily bring this subset of care-seekers into the overall risk pool. Such a measure is also necessary to make the forward-looking provisions in the new law meaningful, and to provide opportunities for education, skill-building and employment. As a public health concern, HIV/AIDS has a history of active community involvement in policymaking, and a highly visible leadership in the West. It would be appropriate for the Centre to initiate active public consultations to draw up the many guidelines to govern the operation of the law. Evidently, the requirement for the ombudsman to make public the periodic reports on compliance will exert pressure on States to meet their obligations. In an encouraging sign, the Supreme Court has ruled against patent extensions on frivolous grounds, putting the generic drugs industry, so crucial for HIV treatment, on a firm footing. The HIV and AIDS Bill may not be the answer to every need, but it would be a folly not to see its potential to make further gains.
