Demographically the second largest country in the world, India has also the third largest number of people living with HIV/AIDS. Available evidence on HIV epidemic in India shows a stable trend at national level. As per the provisional HIV estimate of 2008-09, there are an estimated 22.7 lakh people living with HIV/AIDS in India. The HIV prevalence rate in the country is 0.29 percent (2008-09) and most infections occur through heterosexual route of transmission. However in the north-eastern region, injecting drug use is the major cause for the epidemic spread.
The primary drivers of HIV epidemic in India are unprotected paid sex, unprotected sex between men and injecting drug use. Heterosexual route of transmission accounts for 87 percent of HIV cases detected.
In 1992, the Government launched the first National AIDS Control Programme (NACP-I) with the International Development Association (IDA) Credit of USD 84 million and demonstrated its commitment to combat the infection. NACP-I was implemented during 1992-1999 with an objective to slow down the spread of HIV infections so as to reduce morbidity, mortality and impact of HIV epidemic in the country. To strengthen the management capacity, a National AIDS Control Board (NACB) was constituted and an autonomous National AIDS Control Organisation (NACO) was set up to implement the project.
During the initial years, the major focus of attention was on prevention activities, followed by “care and support” of infected individuals, particularly those suffering from opportunistic infections (OIs). Over the past decade, there has been a tremendous increase in our understanding of molecular biology and the viral structure and pathogenesis of the disease. This knowledge has led to the development of a number of new antiretroviral drugs and treatment protocols. The demonstration of efficacy of these drugs in containing viral replication has changed the world’s outlook on HIV/AIDS from a “virtual death sentence” to a “chronic manageable disease”.
Although antiretroviral therapy (ART) does not cure HIV infection, the decrease in the viral load and the improvement in immunological status brought about by the use of these drugs have resulted in a marked decrease in the mortality and morbidity associated with the disease.
The free ART programme has adopted the public health approach to administration and distribution of ART. This implies a comprehensive prevention, care and treatment programme, with a standardized, simplified combination of ART regimens, a regular secure supply of good-quality ARV drugs, and a robust monitoring and evaluation system. The public health approach for scaling up ART aims to provide care and treatment to as many people as possible, while working towards universal access to care and treatment.
There are two doctors in each ART facility, One doctor in each Community Care Centre and one doctor as In-charge of link ART centre (ICTC) are directly involved in Patient care and are potential candidates for one-year training programme in ‘HIV Medicine’. Currently nearly 8 lakh patients registered for ART and 2, 70,000 eligible patients are on treatment at ART Centres. NACO has nearly 300 ART centre 650 Link ART centres and 250 community care centres which are being scaled up further. About 2000 trained doctors would be needed to man these facilities. The Qualification for SMO at ART centre is MD while for MO it is MBBS. It is planned that MBBS Doctors with PG Diploma in HIV Medicine shall be considered for the post of SMO at ART centre. Hence, there is need of developing a training package in form of PG Diploma in HIV Medicine.
Keeping above inview , IGNOU has developed a one-year PG Diploma Programme in HIV Medicine in collaboration with National AIDS Control Organizition (NACO), Ministry of Health & Family Welfare, Govt. of India. IGNOU will act as an umbrella organization to coordinate the training programme in the country. The PG Diploma in HIV Medicine will help to standardise HIV Medicine training and also help to bridge the gap in trained man power for ART centre.
- Imbibe comprehensive knowledge on basics of HIV as related to details of management of HIV/AIDS in teritiary care set up;
- Manage all complications as well as opportunistic infections due to HIV/AIDS at the time of need; and
- Recognise and handle emergencies related to HIV/AIDS and its complication and take bedside decision for management whenever is required.