In India, NACO is talking to Indian drug companies and adding the pressure by
roping in the Indian Association of Paediatrics. Together, they are trying to
identify locations for diagnostic labs and to define parameters that would help
decide who among the affected children need treatment. Rao says that her
organization is “encouraging people to come forward for testing so that the
extent of infection would be known.” This shows the extent of lack of
information on the prevalence of AIDS in India and shows that the numbers
thrown up by the Health Ministry are at best guesstimates.
The WHO says that globally 660,000 children require treatment, though only a
handful gets it. In south-east Asia, there are 33,000 kids who need treatment
and in India, out of 23,784 AIDS patients receiving anti-retroviral therapy,
only three per cent are children.
Early and accurate diagnosis is impossible because all children born from a
HIV-positive mother will have the antibodies to test positive, even if they may
not have the virus and the common ELISA test is not a reliable tool. The only
alternative available is determining the viral load in a costly polymerase
chain reaction (PCR). NACO will buy six of these machines to be installed in
six high-prevalence states.
Luo says that if the virus is not diagnosed early “30 per cent of the affected
kids would die in a year and 50 per cent would die before they are two years
old” and waiting for results with ELISA after 18 months may be “too late for
many kids.” However, if detected early, children can survive for many years
with proper medication till science catches up with the epidemic and provides a
viable solution. Even then, the drug regimen is harsh and expensive for most.
With the first cocktail mix, they can survive for a minimum of seven years
before moving to the second regimen that can give them an additional seven
years. Crawley says that the disease can be managed easily in children “like
chronic diseases such as diabetes and heart disease.”
Meanwhile, the Tamil Nadu State AIDS Control Society is examining the
possibility of establishing voluntary counseling and testing centers (VCTCs) in
industries. The society is hoping to establish a partnership with industries
that employ large number of workers. The Society has linked up with the
International Labor Organization (ILO) to provide technical support to take
this program forward. ILO admits that counseling and providing assistance to
employees in the workplace is not a top priority for most industries.