“Government Will Protect Me from the Stigma, But Only If I Am Alive”: The Struggle to Remove Four Words From the HIV/AIDS Act

04 May 2017
Amidst other serious implications of the bill getting passed, the HIV movement in India still focused on removing four words from the bill because of its necessity for effective treatment.
Parveen Negi/India Today/Getty Images
Amidst other serious implications of the bill getting passed, the HIV movement in India still focused on removing four words from the bill because of its necessity for effective treatment.
Parveen Negi/India Today/Getty Images

On 11 April 2017, the Lok Sabha passed the Human Immuno Deficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Bill, 2014 or the HIV/AIDS Bill. Since the Rajya Sabha had passed the bill on 21 March, this day marked the passage of the bill by the parliament. JP Nadda, the union health minister, hailed its passage as “historic,” and a plethora of politicians in both houses lauded the bill and the health minister. Shrikant Shinde of the Shiv Sena congratulated the health minister for bringing forward an “important bill.” Ratna De, of the Trinamool Congress, called it a “landmark bill,” while Jairam Ramesh from the Congress expressed his support for the bill by saying it would be passed “unanimously and enthusiastically.” However, the bill received a tepid reception from those it is intended to benefit—people who are living with HIV—and the civil society organisations that support them.

The main contention that these people and organisations have with the bill is the phrasing of Clause 14(1), which states that the central and state governments are required to provide antiretroviral therapy, or ART, “as far as possible.” This aspect of the bill was also criticised by the same parliamentarians who praised its passage—such as Shinde, De, and Ramesh—among others. “It is an escape route for the government, which should not be in the bill,” D Raja, a Rajya Sabha member of the Communist Party of India, said in Rajya Sabha. He continued, “If that is there, it will defeat the purpose of the bill.” Members of the Rajya Sabha from the Congress, such as Husain Dalwai and T Subbarami Reddy, moved amendments to delete the phrase from Clause 14. But upon a verbal commitment from Nadda that “nobody would be denied [ART] on any count,” the legislators withdrew the amendments. The bill was passed in both houses of parliament and enacted into law on 21 April.

The HIV/AIDS Act had the potential to make a remarkable difference in the lives of people living with HIV, but its non-committal provisions on treatment has meant that it falls short on many counts. Although the act provides protection against discriminatory practices, it does not ensure the availability of diagnostic and ART treatment to people living with HIV. Its commitment to to providing medical assistance for HIV/AIDS treatment only goes “as far as possible” for state or central governments. The inclusion of these four words is being criticised because HIV drugs and treatment have to be taken by those living with HIV throughout their lives, without any interruption. Missed dosages can cause drug resistance in the body over a period of time and lead the virus to spread faster. Based on a diagnostic test, people who are HIV positive are required to take a combination of medicines used to treat HIV, which constitutes the first line of ART treatment. The person living with HIV may be shifted to a second line of treatment—which has harsher side effects on the body and is more expensive—in case they develop resistance to the first line. As a result, a positive person who did not receive the necessary drugs during the first line of treatment will need the second line of treatment sooner.

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    Shivangi Misra is a legal officer at Lawyers' Collective.

    Keywords: Drugs medicine HIV/AIDS NACO
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