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ABSTRACT

The world of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) has changed dramatically over the last 35 years. It was a blow to humanity when first described in 1981 as it was an inevitably fatal disease. The disease was expected to devastate the world in an unprecedented manner. In 1996, there was the first glimmer of hope when highly active antiretroviral treatment (HAART) was shown to suppress the viral replication significantly and improve survival. The question from those infected with HIV, changed from “Will I live?” to “How long will I live?” By the turn of the century, Indian pharmaceuticals had started producing generic anti-retrovirals that reduced the cost significantly and increased access drugs in the developing countries. Programs such as “3 by 5” initiative by the World Health Organization (WHO), President’s Emergency Plan for AIDS Relief (PEPFAR) and UNAIDS provided a big push to scaling up antiretroviral therapy. In India too, a free anti-retroviral treatment program was launched by National AIDS Control Organization (NACO) in 2004 and was rapidly scaled up to become world’s second largest program. Currently, it is estimated that almost a million people living with HIV (PLHIV) are receiving antiretroviral therapy, taking together both public and private sector patients.