In July 2000, the UNSC adopted Resolution 1308, calling for “urgent and exceptional actions” to mitigate the threats posed by HIV/AIDS.
As the first disease to be the subject of a UNSC resolution, the exceptional status of HIV/AIDS has brought about unprecedented levels of international funding allocated primarily in developing countries where responses to the disease have been scarce.
What happened then?
While the exceptional approach to HIV/AIDS was warranted in the earlier stages of responses at the national level, it has become increasingly ineffective over time.
The overdependence on international assistance, coupled with the overwhelming policy preference towards HIV/AIDS, has resulted in the marginalisation of other pressing health threats such as malnutrition.
Most importantly, there has been a stagnating and even declining trend of HIV/AIDS international financial assistance in recent years.
In light of the continuous economic boom in India and China, international funding agencies now argue that these countries should be donors instead of recipients of HIV/AIDS-specific grants.
Without renewed and increased commitment from international donors and recipient governments, the sustainability of future national HIV/AIDS programmes is in doubt.
What India is doing now?
In response to the changing global health agenda, most of these countries are prioritising the integration of HIV/AIDS programmes into existing health-related systems.
An integration of HIV/AIDS interventions and primary health-care systems has taken place in India from 2010 onwards.
For instance, six components of the National AIDS Control Programme (NACP)-III merged with the NRHM in 2010.
The integration of HIV/AIDS responses under the umbrella health system is ongoing in the NACP-IV.
At the 2016 high-level meeting at the UNGA, India pledged to follow targets towards ending HIV/AIDS as a public health threat in the next five years, and ending the epidemic by 2030.
India is now playing a larger role in funding its HIV/AIDS programmes, two-thirds of the budget for the NACP-IV is provided by the Government of India and comes from the domestic budget.
Indian HIV/AIDS programmes have progressively become less dependent on foreign assistance.
But in order to ensure the sustainability of the HIV/AIDS interventions, continuous integration of HIV/AIDS programmes into a larger health system is required.
What could be done?
If the goal of ending HIV/AIDS in India by 2030 is to become reality, there not only has to be an increase in budgetary allocation to public health care but also a more concentrated effort to increase AIDS awareness.
Evidence suggests that many people suffering from HIV/AIDS in Asia lack the awareness that they test positive.
Certain levels of AIDS exceptionalism should be maintained when we perceive ending HIV/AIDS as a means to an end.
