Kamal Ghorui
NEW DELHI: Despite progress in HIV control, Delhi continues to face gaps in treatment coverage, with only about 70% of identified patients currently linked to care, prompting the Centre to step up district-level action.At a high-level workshop—‘Suraksha Sankalp Karyashala’—held in the capital, the Union health ministry reviewed HIV response in Delhi and Haryana, stressing the need to improve testing, treatment linkage and patient follow-up.Delhi, with an estimated 59,079 people living with HIV and an adult prevalence of 0.33%, has been flagged for urgent improvement, particularly in ensuring that those diagnosed are started on and retained in treatment.As part of a focused strategy, seven districts in Delhi—North, New Delhi, Shahdara, Central, South East, South and North West—have been identified for intensified interventions and close monitoring.Addressing officials, Dr Rakesh Gupta, Additional Secretary and Director General, National AIDS Control Organisation (NACO), said stronger coordination at the district level is critical to bridging gaps in the HIV care continuum, from testing to treatment and viral suppression.Experts say the gap in Delhi is not due to lack of facilities but challenges in linking patients to care and retaining them in treatment. “Delhi’s current treatment coverage of around 70% does not point to a lack of hospitals or medical expertise. Instead, it reflects a last-mile gap in the HIV care continuum where patients are diagnosed but may not be seamlessly linked to treatment, or struggle to remain engaged in long-term care,” said Dr Neeraj Nischal, Prof of medicine at AIIMS.Delays in starting therapy, stigma, treatment interruptions and the realities of a highly mobile urban population continue to limit progress. Strengthening early initiation of treatment, better patient tracking across facilities and more flexible care models—especially for migrant populations—could help close the gap.He also emphasised the need for portable treatment systems, including a unified patient database, multi-month dispensing of medicines and community-based distribution to ensure continuity of care for people who frequently move for work. The focus, he noted, must shift from a static, facility-based approach to a more patient-centric system that supports continuity of care.Haryana, in comparison, has shown relatively better outcomes with a treatment cascade of around 81:83:95, though further improvements are needed.Nationwide, 219 districts have been identified as priority areas for intensified HIV/AIDS interventions, including 11 in Haryana and 7 in Delhi.The government is working towards the global 95-95-95 targets and is now pushing for an enhanced 95-95-99 goal, with an aim to bring HIV/AIDS under control by 2027.Officials also stressed the need to eliminate mother-to-child transmission through timely testing and treatment.
