J.V.R. Prasada Rao, APCOM HIV/AIDS Ambassador launched his book ‘Celebrating Small Victories’ just in time for World AIDS Day 2020. Former Health Secretary, Government of India, Prasada Rao worked extensively in health sector during and after his retirement from Government in 2004. Prasada Rao then moved to Bangkok as Regional Director for Asia Pacific region of UNAIDS, the joint UN programme for control of AIDS until 2009. Prasada Rao was then appointed as the Special Envoy on AIDS for Asia Pacific region by the Secretary General United Nations, Ban Ki Moon. He interacted closely with political leaders including Presidents and Prime Ministers of countries in the region for prioritizing AIDS control in the national plans and strategies. He facilitated discussions on inclusion of AIDS elimination as a Sustainable Development Goal (SDG) for 2030 which was finally adopted in the UNGA declaration on SDGs in 2015. He also functioned as the Commissioner Secretary of a Global Commission on HIV and Law initiated by UNDP.
In 1997 when I was asked to lead India’s national response to AIDS, little did I ever thought that it will lead to an exciting and purposeful journey running into two decades and still ongoing. I also did not realise that India was going through the peak of the epidemic in the nineties and the response was unequal to the challenge. When I organised the first national sentinel surveillance for the entire country, the number of infections amounted to 3 million and not the 90 thousand that was getting officially reported.
I was fortunate to work under a visionary Prime Minister Atal Behari Vajpayee who could perceive the challenge and pulled India out of the denial mode by launching one of the largest AIDS control programmes in the world with an outlay of $610 million. The National AIDS Control Programme (NACP) Phase 2 met with enormous success in halting the march of the runaway epidemic and started the process of reversal.
In implementing this large programme we could bring several innovations, most important being the intimate involvement of communities who were at risk. My first exposure to these groups which was vividly described in the book resulted in a long and mutually beneficial partnership leading to their empowerment and access to services on a much larger scale.
People living with HIV/AIDS were still not able to access anti- retroviral treatment because of the prohibitive cost. The Indian generic form CIPLA announced a drastic price reduction for first line ARVs which led to drastic reduction of global prices and laid the foundation for one of the largest treatment programmes in India which presently covers 1.2 million people.
The book continues with my tryst with AIDS responses in the Asia Pacific region as the Regional Director of UNAIDS. The next five years saw an intense involvement with the countries of the region to reignite political will and financial commitment to AIDS control programmes. The two independent commissions on Asia and the Pacific on which I served as Member Secretary could successfully bring out the huge economic cost societies will incur if HIV epidemic goes unchecked. The reports which were launched by Secretary General Ban Ki Moon stimulated interest among policy makers and programme implementors in the region to accord priority to AIDS in the national policies and planning.
The book later traces my next phase of involvement as the Special Envoy of UN Secretary General for the Asia Pacific in the run up to the SDG summit of 2015. I was also deeply disappointed by the follow up action in the UNGASS on drugs and the High Level Meet on AIDS in 2016 where the communities were made to act as bystanders.
My narrative ends with an epilogue where I tried to critically analyse the reasons for the waning interest of countries in AIDS agenda and the internal crisis in UNAIDS in 2018 leading to change of leadership. The book essentially aims at two sections of readers – those who are involved in the AIDS response then and now, and young students wanting to pursue a career in public health who would understand the challenges and opportunities in implementing large disease control programmes.