India needs to redouble efforts to fight AIDS

[Guest guest]

India needs to redouble efforts to fight AIDS

By Vidya Deshpande

Even as global political leaders talk of taking the AIDS bull by the horn,

India's response has been stereotypical: denial, blind panic and victim

blaming. Just as health minister CP Thakur was about to leave for the United

Nations General Assembly Special Session (UNGASS) on AIDS last week, a war

of numbers broke out between UNAIDS and National AIDS Control Organisation

(NACO).

UNAIDS released a special document on UNGASS meet, which said India has 5.6

lakh AIDS orphans. NACO officials hotly denied such numbers. " This would

mean that 10 lakh people have died of AIDS. Even though it is impossible to

arrive at an exact estimate, it is impossible for so many children to have

been orphaned by AIDS " , says JVR Prasada Rao, programme director, NACO.

Red-faced UNAIDS had to retract its figures and issue a statement saying the

figure was included due to an oversight. Last year, when the UNAIDS released

its Global Status Report of HIV/AIDS, it reported that 3.6 lakh people had

died of AIDS. Even then NACO protested strongly and said the figures stood

at 11,000 only. UNAIDS then withdrew these figures.

But government estimates have always been treated as circumspect. After all,

the figure could well be the tip of the iceberg, as sex and AIDS are rarely

topics for open discussions.

But quibbling over figures will not help anybody. India already has 3.8

million infected persons, the second highest in the world. South Africa with

4.2 million infected persons and Botswana with 1.9 million infected people

are being ravaged by the epidemic. " Though 3.8 million maybe just 0.7 per

cent of the population, we are talking about a huge number of infections

here, " says Monalisa Mishra, director of Positive Life, a non-governmental

organisation (NGO) that works with people living with the virus. " It's time

we took concrete action, instead of quibbling over numbers, " she adds.

The infection in India has come a long way since the first case of full blow

n AIDS was reported in Chennai in 1986. Today, everyone recognises that

India is at a very crucial stage. Most scientists would consider 1 per cent

infection rate to be alarming and India is not too far away from that

figure. The real danger figure is considered to be 5 per cent, from where it

would be difficult to stop the devastation. Newsweek, quoting a World Bank

reports says that the infection has already spread beyond the vulnerable

groups to the mainstream society. " AIDS is ticking like a time bomb in

India, " the newsmagazine says.

On the basis of these figures, Mr Thakur said before leaving for the UNGASS

meet: " We will asking for a big allocation of funds. " Interestingly, UN

secretary-general Kofi n announced the setting up of a multi-billion

dollar international fund to fight AIDS, malaria and tuberculosis. Initial

contributions have already totalled over $400 million pledged by France, the

United Kingdom and the United States. The Bill Gates Foundation, too, has

donated $10 million as well as Credit Suisse, International Olympic

Committee and Ted 's Foundation.

The fund will be operational by the end of the year and is meant to

supplement countries' efforts to fight HIV/AIDS. The final agenda, which

will be signed by all the participating countries at UNGASS, clearly states

that developing countries have to pledge funds from their own resources and

the global fund will only be in the form of additional support to AIDS

control programmes in these countries. " Spending on AIDS in the developing

world needs to increase five times its present level. African leaders at the

Abuja summit (held in April this year) said they are ready to provide their

share. I urge the leaders (in developed countries) to act accordingly and

mobilise the money required for this exceptional effort, " Mr n said at

the UNGASS meet in New York.

India's budgetary allocation for NACO is Rs 180 crore, a mere 3.1 per cent

of the country's health budget. " Of this, Rs 30 crore is being spent on the

North-east states where infection rates have reached alarming proportions, "

Mr Rao points out. But despite this, Mr Rao is not disappointed, " It is the

highest allocation ever to fight any disease in the country, " he says.

The UN estimates that countries will need $1.5 billion a year for palliative

care of infected persons and their families and care for orphans to control

the face of AIDS in sub-Saharan Africa. Adding anti-retroviral treatment

(ARV) to this will costs several billion dollars more. At current prices,

introducing ARV treatment in the public health system will cost India $350

per person. " This is way too expensive and we are not thinking of it for the

present, " says Mr Rao.

In countries like Botswana, where the adult prevalence rate is approaching

36 per cent, has prompted the government to redouble its efforts to bring

the epidemic under control. South Africa, too, has renewed its efforts to

control the epidemic. Uganda is the only African country to have turned a

major epidemic around. Its national mobilisation effort is being cited as a

world example, with the prevalence rate being pushed down to 8 per cent in

2000 from 14 per cent in the early 90s. Brazil's spirited efforts, too, have

contained a major heterosexual epidemic, UN reports say.

The task before India is to contain the infection rate below the 5 per cent

mark. If the infection increases beyond this, it would fairly difficult to

control the spread of the epidemic, considering the vastness of the

population. The time has come for some hard measures, political mobilisation

and public effort.

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