AIDS in India deserves more attention than before

[Guest guest]

XIV INTERNATIONAL AIDS CONFERENCE Barcelona, July 7+IBk-12, 2002

Peoples Health Organisation (India)

Municipal School Building, J.J. Hospital Compd, Mumbai-400008

Tel.3719020; Fax: 3864433; E-mail: ihoaids@...

Local Address : 6 -13 July: Hotel Turin, Pintor Fortuny, 9, 08001 Barcelona.

Ph:93302 4812

PRESS CONFERENCE at BARCELONA: PRESS RELEASE July 8, 2002

AIDS IN INDIA+AKg DESERVES MORE ATTENTION THAN BEFORE:

India, a country with one sixth of the world+IBk-s population and one fifth of

world+IBk-s HIV infection load, got Zero for its AIDS projects from the Global

Fund for AIDS, Tuberculosis and Malaria (GFATM) in its first disbursal of the

US$616 million grant recently., for its fight against AIDS. Only 1.97 million

US$ has been approved for TB and nothing for Malaria and AIDS, 0.3% grant for

18% of the world+IBk-s population. We must introspect ourselves, discover

politics or lacunae behind our failure and make proper applications to GFATM

for the second round of grants.If we still do not succeed, we need to develop

infrastructure with the support our own corporate sector.

A serious review of actions, statements and statistics of UNAIDS and NACO

vis-+AOA-vis AIDS scenario in India over a decade, makes me wonder. In 1991, our

government believed that there were only 100,000 HIV infections in India; this

estimate escalated to 1.6 million in 1992 with the arrival of the World Bank

with its kitty, a 16 times jump in one year! In last 6 years, since the 11th

International AIDS Conference in Vancouver in 1996, where the UNAIDS Executive

director Dr. Piot said that India is the country with the largest number

of HIV infections; we have been getting a lot of rhetoric. The most surprising

thing that NACO put on its website is that India has controlled the spread of

HIV/AIDS and that there is decrease in new infection rates. The beautifully

drawn graph shows that NACO has in fact overcome the HIV epidemic +IBM from

100,000 in 1991 to 3.5 million in 1998 and now to 3.97 million in 2002,

systematically avoiding to cross the magic figure of 4 million. It would have

been good, if the UNAIDS and our Government would have come out with concrete,

implementable action plan, incorporating successes and failures in past two

decades of the epidemic, for a change. It seems that there is a gross

'intellectual bankruptcy' and some political compulsion to accept the reality.

India does have lot of strengths to offer to the rest of the world. Besides

Khajuraho and Kamasutra to be used as tools of HIV prevention with the motto

+AKg-Many Sexual Postures with One partner than one posture with many

partners+AKg

, family system where senior family members doubles up as counselors and care

givers, today India has a capability to cater to the entire PLWHA population

in the developing countries with affordable medicines including

Antiretroviral. What is required is to create a model of +ANM-ne-Stop shop+ALQ -

that provides authentic education, adequate counseling, treatment of OI,

facilities for investigations like CD4/CD8 and an outlet for ART at affordable

price. We do not need any support from the west for this exercise, as their

models are very expensive and unaffordable to our people. A desired model does

exist and is highly successful. We are in process of replicating it in several

places in India and some of African countries. Beginning is made in Democratic

Republic of Congo. We are willing to offer our expertise and services

elsewhere. We must learn from experiences and mistakes of the west.

After the offer of Indian Generic companies to provide ART at 300/-$ per year,

the multinational companies aree left with only one option - +IBg-Step in Today

or Fade-out Tomorrow!+IBk

Dr. Lieve Fransen,Head-Human & Social Development,European Union; Dr.Salim

Habayeb of the World Bank; Dr. Hans Jaeger, of KIS,Munich; Dr.Arun Purohit of

Ranbaxy and Heinl Wolfgang(UK),Hetero Drugs addressed press in solidarity with

PHO.

The North-South Divide:

Parameters Developed Countries Developing Countries

Consumables in hospitals Wear and Tear Wash and Wear

ART approach Hit Early, Hit Hard! Wait and Watch till illness

Strategy for treatment Based on lab. reports Based on signs/symptoms

Goal for ART/HAART Undetectable viral load Asymptomatic patient

Cost Burden Third party Out of pocket

Affordability of patients Can afford patented drugs Can+IBk-t even afford

Generics

Our Priorities:

1. Political Will: High level 'political will' to contain HIV not only

for the occasions like World AIDS Day, but all around, transgressed into

making and implementing the action plan +IBM even by creating a Special

Ministry on AIDS, as was done in Thailand during 1992-94.

2. National AIDS Control Organisation (NACO): Make it a truly independent

forceful body and have multi-sectoral collaboration. The government should

allocate its own funds to establish its ownership and true participation and

generate local human & economic resources to overcome 'Donor Dependence

Syndrome' followed by 'Donor Fatigue Syndrome+IBk. We must critically review

foreign collaborative programs and their liability vis-+AOA-vis benefits.

3. Support to NGOs: Earmarked funds should be allocated to NGO sector.

There is no proper definition of NGO.

4. Case Reporting and Care: AIDS case reporting system needs to be

strengthened, by using local diagnostic criteria. Strategies to motivate

proper reporting should be in place. Though STD management is major program

component, equipment, testing kits and adequate and regular supplies of

medicines are not made available in the STD clinics. People with HIV/AIDS have

poor access to humane, authentic and subsidized care. They are often subjected

to discrimination and exploitation. Training emphasizing attitudinal change

towards PLWHA rather than mere technical input should be in place. We should

unequivocally expose fake AIDS cures and fraudulent people including quacks

bullying HIV/AIDS patients.

5. Women & Children: Reduce vulnerability of women to HIV by improving

health, legal and social status. Prioritise preventing mother to child

transmission without reinventing the wheel and without loosing time.

6. Youth: Provide youth with Sex Education and means to protect from

HIV/STDs.

7. Condom Supply: Uninterrupted and adequate condom supply of condoms

even to the beneficiaries of targeted intervention project remains elusive.

Often there is confusion between fress distribution, Social Marketing and

trading in condoms that needs to be avoided.

8. Access to Anti-retroviral Treatment (ART): The Federal Government has

removed Excise duty and customs duty on ART since April 2002; however the

state governments still charge sales tax and other levies on ART. Access to

HIV-information, access to quality HIV-counseling, access to authentic

HIV-testing should precede access to ART. AIDS Anti-discrimination bill should

be passed urgently.

9. Implementation of program: It is critical that the National AIDS

Control Program is implemented well rather than it remaining a good program on

paper.

10. Access to ARVs should be further expanded by according +IBg-life-saver+IBk

status, by compulsory licensing to generic manufacturers that is legal under

World Trade Organization (WTO) agreements and the Agreement of Trade Related

Aspects of Intellectual Property Rights (TRIPS).

Dr.I.S.Gilada, Chair, AIDS in India & Secretary General, PHO

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