Silence kills: Raising the issue of HIV in India

[Guest guest]

Silence kills: Raising the issue of HIV in India

What if every individual in Atlanta was infected with HIV? You would

have an approximate visual for the four million plus individuals

living with HIV in India.

While less than one percent of the general population in India is

infected, India holds 10 percent of the world's HIV burden, second

only to South Africa. India is at a stage of the HIV/AIDS epidemic

that Africa reached a decade ago, and some experts estimate that

more than 20 million individuals will be infected in India by 2015,

exceeding the number in all other countries.

These staggering numbers are devastating not only because of the

lives lost, but because the future of India's economy is at stake.

HIV/AIDS has already frozen many economies in Africa, and threat

that this can occur in India is very real.

Perhaps I am being dramatic. Perhaps not.

The Bill and Melinda Gates Foundation recently donated $100 million

for HIV programmes in India. The Global Fund, a partnership between

governments, the private sector, and affected communities, has

approved an additional $100 million over five years for HIV/AIDS

programs. The growing attention of such charitable organizations

reflects the necessity of an immediate and aggressive response.

On World AIDS Day on December 1, the Government of India promised to

provide free antiretroviral therapies for all children and for

patients in the six hardest hit states in India. These treatments

can potentially improve the lives of those infected; however, they

will not slow the rise of the epidemic. Given the challenges in

infrastructure and training for the health care system for proper

distribution of the medicines, prevention is the most viable and

effective option.

We must capture the opportunity to intervene and control the

epidemic in India, now, before it is too late. The Government of

India's strategic response to long-standing diseases such as

tuberculosis is more expansive than for HIV/AIDS. Tuberculosis,

diarrhea and cardiovascular diseases each costs many more lives than

HIV at this time, so an aggressive response to them is

understandable. But these diseases are treatable and are not

exploding at the rate of HIV, for which there is no cure. Moreover,

the spread of HIV increases the burden of existing diseases,

especially tuberculosis, as opportunistic infections.

As HIV has spread into the general population in India including

upper and middle class individuals, the prevention and awareness

efforts must widely penetrate the general population.

I recently spent three weeks in India learning about the situation

of HIV/AIDS in India, and one thing became abundantly clear: silence

about the issue no longer acceptable. Each of us can make a

difference as a member of the Indian community and as citizens of

the United States.

First, we must accept the severity of the problem. India will soon

have more HIV/AIDS cases than any nation in the world. Presently,

there are more than one million AIDS orphans living in India. I

visited an orphanage in northern New Delhi that cared for orphan

children, most of whom were infected with HIV. These children were

full of joy and prepared a dance to welcome me and my colleagues. My

heart broke knowing that most will not live to see their teen years.

This growing number of orphans illustrates the rising number of

parents dying of AIDS in the productive years of their lives.

Second, we must combat the stigma and lack of awareness of HIV that

has driven the epidemic underground in India, where it spreads

rapidly. I visited several slums in Pune and listened to individuals

living with HIV share their experiences in seeking support and

treatment. Most of their families offered support while physicians

and other hospital staff refused to touch or treat them. Individuals

living with HIV formed support groups and cared for others in the

community who lived with the disease. Even without access to

medications, they gained confidence and continued to live productive

lives because of community support.

As members of the larger Indian community, we must help change the

attitude towards individuals living with HIV/AIDS. The stigma and

violence against people living with HIV/AIDS prevents individuals

from being tested or treated for the disease. Numerous cases of

harassment and violence have been documented against HIV/AIDS

outreach workers helping people living with the disease. The next

time you call your relatives in India, discuss the issue and help

clarify any misconceptions. Encourage them to continue spreading the

message to prevent the spread of the disease. Awareness improves one

person at a time.

Finally, we must make our representatives in Congress aware of our

concerns. Indian Americans currently address many domestic and

foreign policy issues through advocacy. HIV in India is relevant to

individuals both within and outside the Indian American community,

since a real economic threat to India will certainly affect the US

economy.

Indian culture gives us the benefits of having a community-centred

society. We must take responsibility for actions within our

community and provide leadership and moral support. It is an

injustice to continue to ignore the issue of HIV in India and hide

in the convenience of our distance from the problem. Every one

percent increase in HIV cases in India equates to approximately five

million more cases. We must take ownership of raising HIV awareness

in our community and for promoting prevention, control, and

treatment of HIV in India.

(The author is Global Health Prevention Specialist at Centers for

Disease Control in Atlanta, Georgia. She can be contacted at

dcontractor@...)

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