Some questions for discussion on the forum

[Guest guest]

Dear Forum,

I was recently asked the following five questions following

India's first National Parliamentarians Forum on HIV/AIDS held on

25-26 July 2003 in New Delhi. At this meeting roughly one thousand

members from the state and central governments met to plan a cohesive

and effective response to the spread of this deadly scourge. The

convention was addressed by the Prime Minister, many other prominent

ministers, and Dr. Piot, head of UNAIDS.

1. Do you think that India is deprived of international attention for

its HIV/AIDS problem because countries like South Africa get more news

headlines? If so, do you think this has contributed to the spread of

disease?

2. Do you think education about AIDS is getting through to the general

population? What barriers are there to effective communication of the

risks?

3. How do you think the recent political acknowledgement of the problem

will change things for the future? Do you anticipate dramatic decreases

in the numbers of people being infected? Or are there barriers that

cannot be broken down simply by political will?

4. What is the pattern of spread of HIV/AIDS in India?

5. What do you think is missing in the fight against HIV/AIDS in India?

My thoughts on these questions are available at

http://t8web.lanl.gov/people/rajan/AIDS-india/MYWORK/fivequestions.html

I look forward to responses from others.

Best

Rajan Gupta

E-mail: rajan@...

[Guest guest]

Dear Dr Gupta,

For the first time I have seen a most comprehensive and well articulated

response to to the HIV/AIDS problem in India. The answers to the five questions

could be the beginning of a dialogue on an appropriate response to the problem.

While India has been strong in taking independent decisions on major economic

and political issues I am surprised at the way India hascompletely surrendered

to the policies of foreign funding agencies as the only way this problem could

be handled. Your prescription that India has to develop its own programme and

contribute its own money for HIV/AIDS control is absolutely correct. I do not

want to hold all politicians as they are following the 'expert'advice provided

from successful experiences. In many situations these have not bee successful

in India.

I represent an NGO working in Tamilnadu India shunned by all funding agencies

because we have promoted a comprehensive programme including condom promotion

without being condom centric. The population I cover is only about 120,000

people. However over the past 10 years we have consistently provided education

to school children in the 9th and 11th standards each year providing both

HIV/AIDSeducation as well inincreasing self esteem and negotiating skills beyond

just condom usage. At the community level we carry out periodic campaigns. Eac

village has one or two trained peer educators who cater to both young people and

the married populations.

In spite of this effort the percentage of adequate knowledge is only 50%. This

is making us change our strategy in the coming year. Since we are working

for over 25 years we have cumulative annual information on the number of HIV+

and AIDS deaths which are are far below prediced levels. We are conscious that

errors could creep in because of anonymity.

Insted of critcizing which approach is correct, whoever is prepared to promote

any method that would reduce HIV must be encouraged and supported.

This e group should start listing what are the key priority areas that India

should focus on. I believe however much policy planners might try to evade there

is no escape from providing the correct education in a manner that will bring

about behaviour change. It is not easy. It requires time. It is not as easily

measurable as the number of condoms distributed or sold.

Yours sincerely,

Abel

Rajaratnam Abel

E-mail: <rajaratnamabel@...>

[Guest guest]

Dear Abel

I totally agree with your point that one needs to go further beyond the emphasis

of condom usage.With my personal experience over the years with

HIV prevention and care I have realized the following:

1. We do need funds and resources for scientific approach of targeted

interventions which definitely are in for scrutiny with indicators and

which involves systems because the question of money is involved. Well

resources are also essential for any NGO to work with their mission.

2. But on the contrary the individual NGOs should be abled and should have the

capacity to deal with the above in satisfying rightly for the funds received and

at the same time insert and integrate to work with the local prevailing

conditions which differs from target to target. For e.g.. you have rightly said

that it requires time towards behavior change and at the same time we should be

able to look at and realize the complexities of relationships that are present

between the target groups like we are working with the cinema industry one of

the unique projects for the first time in India and what we have realized is

that multi partner sexual relationships has become an accepted phenomena and has

been used in different perspectives which is indeed shocking for the general

community.

Say for instance to get a chance to get into the cinema industry and for that

matter to even enter a dance sequence the women had to yield in to sexual

gratification of the men involved in the cinema industry and especially during

the out door shootings the women are exploited. Under the above context there

are two levels at which we perhaps need to work one is for the instant reduction

of HIV/AIDS prevalence and the other is to reduce exploitation among the women

who are involved in the cinema industry.

Both are complement to each other wherein as an NGO we had to be extremely

shrewd in out state of activities and we cannot just afford to work only

towards BCC strategies.

Why we stress exploitation here is for the fact that the woman in the above

instance does not sell sex for money as a commercial sex worker does but

is being exploited for the situation.

3. Therefore funding organizations be it national or international should take

in a broader outlook and aim to nip of the root to the problem rather than just

to look at the instant needs like condom usage, STD treatment etc.

which of course is required but NGOs should be given facilities and space for

brining out their innovativeness in handling the core problem that which

is beyond safe sex. In other words it need not be condom centric with all

target groups.

Regards

Shyamala ashok

sfdrt - pondicherry

E-mail: aabinand@...