Fears grow that AIIDS could spin out of control in India

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Fears grow that Aids could spin out of control in India

By Ray Marcelo in New Delhi

Published: October 22 2003: Health experts fear India's Aids crisis

could spin out of control, despite generous funding for HIV schemes

and official recognition of the seriousness of the disease.

India has moved on from a time when health officials called Aids

an " imported " disease confined to people on society's fringe. The

political consensus in New Delhi now sees Aids as a national health

and social crisis.

But despite the sense of urgency, health experts fear that India has

less than 10 years before infection rates leap out of control, from

4.58m HIV-infected people now to infection rates in the tens of

millions.

Money is pouring into India's HIV/Aids schemes. Between 2000 to 2005,

the government, World Bank, aid donors, and philanthropic groups will

have pledged $621m (€534m, £371m) towards Aids awareness, prevention

and treatment projects.

But despite this kind of money funding the battle, India is not yet

beating Aids, says the World Bank. In a review of India's National

Aids Control Project, a copy of which has been seen by the Financial

Times, the Bank says the 35 state-level Aids control societies and

the 735 non-governmental organisations fighting Aids lack the

resources to beat the disease.

About a third of the jobs in state Aids control societies remain

vacant. Many NGOs lack the technical skills to implement national

Aids control policies. And field data remains unsatisfactory because

only 40 per cent of groups on the ground regularly send information

to the National Aids Control Project's computer database, the Bank's

review says.

Moreover, the Bank says India's National Aids Control Organisation

(NACO) has not provided enough technical assistance for state Aids

control societies, and describes as " deficient " NACO's supervision of

state projects and the NGOs that deliver services.

NACO recognises that its projects alone cannot beat Aids. Meenakshi

Datta Ghosh, its project director, said at a conference in New Delhi

last week that NACO-run Aids care centres, for example, only touched

the fringe of the problem.

" We need to tap the primary healthcare system. We need to ensure that

HIV and Aids no longer runs as a standalone disease control

programme, " Mrs Ghosh said. " We have 5,000 community health centres

across the country. But these centres are not equipped to deal with

people living with HIV and Aids. "

Mrs Ghosh has appealed to business to help join the fight and has

found support from groups such as the Bill and Melinda Gates

Foundation, which last week doubled to $200m its fund to fight Aids

in India - thought to be the single largest grant the fund has ever

given.

Ashok , the Gates Foundation's New Delhi-based director,

said one main task was to conduct large scale " social marketing "

about Aids awareness, prevention and treatment among truck drivers in

the six states with the highest rates of infection.

One of Mr 's plans is to establish " good health " clinics for

people with sexually transmitted diseases. Many of these centres will

be located among the 9,000 petrol stations owned by the Gates

Foundation's business partner, Indian Oil Corporation.

India's government wants more of these so-called " public-private "

partnerships to join the Aids battle. In a boost to this thinking,

management consultancy Booz Hamilton plans to release details

of a " simulation " involving companies, NGOs, government agencies and

health experts fighting Aids in India.

Burns, senior vice-president of the firm, said the simulation

had found that if all groups improved their co-operation, India's HIV

infection rate could fall to less than 2 per cent of the population

by 2010, instead of the forecast 4-5 per cent. And, she said, the

loss to India's GDP could be halved to $7bn by 2025.

But as Fernandes, an Indian parliamentarian, pointed out,

beating Aids in India is as much about beating unemployment; as

people move to cities searching for work, many return home with the

disease. " To say that we'll handle this problem within a period of

five years, or even in 10 years, is wishful thinking, " he said.

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