World Bank study: HIV/AIDS Treatment and Prevention in India, Costs & Consequences

[Guest guest]

Dear Forum members,

Number of New HIV Cases in India Could Reach 5.5M Annually by 2033 if Prevention

Measures Not Implemented, World Bank Says

[Aug 16, 2004]

The number of new HIV infections in India could increase to 5.5 million annually

by 2033 if " urgent steps " are not taken to prevent the disease's spread,

according to a World Bank report released on Friday, Reuters/News reports

(Reuters/ News, 8/13). The report, titled " HIV/AIDS Treatment and

Prevention in India: Costs and Consequences of Policy Options, " outlines

different public funding options for HIV/AIDS prevention and treatment programs

to assist the government in maximizing the use of antiretroviral drugs to fight

the epidemic, according to a World Bank release (World Bank release, 8/13).

If the Indian government does not increase its prevention efforts, HIV/AIDS will

become the leading cause of death in the country, accounting for 17% of overall

deaths and 40% of infectious disease deaths by 2033, according to the report.

Currently, HIV/AIDS accounts for 2% of deaths and 6% of infectious disease

deaths in India. According to the Indian government, there were 5.1 million

people living with HIV/AIDS in the country in 2003. Although India has a program

to fight HIV/AIDS, the disease has spread beyond high-risk

groups into the general population, according to Reuters/ News

(Reuters/ News, 8/13).

The report recommends that the government improve its data collection on the

epidemic, improve the quality of antiretroviral treatment provided through the

private sector and evaluate different treatment programs to maximize patient

adherence to medication regimens, according to the release. In addition, the

report advises the government to continue to scale up prevention programs to

discourage multiple sex partners and needle sharing to inject drugs and

encourage condom use, according to the release (World Bank release, 8/13).

Reaction

The Indian government has said it believes the increase in the number of new HIV

cases is stabilizing and it does not expect the country will face HIV/AIDS

prevalence close to that seen in sub-Saharan Africa, the Financial Times

reports. However, some international health experts say that India has many

of the same factors that played a role in helping HIV spread throughout

sub-Saharan Africa in the 1990s, including migrant labor, large numbers of

commercial sex workers and stigma about sex and HIV/AIDS, according to the

Times. Mead Over, a World Bank economist and one of the authors of the report,

said that although condom use had increased during the 1990s in India, the rates

of condom use recently have steadied, according to the Times.

Over also warned that without an increase in voluntary HIV counseling

and testing and an improvement in patient monitoring, resistance to

antiretroviral drugs could spread rapidly (Dyer, Financial Times, 8/14).

Heywood, a World Bank health specialist and a report author, said,

" Antiretroviral therapy is not going to have a big impact on the course of the

epidemic, " adding, " What will have an impact, however, is the use of

condoms and prevention " (Reuters/ News, 8/13). He added, " If energy and

resources for prevention start to decline, the results would be a reversal in

progress made in fighting the epidemic in India "

(World Bank release, 8/13).

A kaisernetwork.org video feature on HIV/AIDS in India is available online. The

report -- prepared by Fred de Sam Lazaro, also a correspondent for the

NewsHour with Jim Lehrer -- includes interviews with people who are on the front

lines of India's efforts.

source: Kaiser network and from the World bank

HIV/AIDS Treatment and Prevention

NEW DELHI, August 13, 2004—As the Government of India takes stock of its first

four months of distributing free antiretroviral medications for HIV/AIDS, the

World Bank has released a study of various public funding options for the months

and years ahead, designed to help the government maximize the positive

impact of the drugs on the growing epidemic.

The study, HIV/AIDS Treatment and Prevention in India: Costs and Consequences

of Policy Options, focuses on ways the government can provide sustainable

antiretroviral therapy (ART) to the greatest number of people while avoiding

dangerous pitfalls such as the development of drug-resistant strains of HIV and

a surge in risky behavior by people who mistakenly assume the drugs are a cure

for HIV/AIDS.

Full report. [156 pages, 470 kb adobe pdf]

http://siteresources.worldbank.org/INTINDIA/Resources/IndiaARTReport1.pdf

Greetings

Phi Huynhdo

E-mail: <huynhdophi@...>

[a pdf copy of the report is available from the moderator]