Aishwarya Rai calls for action on HIV/AIDS in India;

[Guest guest]

Aishwarya Rai calls for action on HIV/AIDS in India;

Aishwarya Rai describes the spread of HIV/AIDS among women in her

country and a unique attempt to tackle it.

India is on the move, its economy growing rapidly. The gleaming

buildings of its vibrant corporations scrape the sky in its

burgeoning cities, while its universities turn out some of the best

engineers and doctors in the world. Such signs of progress indicate

India's efforts to overcome its development challenges. Although it

struggles to educate the millions who cannot read and to provide

better livelihoods for its citizens who have to survive on less than

$1 per day, there is a powerful sense of energy as its people look

to the future. My work as an actress has taken me across India and I

have seen the challenges and felt the energy. But I have also seen a

new and grave threat to the ability of my country to achieve its

vast potential – the threat of HIV/AIDS.

At an AIDS support centre operated by Freedom Foundation, a private

charity in Bangalore, the beautiful brown eyes of Rajni (not her

actual name), a young Indian mother, look into a bleak future.

Married at 14, she became a widow at 20 when her husband, who ran a

small business, died of AIDS – and she tested positive for HIV. As

she watches her 12-year-old son, also HIV-positive, play in the

courtyard, she speaks sadly of her healthy nine-year-old daughter,

given to her sister so that she does not have to bear the stigma of

the disease. She speaks of a supportive extended family, but frowns

as she describes how the cost of her husband's medical care forced

her family to sell its home and condemned 24 relatives to poverty.

Action now

More than 5.1 million people in India are infected with HIV –

500,000 more than at the end of 2002. Indeed, the country now has

the second highest number of cases in the world. The disease is

already present in all 35 states and some experts expect as many as

15 million people could have the virus by the end of this decade

unless decisive action is taken. By 2010, an estimated 2 million

Indians will die of AIDS if nothing is done to stop the impending

epidemic. Unless we act now, AIDS will ravage India as it has many

countries in Africa, reducing life expectancies in some nations from

60 years to less than 40 and setting economic development back by

decades.

Unfortunately, the widespread ignorance and stigma associated with

AIDS hampers efforts to prevent the spread of the disease. Lack of

education about its nature and causes leaves some people still

believing that AIDS can be contracted from a mosquito bite or from

shaking hands with an infected person, and others not realizing the

dangers of indiscriminate and unprotected sexual activity. Much of

the publicity about AIDS creates the impression that only

marginalized elements of society – such as sex workers and drug

abusers – are in danger from the disease: nothing could be further

from the truth.

AIDS can affect everyone. It is spreading rapidly through India's

general population in both rural and urban areas: they have some 60

per cent and 40 per cent of the infected population respectively.

One third of HIV-positive people are women: more than 75 per cent of

AIDS infections result from heterosexual intercourse, mostly between

husband and wife.

The increase of AIDS in women – the `feminization of AIDs' – is

particularly tragic because their lack of power and security means

that they can do little to protect themselves from infection by

their husbands, who have usually contracted the disease through

sexual activity outside marriage. Widespread ignorance results in

women being infected without recognizing the danger. Their low

status, and the stigma of AIDS, makes them afraid to go to medical

practitioners for help, and their poverty often puts treatment out

of reach. Rajni's eyes light up in anger as she speaks of other

female clients at the centre who were forced to discontinue

treatment, or had their drugs preempted, by their husbands or

families.

Signs of hope

Population increase, illiteracy, lack of information, stigma and

discrimination, poverty, migration, lack of openness about sex, and

inadequate health expenditures are the main factors that fuel the

AIDS epidemic in India. They promote denial and fear, perhaps the

two greatest obstacles to overcoming the threat. But there are signs

of hope. India's new prime minister, Dr Manmohan Singh, is calling

for social reform to fight gender and class inequalities that

promote the spread of AIDS. The government has initiated a

surveillance system to test for HIV/AIDS at 450 sites across the

country. Awareness levels are slowly rising as leaders across the

political spectrum recognize the need to unite in their efforts to

fight the disease.

Victory in the battle against AIDS will require an attack from all

sides. Awareness campaigns can overcome denial. Advocacy efforts

designed to promote better awareness of the causes of the disease –

as well as of the fact that everybody is at risk – can reduce the

stigma associated with it. The attack on AIDS cannot be separated

from the issues of poverty and human rights. Advocating safe sexual

practices will have no effect unless the rights of women are

strengthened and respected. Prevention strategies will have little

effect, and there will be little incentive to report infection,

unless there are links to treatment that provides hope to the

afflicted. Treatment, in turn, cannot be separated from efforts to

improve livelihoods, as anti-retroviral drugs can be harmful to an

empty stomach.

India need not fight this battle alone, and it can certainly learn

from successful efforts elsewhere in the world. Preventing an AIDS

epidemic will require effective partnerships. In the Bellary

district outside Bangalore, Karnataka, and in five other states, an

example exists of partnership between these states, the central

Government, the United Nations system and NGOs that has begun to

reduce women's vulnerability by raising awareness of their

reproductive health and rights. It also seeks to empower them to

negotiate sexual relations and to increase their access to

reproductive health services and information.

The CHARCA (Coordinated HIV/AIDS Response through Capacity Building

and Awareness) initiative – jointly financed by the United Nations

Foundation and the Government of the Netherlands – focuses on women

and girls aged between 13 and 25. It will engage communities and

empower women through community-based organizations such as Freedom

Foundation in collaboration with female elected village officials.

Equality and justice

The CHARCA project is one of the first district-wide interventions

for young women in the general population. It is working towards

creating an environment that fosters equality and ensures justice

for women and girls, seeking to equip them both to protect

themselves against the virus and to realize their rights.

In spite of her condition, Rajni is hopeful. She is one of the

fortunate ones with access to treatment. She is amazingly calm.

Asked why, she says: `I have faith in my country. We will find a way

to address AIDS. If I am not saved, at least my daughter will not

have to suffer as I have suffered.' We must keep faith with her and

the millions of victims of the disease in India and worldwide and

each do our part, however small, to make a difference

________________

Aishwarya Rai, a former Miss World, has won many `best actress'

awards for her Bollywood roles and last year was the first Indian

actor to be a member of the jury at the Cannes Film Festival. She is

to star in Bride and Prejudice opposite and in

Chaos with Meryl Streep.

__________________

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