AIDS in India session at XV International AIDS Conference

[Guest guest]

" AIDS in India " at XV International AIDS Conference

INDIA PROMINENTLY SHOWCASED at XV INTL. AIDS CONFERENCE, BANGKOK

The biggest ever-organised event in the field of AIDS at Bangkok from 11-16

July 2004, attended by almost 19,700 delegates and some 2700 media

representatives, witnessed prominent showcasing of India represented by some

1000 delegates from all walks of life including parliamentarians and chief

ministers.

August presence of the leader of ruling United Progressive

Alliance from India Mrs. Gandhi as the chief guest at the glittering

closing ceremony of the conference with African National Congress leader

Mandela is perceived as the highest level political will to contain

HIV/AIDS. Among other things Mrs. Gandhi made a special mention of the PHO's

'Rajiv Gandhi Mobile HIV Counseling & Testing Services' for being among the

UNAIDS best practice.

In a brief meeting with all the Indian delegates and

indiscriminately Mrs.Gandhi mingled with all including gays, lesbians,

positive people, sex workers, obliging them with photo opportunity. On

suggestion, from PHO Secretary General Dr. I.S.Gilada, on hosting 17th Intl.

AIDS Conference in India, she said, 'why not?'

AIDS in INDIA: Among India-specific meets like 'Showcasing India',

'India-Satellite', 'Leadership meet', 'India Evening', Peoples Health

Organisation (India) {PHO} and AIDS Society of India (ASI) organised an

official satellite meeting on 'AIDS in India' on 15th July; which was

addressed by Director General of Health Services, Dr. S.P.Agrawal; Director

of Bill & Melinda Gates Foundation Ashok ; Director of National

AIDS Control Organisation Minakshi Dutta-Ghosh; President of KIS, Munich,

Germany Dr. Hans Jaeger and Dr. Gilada. Earlier in the day, the Press

Conference on 'AIDS in India' was organised by the PHO and ASI, at the Media

Centre of the Conference; which was addressed by Dr.Gilada along with Chief

of DG-8, Health Dept at the European Union, Brussels Dr. Lieve Fransen and

Mr. .

TB-HIV TWIN EPIDEMICS THREATENS INDIA's FUTURE: Need for Public-Private

Partnership, moving away from donor-dependence to avert the Crisis

India's booming economy and its bright future can take a plunge soon, if

efficient steps on war footing are not taken to avert the crisis posed by

the dual epidemic of Tuberculosis and HIV/AIDS. India's distinction of being

world's Information-Technology and pharma-capital is under severe threat.

However, India has an incredible capacity; which is yet to be exploited

fully through true public-private partnership. India can assist less

fortunate countries in HIV care.

1. Past, Present and Future of the Epidemic: India's plunge in the third

phase, as seen from rising HIV trends among housewives and children signaled

a major AIDS crisis. From a terrible disease, AIDS is now a household topic

as a chronic manageable disorder. From more a psycho-social problem prior to

anti-HIV drugs, it is now more of a medical disease; where the virus needs

to be and can be contained, though it continues to have its socio-economic

ramifications. Though the official HIV estimate for India is 5.1 million,

the realistic figure could be ~ 10 millions (PHO) equal to its share in the

world's population (1/6th). The speed of HIV-spread has slowed down during

last couple of years, but the response to contain the epidemic needs to be

hiked. Six states with 32% of country's population have notable

medico-socio-economic impact.

2. Free/Subsidised treatment for PLWHA: WHO/ UNAIDS initiative of 3 x 5:

Over 90% of PLWHA in developed countries have access to ART, but access is

limited to less than 5% of those in developing countries. Nearly 90%

resources are for 10% of the world's population living in industrialized

countries; while 10% of resources are for 90% of the world's population, a

disparity ratio of 81:1! WHO's ambitious plan to treat 3 million HIV/AIDS

patients by 2005, popularly called " 3 by 5 Initiative " has provided a

glimmer of hope to millions of PLWHAs. India decided to join in this effort

and provide free anti-HIV treatment to 100,000 people from 1st April 2004 in

6 priority states for this dole and currently some 1000 PLWHAs are

benefiting. Though a daunting task, it's not impossible, if we really have a

will to achieve this goal. Excellent planning, proper treatment guidelines,

thorough orientation to physicians, and laboratory back up facilities are

needed with fullest transparency. India has capability to cater to the

entire PLWHAs with affordable medicines including Antiretroviral, at 4% of

global cost. A model of Óne-Stop shop´ - that provides authentic education,

adequate counseling, treatment of OI, facilities for tests like CD4/CD8 and

ART at affordable price, developed by Unison Medicare needs to be replicated

in India and Africa. Indian Generic companies now provide ART at 280/-$ per

year.

3. Moving from 'Donor-Dependence' to 'Self-reliant' National AIDS Control

Program: Support from Bill Gates, the World Bank or Global Fund on AIDS,

Tuberculosis and Malaria for our AIDS program, pleases us all. But

rationally we feel ashamed! When India's economy is booming, its foreign

reserves are 120 billion US$ and it pre-paid ADB loans, do we need the World

Bank loan to stop AIDS? Why our Health budget is a just 0.37% of GDP and 2%

of the Defense budget. However the Govt. has committed to raise it to 2%. We

must mobilize Indian business in contributing to the healthcare. If Gates

can donate 200 million US$ for India, why can't our business giants match it

for our own people? Recently, an Indian Industrialist spent more than the

annual national AIDS budget on a wedding ceremony in Paris! It seems that we

have miserably failed to convince our business houses. High 'political will'

to contain HIV is needed beyond occasions like World AIDS Day, transgressed

into realistic action plan, even by creating a special AIDS Ministry as in

Thailand.

Make NACO an autonomous forceful body with multi-sectoral

collaboration. Government should spend its own funds at all levels, for

ownership and participation in the program. Generate local human and

economic resources for capacity building to overcome 'donor-dependence' and

'donor fatigue', critically review liability vis-à-vis benefits of foreign

collaborations. Continuum of program is not guaranteed if it's donor-driven.

Time-tested models like 'Saheli Project' be replicated to avoid re-inventing

the wheel. Strengthen AIDS case reporting system using local diagnostic

criteria. Training must emphasize attitudinal change towards PLWHA. Expose

fake cures and fraudulent people, quacks bullying PLWHAs. Government should

remove taxes on tests and drugs required for ART and pass AIDS

Anti-discrimination bill. Access to information, counseling, testing should

precede access to ART.

4. Women & Children: Reduce vulnerability of women to HIV by improving

health, legal and social status. Prevent mother to child transmission as an

emergency. Spending years to assess feasibility inflates number of HIV

infected children. Project like PHO model at Wadia Hospital (1993-2002) and

included in the UNAIDS 'best practice' should be replicated, to save our

next generation, rather than relying on a redundant African model of

single-dose Nevirapine at labour.

5. Youth, Alcohol & AIDS: Nearly 70% HIV cases are in age group 20-35. Often

HIV prevention and promotion goes hand in hand. Few public-service spots on

AIDS prevention and several exotic surrogate ads on Alcohol promotion with

brand ambassadors, and poor prohibition law, is responsible for HIV spread

in India. Alcohol leads to risky behaviours as it lowers inhibition and

leads to increase in HIV spread. PHO observed that alcohol consumption and

seeking pleasures from sex workers increases many fold during festivities.

Teens are vulnerable to discotheques, pubs and 'Wet parties' followed by

'Sex parties'. Provide youth with Sex Education and means to protect from

HIV/STDs with regular supply of condoms. With these measure, PHO hopes to

achieve a major containment of AIDS and better access to ART.

Dr.I.S.Gilada, Secretary General, PHO & ASI

Peoples Health Organisation (India)

Municipal School Building, J.J. Hospital Compd, Mumbai-400008

Tel.+91-22-23719020; Fax: 23864433; Web: www.aidsasia.info E-mail:

ihoaids@...

July 18, 2004