Re: India Has fewer numbers of HIV positive people

[Guest guest]

Dear FORUM,

Re: India Has fewer numbers of HIV positive people

Once again all parties behind this news seem to be oblivious of the possible

disastrous effect such constant and repeated bickering about numbers have -

beyond the academic, government and research circles.

Its a 'no:s game' now even though many epidemiologists and researchers are not

in agreement on the methodology used, and in India's case (as per the

implication in the New York times article) the surveillance mechanism used so

far may not have been the right one.

While getting a few good pats on the back for apparently 'good' programming by

the govt of India (that may have brought the numbers down), this also has

another dimension which puts at risk the very positive imaging and the human

rights of people with HIV that a lot of organizations have been working for. As

far as the delivery by the Indian state - many already know that the system is

unapproachable, unhealthy and discriminative with more non deliverables than

deliverables. By implying that HIV is much much more (read as 'only') among high

risk groups - the grounds are being laid for more discrimination, lesser

empowerment for women, and more ostracisation and deaths by neglect or stoning

in extreme cases (where the community is mislead)... and as the NY Times said

'an AIDS patient left on the street outside a hospital to die, five infected

children expelled from school, and a woman beaten to death by her in-laws, who

feared she would infect the family'

Irony is (no the outrage is) while all will agree that the 'woman takes the

brunt of AIDS' - yet budget allocations are less than enough for such a

burgeoning 'sexually active' population; yet the justice mechanisms still have

no legislation for affected people in place; yet within the primary health care,

health care system the poor and affected, vulnerable are still denied respect or

help. And in all this we are saying 'actually we have fewer numbers' - and

sooner or later this will lead to lesser commitment of money and expertise. And

it is clear that this may be dangerous to present action on provision of

treatment and indeed 'Universal Access'.

I suspect this debate will now continue and waste a lot of people's time and

energy in chasing up the wrong street of statistics and 'who is right' and 'who

is wrong'. Once again the right, clear, loud message that complacency or any

lesser political and societal commitment to HIV intervention work and rights of

positive people - will result in disastrous setbacks - may be lost in the din.

The question is that it is early days till the methodology of assessment is

found doubtless by experts AND the organizations on the ground.

Also this speculation is being coupled with the national family and Health

survey - whose finding have also NOT been made totally public.

It's also not surprising that the majority of such surveys are underwritten by

American financing.... Through the govt or through American foundations - known

specifically for their thrust on prevention (and now abstinence) only. The govt

of India and certain prominent American foundations have long since backed only

targeted interventions with a 'prevention mostly' focus - that now has an

'abstinence' push - that may or may not work in our active, moving population.

This may mean a bigger call for more such targeted interventions with so called

high risk groups - and lesser importance given and fewer funds for work with

women, children, migrants other minorities. Funds which had been sought by all

of us using the sheer push of advocacy and urgency of situation that higher no:s

imply.

Who will that be good for?! The answer is not too difficult to guess!

Clearly, if there is more doubt on the growing constituency of positive people -

in our kind of 'mixed up' votebank based democracy and lack of functioning

health, human security and justice systems for such persons - then there is

trouble possibly brewing. If the engagement with affected (not just positive)

people's issues does not go up - we might even face more discrimination and on

the prevention side - (its plain logic) the prevention schemes will also have

lesser effect. A spiral.

Ramesh Venkataraman

Asia HIV and AIDS Coordinator

ActionAid International

e-mail: Ramesh.venkataraman@...