India On The Brink Of
AIDS Catastrophe
By Alan Mozes
DURBAN, S. Africa (Reuters Health) - While concern over the AIDS crisis ravaging sub-Saharan Africa dominates much of the discussion here at this week's XIII International AIDS Conference, researchers and AIDS workers are sounding the alarm for what many consider to be the next big trouble spot--India.
``We have a very serious catastrophe in the offing, and if there's an enemy of India it's not Pakistan, it's not China, and it's not any of the other superpowers--the big threat to India is HIV/AIDS,'' said Dr. Ishawar Gilada, the secretary general of the People's Health Organisation (PHO) in India. PHO is a non-governmental organization established in 1985 to raise awareness about the risks associated with HIV and to promote prevention, control and management of the disease.
With a population of over 1 billion people, India already accounts for almost 20% of all infections worldwide--currently the largest absolute number of HIV infections of any single country. And speakers at two press conferences here cautioned that a pervasive culture of denial about the Indian epidemic, among both government officials and healthcare professionals, threatens to allow the crisis to spin out of control.
``There's been an extraordinary degree of denial about the nature of the problem, and it requires the most extraordinary public health education effort to prevent this from becoming a very major problem,'' said Dr. Roy Anderson, an epidemiologist at the University of Oxford in Great Britain who spoke at a press conference on the future of AIDS.
Labeling the situation in India ``a staggering problem,'' Anderson emphasized the need for an acknowledgement by India's scientific and political communities of the risks AIDS poses to Indian society--along with substantial government funding for education, research, treatment and prevention. But, in a concurrent press conference, Gilada lamented that the current reality is that such funding is practically nonexistent at the federal government level, leaving India's 27 states to fend for themselves in the struggle to raise both money and awareness to stem the rising number of infections.
Gilada told Reuters Health that two of the most hard hit states, Maharashtra and Tamil Nadu, have managed to effect credible AIDS programs that have resulted in a drop in infections. But he emphasized that these success stories are an exception to the current rule, because while India does have a 'National AIDS Control Program,' it is ``all on paper.''
Although India has a relatively strong economy, technological prowess, and 10% of the world's richest individuals, he warned that a lack of national political will to combat the disease means that in the not too distant future, India's epidemic may come to resemble the crisis in Africa.
``We have video channels of about maybe 50 or 100 channels, we have information technology, we have e-mail available everywhere, we have cyber cafes everywhere, but after 5 years or so there will be one HIV patient in each family,'' he said. ``So even though we have all this paraphernalia of development, with an HIV case in each family the people will not enjoy the benefits of development.''
``We're trying to learn from Africa, to avoid the mistakes, but nationally we are repeating the same thing,'' he noted. ''What South Africa has gone through 10 years back India is going through now.''
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