PARIS, July 25 (AFP) - The United Nations' top official on AIDS has bluntly told India that if it wants to skirt catastrophe, it must pump money into distributing condoms, tackle stigma and smash a wall of silence about sex.
India, with its huge contrasts of wealth and poverty, "is a land of castes, of stigmatisations, and conservativism is not making it easy to promote condom use," UNAIDS Executive Director Peter Piot said ahead of India's biggest-ever forum on the AIDS crisis.
"If you cannot talk about sex, you cannot attack AIDS. Distributing condoms has to be part of the prevention strategy."
Piot mentioned no names in his interview with AFP, but his remarks seemed to be aimed at Indian Health Minister Sushma Swaraj, who is a critic of so-called "condom-centric" prevention policies.
Swaraj, under pressure from conservatives, recently told the press that her country's AIDS programme had to focus on sexual abstinence and monogamy rather than just condoms, a stance that has caused dismay among HIV campaigners.
"India has more than four million people with HIV. It probably has more infected inhabitants than South Africa," Piot said, referring to the country that at present has the largest number of people with the human immunodeficiency virus.
"It has to act now before the epidemic infects tens of millions of people, which will surely happen if things continue down this path."
Piot's grim predictions are backed by the US Centers for Disease Control and Prevention (CDC), whose director, Julie Gerberding, warned on July 3 that China and India were on the brink of following Africa down the path towards "catastrophe."
According to the US National Intelligence Council, the number of Indians with HIV/AIDS could reach 25 million by 2010.
"This is the most pessimistic estimate, but it is not impossible. This is why the time to act is now," Piot said.
Piot was interviewed on Wednesday ahead of a major two-day gathering to assess India's worsening AIDS problems.
The first-ever National Convention of the Parliamentary Forum on HIV/AIDS, meeting in New Delhi on Saturday and Sunday, will gather legislators, state ministers, mayors and local leaders.
One of the goals is that by speaking openly about HIV/AIDS, these figures will attack discrimination and stigma -- two of the conditions that drive the epidemic underground and let it flourish.
Piot warmly praised the meeting as "a breakthrough event... it is an unprecedented show of unity, and about time, too."
He called on lawmakers to approve laws that would discourage and punish the stigmatisation of people with HIV and push through budgets to expand prevention efforts.
Piot said he was struck by the diversity of the HIV/AIDS problems in India, highlighting incidence of the disease in the western city of Bombay and surrounding Maharashtra state.
"In Mumbai (Bombay), 50 percent of prostitutes have HIV and across Maharashtra state, between three and five percent of pregnant women are infected, which is enormous," he said.
But in the same state, he noted, big strides had been made to dampen prevention among risk groups.
Condoms were being used by 66 percent of known sex workers, 77 percent of their clients and among 52 percent of intravenous drug users, he said.
In Tamil Nadu, more than one percent of the total population is infected, he said. As many as three out of every four intravenous drug users in the southeastern state of Manipur, near the border with Myanmar, had the virus.
Again and again, Piot said, experience in other countries had shown that the virus does not stay confined to small groups within the population -- it leaps out and infects the wider community.
030725
AF0307B8
©AFP 2003. All Rights Reserved. AFP articles contained on the AEGiS web site may not be reproduced, distributed, transmitted, displayed, published or broadcast without AFP's prior written permission. You may make one copy of each article for your personal, non-commercial use only; more copies would require AFP's prior written permission. obtained from the owners of any trademarks or copyrighted materials whose marks and materials are included in AFP photos or materials. Therefore you will be solely responsible for obtaining any and all necessary releases from whatever individuals and/or entities necessary for any uses of AFP stories, photos or graphics. - http://www.afp.com/
AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2003. This material is designed to support, not replace, the relationship that exists between you and your doctor.
©1990, 2003 - AEGiS. AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.
