NEW DELHI, Dec 24 (AFP) - The Indian government suddenly woke up to AIDS in 2003 by proposing cheaper drugs and moving away from its past stress on abstinence, but critics say more needs to change to combat the epidemic.
India has 4.58 million people with HIV/AIDS, second only to South Africa with five million, and a recent study warned the figure could skyrocket if urgent action is not taken.
The Hindu nationalist-led government, in power since 1998, had long come under fire from activists for saying AIDS prevention should focus on abstinence rather than condom use.
Health Minister Sushma Swaraj started to change the tone in early 2003 when she publicly hugged two HIV-positive young children and intervened to get them admitted to school, where they had been turned away.
"There are such cases of terrible cruelty against HIV patients in India that we have to follow a holistic approach to fighting stigma," Swaraj said. "And people's attitudes are changing.
"Condom usage is a must. We are saying this all the time but there is no harm in also saying people should be faithful to their partners."
However, critics say the AIDS strategy remains marred by dull awareness programmes, poor treatment facilities and ignorance about the disease in villages, where 85 percent of India's billion-plus people live.
"Awareness levels of HIV/AIDS in rural areas are shockingly low," said A.R. Nanda from the non-governmental Population Foundation of India.
"Indian men tend to leave their families behind in villages to go out to find work, some of them have no scruples about engaging in sex outside marriage and a vast majority of them (with HIV) later infect their unsuspecting wives."
"Can the poor wives insist their husbands wear condoms? Yes, in an ideal world, but in India most women are forced to treat their husbands like God."
Nanda's group and the Washington-based Population Reference Bureau last month issued a report saying India could see an AIDS epidemic similar to that in some African countries where it is the leading cause of death.
The study said that while 90 percent of people living in cities knew about HIV/AIDS, more than a quarter in rural areas had never even heard of the disease.
The Indian government got a jolt in November 2002 when a foundation set up by Microsoft head Bill Gates pledged 100 million dollars to combat the disease in India.
Even though some officials here accused the software mogul of spreading panic, the Bill and Melinda Gates Foundation doubled its contribution a year later.
Former US president Bill Clinton also got involved, working with three Indian pharmaceutical companies to slash the costs of AIDS drugs by nearly a third to 38 cents a day for the developing world.
But Clinton's initiative did not involve Indian patients. New Delhi later announced its own plan to cut prices even lower to less than 20 cents a day, compared with the current average of one dollar.
Meenakshi Datta Ghosh of the state-run National AIDS Control Organisation said the government was negotiating with Indian drug companies to get "rock-bottom drug prices" for patients by April 2004.
"We are doing everything to make sure Indian AIDS patients get the world's cheapest drugs," said Ghosh.
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