WASHINGTON, June 30 (AFP) - The World Bank on Wednesday accused India and other South Asian nations of sweeping the ballooning HIV-AIDS problem under the carpet, warning that they would be devastated by an African-like crisis if no swift action is taken.
The Washington-based bank, which has poured 380 million dollars to date for national HIV/AIDS programs in South Asia, said a key obstacle in overcoming the problem was refusal of the political leadership to accept the fact that the disease had gained a foothold in the region.
"The leaders are in a state of denial and there is a very high level of discomfort to even talk about it," said Praful Patel, the World Bank Vice-President for South Asia.
He said the leaders thought "HIV-AIDS is an African problem and it cannot happen in South Asia," calling for a perception change in leadership "from the states at the ground level all the way to Prime Minister and head of state.
Patel, who took up his position recently after helping the bank combat the disease in Africa, said he experienced the same attitude among leaders in Africa about seven years ago when HIV/AIDS was emerging as problem there.
"We are facing exactly the same sitiuation in South Asia now where this disease has gained a foothold and absolutely there is no serious strategy to address it," he said.
The Ugandan-born Patel said that to his amazement, during a recent trip to India, officials were quibbling about the estimated number of people suffering from the disease rather than moving on to plan strategies to combat the problem.
About eight million people in South Asia are living with HIV/AIDS, comprising nearly one fifth of the world's HIV infections, according to the United Nations.
Almost two-thirds or 4.6 million of those infected are living in India.
Although the infection rate in the population at large is still low due to its large population, India has one of the largest HIV-positive populations in the world, second only to South Africa.
Patel cautioned that the epidemic has already advanced into the generalized state in six of India's 28 states.
"Last week I was in three different states and I met the Chief Ministers. They were not interested when I tried to bring HIV/AIDS on the agenda," he lamented. "In fact, in one state, I tried very hard to bring this up three times."
Other countries in the region, such as Bangladesh, Pakistan and Nepal, are characterized by low prevalence among the general population but have significantly higher rates among subpopulations engaged in high-risk behaviours, such as injecting drugs with contaminated needles and those engaged in commercial sex.
Patel said what was "frightening" was that the size of the subpopulations engaged in high-risk behaviours was extensive, increasing the threat of a rapid spread of infection in the region.
In India, HIV prevalence in the general population was about 0.8 percent but prevalent rates among sex workers in Bombay was nearly 55 percent.
Nepal has a 0.5 percent prevalence rate but among injecting drug users in the country it was as high as 68 percent.
Another worry in South Asia was the reluctance by officials to accept the extensive experience and good practices and lessons learned from fighting the disease in particularly Africa.
"What is the problem in just picking up something that worked in Ghana and Uganda and Thailand?
"The learning that has taken place in dealing with this HIV-AIDS pandemic up to now can be used to leapfrog in the South Asia region," he said.
Patel said the 15th International AIDS Conference in Bangkok from July 11 to 16 would address the multifaceted HIV-AIDS problems in Asia, including the question of leadership.
"Our challenge is how do we put this on the table in such a way that the Indian leaders, for example, cannot leave Bangkok without actually taking this important message home," he said.
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