TORONTO, Canada, Aug 14, 2006 (AFP) - South Asia's AIDS epidemic could smash through vulnerable populations unless India and its neighbours take the battle into high-risk areas, including the sex industry, the World Bank warned Monday.
The report, issued at the world's biggest-ever AIDS meeting, painted a picture of an HIV time bomb that ticked in South Asia -- but also said there was hope of defusing it with fast, pinpointed action.
The study tracked the spread of the AIDS virus through India -- where 60 percent of all people living with AIDS in Asia live -- and seven other South Asian nations, laying out an anti-HIV battle plan.
"South Asia's HIV epidemic is severe, but further spread is preventable," said the report, entitled "AIDS in South Asia."
To stop the spread of the disease, South Asian nations must roll out prevention programmes for sex workers and their clients and intravenous drugs users and their sexual partners, as well as for gays and bisexuals, the report said.
A second string of the strategy must tackle the "social and economic drivers" of the epidemic, including poverty and sex trafficking of women, the report said.
Without prompt action, prospects for checking the spread of AIDS in India may be dire, confounding some recent grounds for hope.
Earlier this year, new data indicated that HIV prevalence had dropped over a third among 15- to 24-year-olds in the southern states of Tamil Nadu, Maharashtra, Karnataka and Andhra Pradesh. Those areas are home to 75 percent of people living with HIV in India and have been the main targets of the country's anti-AIDS efforts.
Despite this, World Bank experts at the 16th International AIDS meeting warned against a false dawn in India's struggle with AIDS.
"There are absolutely no grounds for complacency, we need to be very careful that we don't begin to say 'there are only five million cases in India,'" said Julian Schweitzer, director for human development in the Bank's South Asia team.
"It's like stuffing the genie into the bottle, it could burst out at any moment if we get complacent."
Schweitzer said South Asia remained a fertile breeding ground for conflict -- partly because of its location between the world's top two drugs-producing nations Afghanistan and Myanmar.
Raging and festering war and unrest were also a threat, he said.
"This is a region with a fair amount of conflict ... and we know that this is a virus which loves conflict."
David Wilson, a World Bank specialist who co-authored the report, said that despite fierce challenges, there were grounds for hope.
"If we can protect vulnerable groups we can avert an epidemic in South Asia," said Wilson. He also said the disease in India was manageable, and preventable.
The Bank report gave conditions reports and offered AIDS strategies for eight countries.
-- India: Stemming the epidemic will depend on prevention programs for sex workers and clients, men who have sex with men and injecting drugs users, especially in northeastern states. Stigma and discrimination of high risk populations also needs attention.
-- Nepal: Again, the disease's toll could be cut by concentrating on sex workers and drugs users and their sexual partners. Nepal's political unrest is a "formidable challenge," and efforts to stop trafficking are vital.
-- Pakistan: The epidemic is mostly fostered among injecting drugs users but is increasingly spreading among men who have sex with one another. But infection among sex workers remains low.
-- Bangladesh: Injecting drugs users and their sexual partner are again under most threat. Sex worker infections are also low.
-- Sri Lanka: Epidemic still at low rate, even among high-risk groups. To keep epidemic under control, programs should target sex workers and clients. "The country has an opportunity it must not lose," the Bank said.
-- Afghanistan: Increasing HIV transmission among clusters of drugs users. Users returning from Iran which has a significant problem of drug use form a high risk.
-- Bhutan and Maldives: Low HIV prevalence and small numbers of drugs users, sex workers and clients. Even so, there is a potential threat, as the tally of injecting drugs users is growing.
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