Inter Press Service - May 2, 1999
Ranjit Dev Raj

According to estimates in the report of the authoritative Parliamentary Standing Committee on Dreaded Diseases, one out every four people in the world who are infected with the AIDS virus, lives in India.

The report was tabled in Parliament even as another World Bank anti-AIDS project worth 250,000 dollars got underway. This follows the bank's 84 million-dollar AIDS control project which ran from 1992 to 1997.

Indian lawmakers could not discuss the implications of the report as the house was dissolved following the defeat of Prime Minister Atal Bihari Vajpayee's government in a trust vote last month.

The new figures are a warning that India, which was once seen to be relatively immune to the virus, could face a major public health crisis with severe socio-economic implications.

According to estimates by specialised U.N. agencies, an HIV/AIDS pandemic could cost India 11 billion dollars, or five percent of the total national income, by the year 2000 in health care and lost economic productivity.

However, the latest UNAIDS calculations are based on the assumption that there are only four million HIV cases in the country presently.

Health activists and non-governmental organisations (NGOs) have long protested against alleged mismanagement of anti-AIDs funds and claimed that the World Bank projects have not offered any real help to victims.

The bank project has been criticised for misplaced priorities. The money is provided to the National AIDS Control Organisation (NACO), a federal government body.

Critics say that NACO is spending on activities like information and communication and importing expensive blood banking equipment most of which is lying unused for lack of basic infrastructure like a steady power supply.

"India could follow the example of Thailand which successfully integrated HIV/AIDS management into its primary health care system," says leading anti-AIDS activist Purushottaman Mulloli.

Mulloli and others like him think that HIV/AIDS programmes of the types being promoted by donors cannot work in India in the absence of an effective primary health care system.

The second phase of the World Bank's AIDS control project for India will dovetail into the Ninth Development Plan (1997 - 2002). It aims to provide an enabling socio-economic environment for affected families and victims. Health activists have mounted legal pressure on NACO through a series of public interest appeals in the courts to compel the organisation to do what it was mainly set up for.

One of them is SAHARA which runs the only hospice for people with HIV/AIDS in the Indian capital and has turned to the courts to seek support for its initiative. "We get a new patient every two days but have beds for just 40 people," says Cedric Fernandez of SAHARA.

The government's AIDS control efforts have also come under fire for focussing on the so-called 'high-risk' groups. Health activists have complained in a public interest suit that NACO's targetting of highway truck drivers has led to social ostracism of the group.

The anti-AIDS effort will not get far unless medical professionals too change their attitude, say activists.

"Doctors remain unwilling to work with HIV positive people while society reacts with paranoia as the epidemic unfolds," complains Siddharth Vatsyayan of the AIDS Awareness Group.

According to John Roegner of the NAZ Foundation (India Trust), hospitals and doctors in the Indian capital regularly turn away AIDS patients . "They just don't want to see them and tell us they don't have the training, facilities or funds (to treat them)," he said.

"We hope the World Bank and UNAIDS will now look at the real issues and redirect funding," Roegner said.

India, along with other poor South Asian nations, is said to offer a conducive environment for the AIDS virus to flourish.

Poverty, malnutrition, unemployment, spiralling urban growth, poor sanitation and the low status of women have combined to create a favourable setting for the large-scale spread of HIV in these countries, according to Peter Godwin, former chief of the U.N. Development Programme's Regional Project on HIV and Development. (END/IPS/ap-he/rdr/mu/99)

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