Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.

Reuters NewMedia - November 20, 2005
Kamil Zaheer

India, which has 5.1 million people living with HIV/AIDS -- second only to South Africa -- announced earlier this year that new infections had fallen dramatically to 28,000 in 2004 from 520,000 in 2003, sparking disbelief among voluntary groups.

Peter Piot, the executive director of UNAIDS, told Reuters he did not believe that India could have witnessed such a drop.

"India having only 28,000 new infections is plainly impossible," Piot said in an interview late on Saturday. He said some districts across the country with populations of several million had about four percent or more adults infected and a 400 percent fall in 2004 would be a "miracle".

"There are a number of states where reporting of cases is weak," Piot said in Guwahati, the main city of India's remote northeast, during a visit to push authorities in the region to do more to fight AIDS.

Piot did not say what UNAIDS felt the real number of new cases was in 2004. His comments came ahead of the release of the U.N. annual global report on AIDS in New Delhi on Monday.

Piot said two of India's most populous states -- Uttar Pradesh and Bihar with a combined population of more than 250 million -- had poor surveillance.

"We don't know exactly what is going on there," said Piot. "I don't think there is a conspiracy to suppress information but it (surveillance) is not well-organised to say the least."

India's state-run National AIDS Control Organisation says 0.92 percent of the country's adult population is living with HIV and there are six states, and possibly a seventh, with a infection rate of more than one percent.

Piot said the AIDS picture in India, which has 29 states and more than a billion people, was complicated with new infections falling in some areas and rising in others.

For instance, new infections were falling in urban areas but rising in rural areas in the southern state of Tamil Nadu.

The spread of the deadly HIV virus was being fuelled by millions of poor male migrants who go to cities for work. Some of them get infected after visiting prostitutes and pass it on to their wives in rural areas, experts say.

The Indian government and voluntary groups needed to boost efforts and expand small but well-managed anti-AIDS projects, Piot said.

Many HIV-positive people in India's northeast had been left out of nationwide HIV counts and not all those accounted for were getting anti-retroviral drugs, he added.

"A virus does not have feet, you know. It is transported by people," Piot said. "I am disappointed the programmes are not reaching more people."
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