Voice of America - August 17, 2007
Steve Herman
New Delhi

India was once thought to have the world's highest number of people with HIV -- the virus that causes AIDS. But the estimate was recently reduced by more than half -- down to 2.5 million from 5.7 million. The reduction, however, does not mean India is relaxing its fight against the epidemic. VOA's Steve Herman reports from New Delhi.

Officials say improved counting methods lowered the estimate of the number of Indians infected with the AIDS-causing virus. The new estimate means that India has fewer cases than South Africa or Nigeria.

The country coordinator here for the Joint United Nations Program on HIV and AIDS, Dr. Denis Broun, says the new number is no reason to be less vigilant.

"You are not going to tell people that it's safe to go and see sex workers without condoms because it's 2.5 million, not 5.7 million," says the doctor. “Prevention policy is still the same. People still need to know about HIV, still need to be educated about HIV, they still need to use condoms in safe sex. They still need to have prevention of injecting drug use."

But no one really knows for certain how many of India's 1.1 billion people are HIV positive.

Dr. Broun added, "People hesitate to be tested for HIV. Just asking for an HIV test is sometimes a way of being stigmatized. People are not well considered and not treated in a humane manner in many hospitals. They are discriminated against by the health professionals."

Risky sex by migrant workers, truck drivers, students and others is spreading the virus, and in some parts of the country illicit use of injected drugs is a growing problem.

Ashok Alexander is the director of Avahan, the India AIDS initiative of the Bill and Melinda Gates Foundation. He contends that such a huge country cannot effectively combat the disease if the fight is left just to the government.

"Government has a primary role to play, but media has a huge role to play, societal leaders have a tremendous role to play. There are people in India, whether they are Bollywood stars or cricket -- sports -- leaders, a single word reaches millions of people at one time," he says.

The government is sharply increasing the amount of money it spends fighting AIDS -- by nearly 40 times -- to almost $2 billion. An additional billion dollars will come from overseas donors.

The priority is on prevention, rather than treatment.

Despite a pledge by India's government to treat 100,000 HIV-positive people for free by the end of this year, progress is slow. Only 10 to 15 percent of those who need anti-retroviral treatments are receiving them.

Ashok Alexander of the Gates Foundation's India AIDS initiative says, "HIV unfortunately affects the most marginalized and the poorest populations first and for them to spend $100 or more per month is completely out of the question. In fact, a disease such as HIV can put a family into debt for generations."

The prognosis for India remains sobering. Despite the lowered estimate, few experts doubt that millions of people here will develop AIDS in the years ahead. That will prove to be a significant challenge for India, where the goal of providing the most basic health care to the vast number of rural and urban poor remains unfulfilled.

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