India’s
battle against AIDS
Siddharth
Srivastava
India is
beginning to make genuine attempts to tackle the AIDS scourge
and a lot of the credit goes to two gentlemen from the US: Microsoft
boss Bill Gates and Chicago star Richard Gere.
Gere was in India last week, his fourth AIDS-related visit in the
last five years, attending fund-raisers and other gala events linked
to the disease. The actor’s donation of $400,000 for the cause so
far is no small change while Gates’ initial contribution of $100
million last year jumpstarted the fight against AIDS. This year the
Gates-Melinda foundation doubled their contribution to $200 million.
The Gates-Gere India interest is understandable as the figures are
alarming. The ministry of health and family welfare estimates that
between 3.82 and 4.58 million people, or 0.8 per cent of the Indian
population, is HIV-positive. In the entire world, only South Africa
has more HIV-positive people. The Treat Asia report that was
released this Sunday to coincide with the 15th International AIDS
conference in Bangkok says that ``India is poised to surpass South
Africa as the nation with the greatest number of people living with
HIV by 2006.’’
Like South Africa, in India the disease is spreading through
heterosexual transmission to the general population, unlike in the
US where it is seen more as a gay problem. In Mumbai, experts
believe that 50 per cent of sex workers are now infected, and one in
every 40 women visiting prenatal clinics carry the disease. The
National AIDS Control Organization (NACO) has warned that
businessmen, men in the service sector and hotel employees are most
at risk. Despite decades of ads for condoms, more than 85 per cent
of HIV infections in the country are due to unsafe sex.
Not that the Indian people and establishment have not been aware of
the AIDS time bomb. But, the efforts have been piecemeal, to say the
least with often an ostrich approach to the problem. In 2002 when
Gates announced his intention to take on the Indian AIDS challenge,
then Indian health minister Shatrughan Sinha publicly took him on
the actual estimate of HIV positive patients, rather than welcoming
the huge gesture.
Over the years being concerned about AIDS is the most saleable
statement to make. December 1, World AIDS day each year is marked by
fashion shows, cocktail dos and celebrity walks with the who's who
jostling for that special photo-op, an opportunity to be seen with
the right set as well as a sure shot access into reams of paper
written on the subject in the society news sections. Similar
utterances have never emanated about the ``unfashionable’’ diabetes
that is likely to strike more than 7 million Indians by 2005.
For long, the winter months New Delhi and Mumbai have been witness
to fashionable AIDS parties. The list of patrons is unending. From
top actors such as Amitabh Bachchan, Aamir Khan, Salman Khan to
cricketers like Kapil Dev, actresses-turned social activists Nafisa
Ali, Shabana Azmi, Nandita Das, painter M F Husain, Lata Mangeshkar,
Anoushka Shankar to corporate bigwigs Anand Mahindra and Parmeshwar
Godrej... everyone has been concerned. And the message the same each
year, “India is about to explode with AIDS, and we all need to do
something.'' But, the figures have only gotten worse.
Nobody, of course, minds the celebrity endorsements and clinging
dresses if they served a purpose. Reports have been to the contrary.
A study on NGO responses to HIV and AIDS
in India published by Actionaid, the
British Council and UNDP admits: “Most Indian NGOs have little or no
direct contact with people living with HIV or AIDS. AIDS has become
a celebrity cause for fund-raising dinners, fashion-shows and
T-shirt sales.''
Then there is the accusation of the huge funds that flow in due to
AIDS to parent black-tie NGOs for activities that don't necessarily
yield tangible results. Not surprisingly, in a study done by the
ministry of health, prevention indicator surveys carried out in
Maharashtra, Tamil Nadu, West Bengal, Delhi and Haryana show
awareness levels ranging from 10 per cent to 78 per cent in urban
areas, and from 13 per cent to 20 per cent in rural areas. There is
the further criticism that most of the HIV/AIDS awareness efforts
rise to serious misconceptions. For instance, as the report points
out, people confessed to just looking at top actress such as Madhuri
Dixit in the advertisements, and paying little heed to what she was
saying.
Dissatisfied with the progress Gere said last year that he was
unhappy about the way in which funds raised during his first trip
had been spent. Even though India has taken a loan of $ 190 million
from the World Bank, AIDS experts feel that a revised and new policy
was the need of the hour.
But, there seems to be some positive change now. Over the past
one-year there have been genuine efforts to take the disease
head-on, though there is still a long way to go. Observers attribute
that the Gates-Gere combination has provided the necessary momentum
to take on the disease that threatens epidemic proportions. While a
high-profile celebrity like Gere brings the disease in the eye of
the highest forums, Gates has made a difference through brute
money-power.
During his current visit, Gere has expressed no misgivings and said
of the funds being spent: “It’s been clear and accountable all the
way. Most of the money was given to the Naz Foundation in Delhi. I
have visited their clinics and found them to be very successful.’’
Gere is further happy that the Indian government is no longer
defensive about AIDS, but is vocal and tackling it with depth and
understanding.
In last week’s budget announcement, India’s new Finance minister P
Chidambaram’s has allocated $ 50 million for checking the spread of
AIDS with the intention to "shift the focus from raising awareness
to changing behavior through interventions, particularly for groups
at high risk’’.
The union health ministry earlier under the vocal minister Sushma
Swaraj in the previous government had been at the forefront of
taking on the disease. Swaraj publicly took up the cause of two
HIV-positive orphans (Bency and Benson Chandy) who had been expelled
from four different schools until their grandfather launched a
hunger strike to pressure school officials into accepting the
children.
Swaraj said that cure and prevention would be part of the government
policy on HIV/AIDS and her words find echo even now.
"I have declared that women, children below the age of 15 and those
suffering fully from AIDS will be provided anti-retroviral drugs in
government hospitals from April 2004," she said ``To begin with,
100,000 patients a year will be administered the drugs and the
numbers will be increased in a phased manner. The total cost will be
met by the government,’’ she said.
"India has accepted the challenge of AIDS
and we are probably the first country in
the world which has drawn up a
comprehensive prevention and cure policy on AIDS," Swaraj said.
Another major shot in the arm has come from Indian
pharmaceutical companies manufacturing cheap generic drugs.
The situation was particularly alarming as most Indians were not be
able to afford the steep expenditure involved in treatment. The
retro-viral drug, which helps increase life expectancy by almost
15 years, alone worked out to between $ 400-600 per month,
unaffordable by most Indian.
The success that India has had in finding private sector and
international partners in its efforts to battle the disease has also
gone a long way in bringing the battle to the open. Seven
organizations were awarded five-year grants by the Gates Foundation
to reduce HIV infections among high-risk groups (sex workers and
sexually-active youths) through condom distribution programmes,
high-profile public awareness campaigns and increased funding for
treatment of HIV and other sexually transmitted diseases. It is the
single largest commitment to any AIDS-related initiative anywhere in
the world.
While the going has been good for the past year, the battle has only
just begun. Then, it is better late than never.
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