The Hindu : The scourge continues

Online edition of India's National Newspaper
Saturday, Jul 13, 2002

Opinion

Opinion - Editorials

The scourge continues

THERE IS SOME room for optimism in the global fight against AIDS though the bleak news continues to dominate. The danger is that without renewed efforts to contain the spread of the HIV virus, the affliction of AIDS is going to worsen and not improve in the years ahead. Researchers and policy-makers, on the eve of the XIV International AIDS Conference in Barcelona, suggested first of all that a vaccine against HIV may be available sooner than originally envisioned, five and not 10 years from now. There is hope today as well with new research confirming that the use of certain drugs can reduce the likelihood of transmission of the virus from mothers to children. And at least one developing country — Uganda — has been able to substantially reduce the prevalence of HIV among its adult population, a remarkable achievement considering that in the rest of Africa the virus is spreading. But this is about all there is by way of positive development on the AIDS front.

The first distressing feature of the present state of the AIDS epidemic is that the growth of new HIV infections is not levelling off. The U.N. reports that the virus is spreading rapidly in new areas (populous China and Indonesia are examples) and it has not stabilised in the countries which are now the worst affected, located mainly in sub-Saharan Africa. The result is that, in the U.N.'s estimation, 68 million people will die from this scourge in the 45 most affected countries over the next two decades, five times as many as the 13 million who have died in the past two decades. The fall in prices of anti-retroviral drug therapy has not meant a dramatic increase in treatment. Only four per cent of the people in the developing countries who could benefit from this treatment are able to access these drugs. At the AIDS conference, pharmaceutical companies announced research on new and more effective drugs. But these patented medicines could cost up to $15,000 a year. The World Health Organisation estimates that $10 billion a year is needed to fight the spread of the HIV virus and AIDS, but only $3 billion from domestic and external sources is now being spent. Moreover, anti-retroviral therapy may soon be also of limited help. A disturbing development which has recently been reported from North America is that certain strains of the virus are proving to be drug resistant. But two studies and accompanying proposals have indicated that HIV prevention, which is the best cure, is still possible. All that is required is motivation and, of course, funds. One U.N. study suggests that two-thirds of the 45 million new infections expected to take place by 2010 can be avoided if only more attention is paid to advertising campaigns, school and workplace education and promotion of safe sex. Research confirms that more than two decades after the widespread prevalence of HIV became public knowledge, poor awareness remains the most important cause of new infections. The second study, prepared by HIV prevention specialists, puts a number on the cost of prevention. The estimate is that if $27 billion can be spent on health infrastructure, prevention and treatment by 2010, the war on AIDS would show substantial success.

The Government of India's own attitude towards AIDS has been ambivalent. A considerable amount of money is being spent on information and education, but the reality is that this is having little effect on controlling the spread of HIV mainly because the funds are being mis-spent. To make matters worse, Government agencies appear to be actively hindering anti-AIDS campaigns. A report released in Barcelona accuses police in three States of harassing social workers involved in prevention campaigns. HIV prevalence rates in India are low, less than one per cent of the adult population. But because of India's large population this translates into an HIV population of close to four million, which is the world's second largest after South Africa. While there could be some doubts about the actual size of India's HIV population, it would be an ostrich-like attitude to pretend that HIV/AIDS is not a major problem in the country.

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