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HIV/AIDS: Prevention, cure and care
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The focus of AIDS awareness campaigns is more on prevention and cure. But what about those already infected? Who will take care of them, asks GAUTAMAN BHASKARAN.
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SAD but true, most people with AIDS are left to die without any treatment. The disease has already killed 25 million people in the quarter century that we have lived with it, and can infect 100 million more by 2010. Yet, the world's focus is on prevention, and not on care. This, despite effective drugs that can turn a death sentence into one of life, and, even stop the HIV from finding a new victim in the mother's womb.
In developing countries, six million people infected with the virus are getting little medical attention, and it is predicted that this number will become 36 million in the next few years. The reasons for what some call, in the most brutal of terms, "bloodletting" are well known. There is no proper infrastructure to look after the sick. The medicines are expensive and beyond the reach of most sufferers. Worse, some nations cloak their own ineptitude in foolish expressions of denial. While South Africa, which has the highest number of cases, even questioned the link between the HIV and AIDS, India sulks every time the United Nations or Bill Gates presents numbers. The U.N. says that India can have 25 million affected people by 2010. This figure is hotly disputed by New Delhi.
What is now imperative is to get one's priorities right. Clearly, they are not debates and arguments. They are not even just education and prevention. Rather, they ought to include treatment for the four million victims of this scourge.
Prevention and education alone do not work. After all, who is going to be tested unless he knows that he is not going to die? And if he is cared for, he will live longer and lead a healthier life. He will be productive, and may well serve as an example of hope and caution. The governments will lose less, and the economy will do better.
Actually, States such as Brazil have proved that adequate and effective care of those ailing actually helps save money. Obviously. A person, disabled by lack of treatment, cannot be economically constructive. And greater the number of such people, the greater the burden on the country, as some African nations have proved.
Of course, one can argue that Brazil is relatively better off than India. But the World Health Organisation has established that AIDS can be satisfactorily treated even in "poor resource settings". Haiti is a good example of this.
What may sound shocking, even scandalous, is that India has virtually no public health service in place to look after those with AIDS. This is the case 16 years after the first case of HIV was reported.
One who can afford the three-drug cocktail therapy at roughly Rs. 1,800 a month can get care in any number of private hospitals. But, in India, where nearly 300 million people — a little less than a third of the total population of a billion — live in abject poverty, AIDS drugs are but a dream for most. How many even among the 350 to 400 million people in the middle classes can afford to spend nearly Rs. 2,000 on medicine alone every month?
Ranbaxy Laboratories, for instance, whose products are among the cheapest in the world, has said that it will be able to cut the prices of AIDS medication further, provided the demand for it rises.
Most companies agree that cost can become affordable if there is additional demand. And, if the Government were to divert to treatment some of the funds now available for AIDS, and pay equal attention to care and prevention, the infection need not sound the death-knell. The multi-drug prescription can certainly prolong life, and even improve its quality.
An effort to focus on both treatment and precaution will lead to not only a greater awareness of the disease itself and the way it spreads, but also a sense of openness. Today, we are still guessing that the number of Indians harbouring the HIV is four million. It can be more. We are still not sure if the 2010 figure will be 25 million, which Western analysts and administrations are projecting. India's estimate is around nine million.
But, what is more important than bickering over numbers or conducting discussions and seminars in the plush confines of star hotels is a resolve by the Government to step into "care", and to ensure that it reaches the poorest of the poor. This can only happen if AIDS funds are distributed between treatment and prevention. Let us not forget that effective remedy is an important form of prevention and education.
This, nonetheless, is not even to suggest that AIDS precaution be pushed aside. If distribution of inexpensive condoms must be wider, people, especially teenagers, should be taught the significance of safe sex. Today, nobody will listen to sermons and morals: what they may be willing to look at is the enormous benefit of using a condom, and the way it cuts down the risk of falling prey to the deadly HIV. High schools and colleges have a responsibility here, and they can shy away from it only at the peril of causing terrible harm to society. In the final analysis, with large funds flowing into India for tackling AIDS — including Bill Gates' pledge of $ 100 million — the Government must ensure that adequate money is also spent on those ill with AIDS. Every life is precious. Save it, if you can. But prolong it, you must.
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