I just wanted to make sure that everyone was aware that AIDS “turns” 25 this week. India now has the largest number of infected people and is still trending downhill:
Twenty-five years after the first AIDS cases were reported, there is no sign of a halt to the pandemic which is likely to spread to every corner of the globe, the head of the United Nations’ AIDS agency said.
Peter Piot was speaking as UNAIDS released a report which declared that the world’s response to the disease, that has infected about 65 million people and killed 25 million, has been nowhere near adequate. Five years after a special U.N. session pledged its commitment to halt the AIDS pandemic, only a few countries have met the targets laid down…India has the largest number of people living with the virus. With 5.7 million infections, it has overtaken South Africa’s total of 5.5 million. But, the epidemic is still at its worst in sub-Saharan Africa, where 90% of the world’s HIV-infected children live. [Link]
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p>The first reported case in India came nearly 5 years after the first reported case in the U.S.
The first case of HIV infection in India was diagnosed among commercial sex workers in Chennai, Tamil Nadu, in 1986. Soon after, a number of screening centres were established throughout the country. Initially the focus was on screening foreigners, especially foreign students. Gradually, the focus moved on to screening blood banks. By early 1987, efforts were made up to set up a national network of HIV screening centres in major urban areas. [Link]
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The statistics are grim:
The UN Population Division projects that India’s adult HIV prevalence will peak at 1.9% in 2019. The UN estimates there were 2.7 million AIDS deaths in India between 1980 and 2000. During 2000-15, the UN has projected 12.3 million AIDS deaths and 49.5 million deaths during 2015-50.
A 2002 report by the CIA’s National Intelligence Council predicted 20 million to 25 million AIDS cases in India by 2010, more than any other country in the world. [Link]
So you guys tell me. We know what some of the problems are. What more can be done to stop this boulder from rolling?
I had a grim experience. Visiting Punjab, my ancestral village. Typical picturesque lovely Punjabi pind as everyone knows and loves from the poetry and movies. Quiet, rural, fertile. Untouched by the vices of the city. Except that one of the men there died of AIDS a few months before I arrived through sharing a needle with an addict in Jalandhar. He infected his wife too and she will die soon. Drug abuse is a big problem in some cities in Punjab.
Prem you touch upon an important point. Intravenous Drug Use (IDU) is one of the major reasons HIV is spread in Asia, India and China in particular.
But the other big transporter of the disease is the trucking industries, much like in Africa, truck drivers and other migratory men tend to be the ones who spread this disease.
Check out: Badmash’s take on the attitudes towards talk about sex/AIDS
Breakthouth also has info on the “What kind of man are you?” campain urging men to be faithful, or at least wear condoms if they’re not going to be to protect their wives since most women in India are infected by their husbands. I love this video too…
breakthrough’s “What kind of man are you?” campaign page
Hi Abhi, Here goes my two fils worth: Lots of NGOs try and do their bit to create awareness about “the disease with no cure”; however, whilst focussing on the sex-workers, they often forget the humble truck-driver who plays a huge part in acting as a carrier for the virus across far-spread communities. Of course, achieving ultimate success in conquering the virus lies in creating a sort of awareness that permeates all societies and reaches every individual, combined with committed, ethical, medical research where financial benefit is not the impetus. Also, the Catholic Church, which has an extremely strong influence in Africa – it has to be seen to be believed – should review its stand on the issues of birth-control and pre-marital sex. I sincerely hope that I haven’t set myself up for a battering by that last sentence; it is not my intention of hurting someone’s religious beliefs.
Hi Kenyandesi, I would like to state that though you were first in posting about truckers, I am sure that I thought about truckers before you:) But, SM history will remember you as the first and me as someone who did a Kaavya on you! By virtue of having a faster browser and living someplace closer to the SM server, you win; a shallow, hollow, victory. I tip my hat to you. I’m practising on my left-clicks and will be faster and meaner, the next time:) Peace
Is there is any information on why it is that the epidemic seems to be coming out of the south? If we break it down further do some states have higher prevelance rates that other? Is it primarily urban?
Some glimmer of hope??
Intensive peer education efforts, outreach programs, condoms, condoms and more condoms seem to be key. I guess the Ugandan style of A(bstinence) B(e faithful) C(ondoms) suitably modified for desi consumption is what seems to work.
Ob.Trucker reference: Years ago NPR had a piece in which they interviewed a Tamizh trucker about his penchant for hookers (this was in the context of transmission of HIV-1 back into his house to his poor monogamous wife). He explained that after driving for hours, he felt “the heat” and need to visit with the ladies of the truck stops.
Jayv – the reason southern India shows up with higher number of HIV cases is because the governments report the cases. It probably got to do with the governments down south are less conservative than their northern counterparts.
According to many of my doctor friends who worked in Bangalore, Hyd, Delhi, Chandigarh etc – most of the HIV cases all over India used to be reported as “Tuberculosis”, but southern hospitals have reacted a bit early and noting those cases as HIV related instead of TB.
I hope this situation gets corrected all over the nation – which leads to real question, how many HIV patients are really there in India.
It doesn’t help when the Vatican labels condoms as “tools of satan”. I was shocked to learn Christian exremists’ argument that funding distribution of condoms is a waste of taxpayers’ money when humans can control themselves and by taking sexual responsibility. http://www.choicetolive.com/?blog=17
I think there is a misconception that condoms will solve the major part of the problem dealing with HIV infection. There are cultural and social implications that are not being considered. I find it hard too believe that sex workers in South east Asia have the choice of asking their customers to put on condoms. In fact many are afraid to lose business in that given scenario, if they refuse to comply they face physical abuse from the pimps that devour more than 50% of their income. These girls are so poor that selling sex is the only way they can survive. There have been instances in Uganda where condoms are used as bicycle air valves instead of preventing infection. I think their needs to be changes culturally and also economically so that the poor are not forced into these situations. More attention should be paid to that cause if we are planning on stopping the disease. Here’s an article that gives a more realistic and gruesome picture of where the actual problem lies http://www.pbs.org/frontlineworld/blog/2006/04/myanmars_hidden.html
Systematic testing coupled with education on and availibility of HIV prevention measures is key in curbing the spread. But India should also tear a page off Brazil’s book and guarantee antiretroviral treatment for all Indians diagnosed with AIDS.
All at taxpayer expense, of course.
M. Nam
asaap’s ads address aids awareness – lazy – not diging lings agin.
Moornam – that was an extremely insensitive statement to make. Ofcourse it would come out of taxpayer’s expense. What would you rather money be spent on, other than taking care of such drastic medical needs?
I am not gonna preach, because I am sure you would be able to grasp the gravity of this problem (it isnt just health, it is a social problem too) if you think about it for just 10 minutes.
cheers -P
M. Nam – I live in Canada. I pay for health care benefits I have never used. Like MRIs, transplants, overdose treatments, etc., including partial coverage of antiretroviral treatments. And I am seriously poorer of pocket as a result. So, my answer to your statement is, “Sure”. Guaranteed treatment worked in India with the polio eradication scheme so why not with HIV/AIDS?
Prasad,
The moment you give the Government full control over any aspect, I can guarantee you there will be corruption. What you will end up eventually is adulterated AIDS drugs, siphoning off of good drugs into the black market, rising costs, falling quality, deaths by hundreds of thousands (of mostly poor people) due to ineffective distribution etc etc. I don’t want all that. I want this to be handled by private charitable organisations (like the Gates foundation) who will be ruthlessly efficient about this.
<>>that was an extremely insensitive statement to make
I say it like it is. If views like these are not challenged and nipped in the bud, you will have millions of corpses to deal with. That should desensitize you.
M. Nam
For those you in the US I highly recommend a viewing of the two part Frontline documentary on AIDS. The documentary covers both the history and current (scientific and political) issues with AIDS. Here is a link:
http://www.pbs.org/wgbh/pages/frontline/aids/
It is stunning and heart-breaking how denial and it’s (unjustified) association with homo-sexual pratices and drug-abuse has made AIDS an epidemic that it is today.
Neha writes:>>Guaranteed treatment worked in India with the polio eradication scheme so why not with HIV/AIDS
There is no guaranteed treatment of polio in India – there is only a vaccination (which is very cheap). Moreover, polio is not a disease that’s spread due to lifestyle choices. It’s not spread from mother to child. Moreover, it’s not true that the Government eradicated polio. People want the best for their children – they don’t mind spending a hundred rupees for a vaccination. The private sector stepped in with the vaccine. There was no money to be made in hoarding or black-marketing the drug.
AIDS, on the other hand, has an expensive treatement. Can you imagine the cost when Government of India spends thousands (or lakhs) of rupees per AIDS patient? They’ll need a ministry ( a much coveted, juicy job) to handle this. Moreover, unlike polio, AIDS just keeps on coming. Free treatment means that whores, I mean sex workers, aaaahhh forget it, whores will not insist their clients to use condoms. What the hell! If she gets AIDS, she’s got a free treatment waiting for her. As for the clients, it’s champagne time!! As for the middlemen, politicans, adulterators (both kinds, the ones who cheat on their spouse and the ones who make bad drugs) will have a field day.
Sorry, not on my watch…
I am willing to concede only on one thing (and I am going against all my Libertarian principles on this one): If there is a child being born to a mother who has AIDS, I think the government could step in to save the innocent little thing. This is a limited, non-recurring problem which should not cost much. The mother must be forced to go snip-snip after child-birth. No more kids for you.
M. Nam
Thanks for the post, Abhi. One can’t stress the importance of this topic enough.
A stark fact: Most of the UN funds for research into AIDS, and almost all of American and European funds for AIDS research does not benefit the affected population in Africa, Asia and South America. Reason: Dominant HIV strains in the US and Europe are different from the strains prevalent in developing countries. Even here, the African strain is different from the one found in India.It is any body’s guess as to which strain the scientific research is focused on (for the most part that is).
Secondly, I am having some trouble with these statistics.While the UN says 5.7 million infections, the NACO (National AIDS Control Organization) reports around 111, 608 cases as on 31, July 2005. Their web site does not have data beyond that point ! Assuming average of 1,000 new cases per month, as per NACO, it should not be more than 124,000 cases by now.
What is the reason for this discrepancy? NACO counts only cases reported by its State-level counterparts who liaise with govt and private hospitals.Apparently, NACO also has the UN, USAID and other such organizations as its partners in the fight against AIDS. And when UN says 5.7 million infections, one has to assume they mean 2.7 million people who have been diagnosed as having AIDS. The discrepancy in figures is too high for it to be a common calculation error. If some one can throw more light on this (no assumptions please!), will be grateful.
The UN also says 2.7 million deaths due to AIDS.This is again a mind boggling figure.With out knowing the basis for arriving at this figure, I find it hard to believe that 27 lakhs have died in India due to this disease already, but the common man is more worried about chicken flu than AIDS.Surely, the common man in India is not that dumb to ignore 57 lakhs of infected people in all parts of the country?Are we saying that ‘awareness’ is the main problem in India?
Ok..now for some personal observations.
Picture this: Dozens of HIV infected children and destitutes outside some temples and dargas in Mumbai.No one bothers. Except may be some Seth-jis who come in their cars and distribute food packets every morning.I donno what these hapless patients need to do to attract the attention of aid agencies and NACO.
The case of truck drivers and sex workers on South Indian highways has been well documented.But the truck drivers continue to patronize the sex workers.The wives of some of the truck drivers have given birth to children who are HIV positive as well (not in all cases, but there are some). I travelled through those routes in Dec 2004.Apart from the occassional poster on using condoms for safe sex, I have not seen any visible evidence of the ‘awareness programs’ funded by aid agencies.I am sure they are doing a lot. But if 5.7 million infections is the right number, it (the disease control effort) seems to be a drop in the bucket.
Well, it has already been a long comment.I think I will have to blog the rest of my thoughts on this.
But before leaving, please let me know if any of you are aware of any NRI-driven efforts in combating AIDS in India.
-Kumar
MoorNam,
NGO initiative alone will not be enough.The government, people, NGOs, every one has to chip in.
Also, Neha is right. The Union govt and various State govts, have achieved great success with Polio in India.There is a guaranteed treatment program.Every year, at least twice,there are nationwide Pulse Polio immunization campaigns. If you ever happen to visit India during one such program, you will be amazed at the efficiency of the public-private-NGO partnership in the Pulse Polio immunisation program.
Again, I think the main danger with AIDS in India, is that we don’t seem to have a handle on the extent of the problem.And apart from truck drivers and sex workers, we don’t seem to know which are the other high risk categories (people who go to hair salons that reuse razor blades?People who get blood tests and injections done from labs and small clinics in mofussil areas? No exhaustive research and census; only case studies for charity orgs to put on their web sites.)
my friend’s article, who writes for knight ridder. mostly about africa (where he’s based), but interesting tidbits about india, and how seemingly things aren’t as dire as most had feared some time ago.
Mnam: Just because something is put in the private sector doesn’t necessarily mean it will get done better. It may, but it is not a given. Look how well the private sector rebuilding of iraq is going. You can’t spit without hitting private contractors there. Locally, United Way, American Red Cross all have had horrendous problems with mismanagement. The Gates foundation recently went through a shake up at the highest levels. It is touching to read folks faith in the private sector but like all organizations they too have problems of inefficiency/corruption/cronyism.
In the healthcare business in India, the private sector has stepped in ably to provide top notch care for the wealthy and middle classes with the Apollo and Escorts systems and health insurance companies. Where does that leave the indigent?
PS: Polio eradication was a massive GOVT effort. Here and elsewhere. Not a good example for the private sector goodness. Same with small pox. They are working on malaria/TB etc with massive GOVT funding. The Gates folks are johnny come latelies in the business.
PPS: “Lifestyle choice” or not, the cost to society is still the same.
KumarN:
Clades (strains)that are extant in the African and Asian continents are still susceptible to the AntiRetroVirals that are developed stateside. As far as vaccinations are concerned, where the clades will make a difference, we barely have an idea what makes a good vaccine for anything. If a good vaccine can be easily “designed” with the European or American clades in mind then the Asian or African ones will be easy too. It just isn’t easy to design vaccines for what ever clade you are looking at. If you throw in the HLA types into the mix then the shit really hits the fan.
For what it is worth, there are clinical trials afoot in Kenya, that have a multi clade vaccine designed by BIG GOVT from the US. If it is any good the trial will be expanded.
MNam:
I know this is a stupid question but I don’t know any whores. Do all whores behave like you describe? Only the ones in India or do the American ones think this way as well? The reason I ask is because I think you can get Medicaid to pay for treatments in the States, so there must already be an incentive to get AIDS here. Is this insight from studies here being extrapolated to India or have there been independent studies in India about the whores and their interests in free treatments? I didn’t quite get the adulterators remark either.
just wanted to thank you for posting this video. it’s the sweetest melody and the video tugs the heart for the loss of something i’ve never had. :-/
hey ppl
i need ur help
i hv got exposed one and a half months ago and hv taken safety measures but am damm scared about this hiv infection. now what do i do?
can this b cured now if at all i am infected. will regular blood test in the hospitals do? is that enough to get tested and how long will it take
me to know that am clean from this virus permanently?
plz help me.. ineed some one 2 help me
sunil_atmakuri@rediffmail.com is mu mail id plss take some time and mail me..