Gates' gift re-opens debate on Aids

MUMBAI: Microsoft tycoon Bill Gates’ $100 million grant for Aids prevention programmes in India has rekindled the controversy about the actual number of Indians infected by HIV and renewed the charges of skewed priorities in the country’s health programme.
A recent US Central Intelligence Agency report covering five countries described India’s HIV\Aids epidemic as a “security threat’’ to the US.
It trashed the Indian government’s official figures—an estimated 3.86 million people infected by HIV—and said five to eight million was a more realistic statistic. The report projected that these numbers would rise to 25 million by 2010.
The CIA has claimed that the report was prepared in consultation with Indian experts. But public health activists here suggest that the agency has extrapolated data collected by NGOs working with highrisk groups to devise a scenario for the entire population.
They charge that the CIA’s figures are not based on hard evidence. Health minister Shatrughan Sinha has also strongly contested these numbers.
Unfortunately, add the experts, official Indian HIV\Aids figures appear to be equally unreliable, making it difficult for the Indian government to present a strong case.
Although the country is in its second decade of the Aids epidemic, there are still no reliable communitybased statistics available, says Vikram Patel, a researcher with the Goa-based NGO, Sangath Society.
The National Aids Control Organisation (Naco) depends on data from so-called sentinel surveillance sites set up to monitor HIV prevalence.
These sites are based in clinics attached to public hospitals that treat sexually transmitted diseases and provide antenatal care. But, say the experts, Naco has made no effort to obtain data from the private hospitals which, according to studies, treat 70 per cent of these cases.
They add that Naco has recently tempered its earlier alarmist tone to state that “while the epidemic is still spreading in the country, there is a gradual decrease in new infections. Over a period of time the new infections may reduce to a negligible number,which is an indicator of the plateauing of the epidemic’’.
Many public health experts here also question the thrust of programmes focused on HIV-prevention than on care and support for patients.