The AIDS scare is real

<div class="section1"><div class="Normal">For a long time, the Indian government sought comfort in the belief that the HIV/AIDS epidemic had behaved exactly as it had wanted it to: coursed a few decimal points below 1 per cent prevalence, the tipping point of the epidemic. Any warnings to the contrary led to a strong defence of official estimates even though they came out of a rudimentary public health system. It is no surprise that the government reacted sharply to recent international references to Indian HIV numbers being the highest in the world. But anyone who knows how HIV is travelling to the remotest villages, carried unknowingly by millions of migrant workers from cities, would argue for a sound scrutiny of existing numbers.<br /><br />Far from the reach of any surveillance system, in the villages of UP, Rajasthan or Bihar, countless men, women and children are dying of deadly diseases brought on by this infection. As these states are considered to be "low prevalence" they remain low on priority for both government and non-government organisations. <br /><br />In a village in Sikar district of Rajasthan, 12-year-old Pinki is dying in the absence of any medicines, care or support. There is no hope for her three siblings who too are HIV positive. These children have not had a home since the death of their parents. Only the kindness of a relative and some villagers has helped them survive so far. Across homes and across villages in the district, this seems to be a story repeating itself. Almost every household in the village has at least one man working in the tile factories of Surat or Mumbai. And one by one, they are finding out about the infection. <br /><br />In Uttar Pradesh, a young woman in a village is rushing through chores of her joint family household; her bed-ridden mother-in-law is waiting for her needs to be attended to; her five-year-old son is crying for meals and she needs to get to the fields to earn her wages. Nothing unusual about this scenario except that Ramvati is driven by a constant fear of being thrown out. Her husband succumbed to AIDS a month ago. Ramvati could be infected. But she does not know. Neither does she know that she needs to get herself and her child tested for HIV. Ramvati and several others will not even appear as statistics in government records. <br /><br />Despite the millions that have been spent on information, education and awareness campaigns by the government, only few in these villages know or have heard about HIV/AIDS. Wives of men, who are migrating for work, are often the ones who are most ignorant. What is AIDS? Some believe it is an address, some others say it''s somebody''s name.<br /><br />In New Delhi, successive governments have been reluctant to admit the increasing numbers. Politicians, at times, have stretched their claims to a point where HIV would seem to have plateaued. Bureaucrats on their part get risible over statistics. After almost 20 years'' work to stem the tide of this epidemic, the virus continues to ride on such widespread ignorance. Poverty, migration, low status of women, traditions and poor healthcare practices provide the necessary fuel for spread. Most villages in the country still follow a dangerous practice of reusing needles without sterilising them. In many villages, it is customary to re-marry a young widow within the family.<br /><br />The UPA government needs to put together a strategy that looks at checking the epidemic. The policy of concentrating efforts on six "high prevalence" states is shortsighted. Union health minister Anbumani Ramadoss had promised a close evaluation of HIV numbers soon after he took office. Surely, there can be no headcounts on HIV but it is time that the government involves private centres to get a real estimate on numbers. Beginning with this exercise, the government needs to look ahead. Even with the present numbers, it will not be able to cope with the care and treatment that the increasing number of people with HIV will require in the coming years. There is no time to lose. But first, let''s accept the problem.<br /><br /><span style="" font-style:="" italic="">The writer is a journalist specialising in healthcare issues.</span></div> </div>