South Asia Lacks Leadership, Strategy for Fighting HIV/AIDS, World Bank Officials Say

South Asia lacks the leadership and strategy necessary for confronting the region's HIV/AIDS epidemic, World Bank officials last week said at a news conference ahead of the XV International AIDS Conference, the Taipei Times reports (Taipei Times, 7/5). Asia accounts for 60% of the world's population and has experienced some of the sharpest increases in numbers of HIV cases, according to the 2004 UNAIDS Report of the Global AIDS Epidemic. Asia has 7.4 million HIV-positive people, the report said (Kaiser Daily HIV/AIDS Report, 7/6). Although the World Bank has set aside $380 million annually to address AIDS in the region, much of the money has not been spent because of a lack of programs, World Bank Vice President for South Asia Praful Patel said. The officials said that political leaders have "wasted time arguing" about the number of people with the disease instead of implementing programs to address it, according to the Times (Taipei Times, 7/5). "We are facing exactly the same situation in South Asia now where this disease has gained a foothold and absolutely there is no serious strategy to address it," Patel said. There are approximately 4.6 million HIV-positive people living in India, almost two-thirds of South Asia's total number of infected individuals, and the epidemic has progressed from being concentrated in high-risk groups to a generalized epidemic in six of the country's 28 states (Agence France-Presse, 6/30).

Women, Other Groups
The epidemic is also increasingly affecting women, previously considered a low-risk group, according to India's National AIDS Control Agency's Project Director Meenakshi Datta Ghosh, VOA News reports. "We used to believe that for every eight men getting the infection maybe one woman will get it," Ghosh said, adding, "But now we believe that is not so. For every eight men getting (HIV) maybe three women will be getting it" (VOA News, 7/6). Other countries in the region, such as Pakistan, Bangladesh and Nepal, have low HIV prevalence among the general population but high prevalence among injection drug users and commercial sex workers. However, the size of these subpopulations is "frightening," and could lead to an increase in HIV prevalence in the region, Patel said. For example, although HIV prevalence among the general population of Nepal is 0.5%, the prevalence among injection drug users is as high as 68% (Agence France-Presse, 6/30). The lack of leadership in fighting the disease could be a setback in the economic development of the region, Jean-Louis Sarbib, World Bank vice president for development, said. The epidemic could reduce economic growth by as much as 1% and could lead to a 1% to 3% increase in health expenditures, according to World Bank estimates (Taipei Times, 7/5).

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