AIDS Begins to Widen Its Reach in India

In some southern India localities, blood tests from pregnancy clinics show HIV infection rates as high as 5 percent to 8 percent, according to state AIDS agencies and independent researchers. The disease is spreading beyond high-risk groups to the general population. 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.

Despite private and governmental efforts, particularly at the state level, the national response to HIV/AIDS has been spotty, say AIDS specialists from international donors as well as Indian and foreign nonprofit groups.

In India, even a 1 percent HIV prevalence rate among adults translates into 4 million infected people, according to UN statistics. Its current infection rate is estimated at 0.9 percent to 1.4 percent. Antiretroviral drugs, costing just $350 per year in India, are affordable to but a tiny fraction of patients.

Prime Minister Atal Bihari Vajpayee has delivered several speeches on the disease, and the government has orchestrated multiple HIV/AIDS prevention and awareness ad campaigns. In hardest-hit Andhra Pradesh, the state AIDS agency once inflated a giant condom outside the state legislature to dramatize its campaign. But India's Planning Commission, which sets government spending priorities, says in its 2002-2007 economic plan that the disease is set to "plateau" in 2010 and has caused "only a small reduction in expected improvement in longevity." Government spending on AIDS has remained flat for the last several years.

The Planning Commission also sets annual ceilings on the amount of money -- government or otherwise -- that can be spent on various programs, including those related to AIDS. That puts India in the seemingly bizarre position of refusing some money that donors are eager to give.

After a senior leader of India's Hindu-nationalist party pulled a television campaign stressing the protective benefits of condoms -- conservatives had complained they encouraged promiscuity -- the ads were retooled to emphasize abstinence and faithfulness. One recent spot shows a village councilwoman urging other women to be faithful, but says nothing about how they should protect themselves if their husbands fail to follow the same advice.

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