The rate of new HIV infections in 33 countries, including 22 in sub-Saharan Africa, has fallen by at least 25%, according to the UN secretary general’s 2011 report on AIDS, which was released on Friday. However, issues such as weak national infrastructure to combat AIDS and continuation of discrimination against people infected with the virus remain. To combat this, the report stresses the need to harness the energy of the youth, push for cost-effective HIV programmes and promote the health and dignity of women and girls. Edited excerpts from an interview with Dr Charles Gilks, country coordinator, UNAIDS, India:
What are India’s major achievements in the fight against AIDS?
What’s really encouraging is the fact that there has been a reduction of 50% in the number of new infections in India in the last decade. Contrast this with the fact that the rate has doubled in the UK in the same time. India has made remarkable progress with female sex workers, which in turn ensures that the spread of the virus to the clients is also controlled. Yet significant work needs to be done on curbing the spread of the disease among those who inject drugs and men who engage in sex with men.
Can’t take it easy: Complacency is the enemy, says Gilks. Ankit Agrawal/Mint
One of the report’s five recommendations is harnessing the energies of young people for an HIV prevention revolution. Don’t you think the initiative comes a bit late?
It’s come late, agreed. But instead of questioning it, we must now work at it. Don’t spend money on things that don’t work. Although a lot of progress has been made with the sex workers, the statistics for the young people are not as encouraging. Our youth is most vulnerable to the disease since one begins to experiment with injecting drugs at this age. Men who have sex with men are another vulnerable group.
Do you sense a complacent attitude towards policymaking in India when it comes to AIDS?
The problem is that there is always a temptation to move on to something else. People and the political class need to realize that this disease has been in India for a long time. The policies need to be framed accordingly. One cannot combat this disease without revitalizing the funding scenario. AIDS is a long-burning problem, and even though we have an AIDS 2031 programme, we realize that we need to think even further.
What sets the AIDS 2031 programme apart?
AIDS 2031 was a scenario exercise set up in 2006 to look at where the epidemic could be if different ways were used to combat it. It was always looking to the future, 25 years into the future in this case. It aimed to engage debate, rethinking and reflection.
What about the risks posed by an increase in migrant populations?
We have noted a trend of circularity among the migrant populations. They go to a city to earn their livelihood and then return to their villages. On returning, neither they nor their wives have any idea that they might be carrying the virus. Once the wife gets infected, it puts her at risk of gender-based violence since in most cases it is the woman who is blamed for bringing in HIV. It also puts her children at the risk of being infected. Thus, we need to work with these migrants both at the source and the destination. And when they return to their villages, we need to broaden our programme to couples.
What are your immediate goals in India?
We have to continue to promote the fact that it is going to be a long journey. We must not declare victory and must fight against complacency. Everybody needs to realize that the first reduction of infections is relatively easy. The next half will pose more problems since it is more difficult to reach. Millions of citizens will need treatment in the next five years. Their costs go up because in the case of this disease the treatment is always for life. Till now, the case for funding hasn’t been put forth strongly.