Number of New HIV Cases in India Could Reach 5.5M Annually by 2033 if Prevention Measures Not Implemented, World Bank Says
The number of new HIV infections in India could increase to 5.5 million annually by 2033 if "urgent steps" are not taken to prevent the disease's spread, according to a World Bank report released on Friday, Reuters/Yahoo! News reports (Reuters/Yahoo! News, 8/13). The report, titled "HIV/AIDS Treatment and Prevention in India: Costs and Consequences of Policy Options," outlines different public funding options for HIV/AIDS prevention and treatment programs to assist the government in maximizing the use of antiretroviral drugs to fight the epidemic, according to a World Bank release (World Bank release, 8/13). If the Indian government does not increase its prevention efforts, HIV/AIDS will become the leading cause of death in the country, accounting for 17% of overall deaths and 40% of infectious disease deaths by 2033, according to the report. Currently, HIV/AIDS accounts for 2% of deaths and 6% of infectious disease deaths in India. According to the Indian government, there were 5.1 million people living with HIV/AIDS in the country in 2003. Although India has a program to fight HIV/AIDS, the disease has spread beyond high-risk groups into the general population, according to Reuters/Yahoo! News (Reuters/Yahoo! News, 8/13). The report recommends that the government improve its data collection on the epidemic, improve the quality of antiretroviral treatment provided through the private sector and evaluate different treatment programs to maximize patient adherence to medication regimens, according to the release. In addition, the report advises the government to continue to scale up prevention programs to discourage multiple sex partners and needle sharing to inject drugs and encourage condom use, according to the release (World Bank release, 8/13).
Reaction
The Indian government has said it believes the increase in the number of new HIV cases is stabilizing and it does not expect the country will face HIV/AIDS prevalence close to that seen in sub-Saharan Africa, the Financial Times reports. However, some international health experts say that India has many of the same factors that played a role in helping HIV spread throughout sub-Saharan Africa in the 1990s, including migrant labor, large numbers of commercial sex workers and stigma about sex and HIV/AIDS, according to the Times. Mead Over, a World Bank economist and one of the authors of the report, said that although condom use had increased during the 1990s in India, the rates of condom use recently have steadied, according to the Times. Over also warned that without an increase in voluntary HIV counseling and testing and an improvement in patient monitoring, resistance to antiretroviral drugs could spread rapidly (Dyer, Financial Times, 8/14). Peter Heywood, a World Bank health specialist and a report author, said, "Antiretroviral therapy is not going to have a big impact on the course of the epidemic," adding, "What will have an impact, however, is the use of condoms and prevention" (Reuters/Yahoo! News, 8/13). He added, "If energy and resources for prevention start to decline, the results would be a reversal in progress made in fighting the epidemic in India" (World Bank release, 8/13).
A kaisernetwork.org video feature on HIV/AIDS in India is available online. The report -- prepared by Fred de Sam Lazaro, also a correspondent for the NewsHour with Jim Lehrer -- includes interviews with people who are on the front lines of India's efforts.
