U.K. To Redesign HIV/AIDS Initiative in India in Response to Government’s New Prevention Approach

The United Kingdom plans to redesign its $219 million HIV/AIDS initiative in India to reflect the "willingness" of the country's newly elected Congress Party government to address the epidemic, according to Gareth Thomas, British junior minister for international development, the Financial Times reports (Marcelo, Financial Times, 10/6). According to the most recent United Nations data, India has 5.1 million HIV cases -- second only to South Africa with 5.6 million (Kaiser Daily HIV/AIDS Report, 9/16). "The sheer numbers of vulnerable people mean [HIV/AIDS] is a huge challenge for the country," Thomas said. However, the U.K. HIV/AIDS initiative has "hit bureaucratic barriers" in India's National AIDS Control Organization in the past, and only $49.9 million of the $219 million has been distributed over the past few years, according to the Times. The U.K. initiative has experienced additional "hiccups." Last year, the government banned an advertisement funded by the initiative that showed a woman packing condoms in her husband's suitcase, the Times reports.

'Flexible' Approach
The Congress Party government, which was elected in May, has a more "flexible" approach than previous governments to curbing the spread of HIV in India, according to Thomas. Although NACO in the past has "long endured criticism from foreign donors for its excessively bureaucratic culture," the organization's newly appointed head, S.Y. Quraishi, has been "keen to step up" the organization's work, Thomas said, adding, "India has changed the way it operates, and we respond to that." Quraishi has "invited public scrutiny" of NACO's operations and has initiated HIV/AIDS awareness campaigns, including a television series produced by NACO, the BBC World Service Trust and Doordarshan, India's national broadcaster. Moreover, the Congress government "appears less squeamish when discussing sexual health" and has allowed advertisements promoting condom use on television, according to the Times. "We have come out of the denial of the late 1980s," Prasada Rao, India's newly appointed health secretary, said, adding, "We would like to assure you that India takes HIV/AIDS very, very seriously." Thomas said he is "encouraged" by India's new approach to HIV/AIDS prevention, adding that the remaining $169 million from the U.K.'s initiative will be spent by March 2007, according to the Times. The United Kingdom also plans to distribute $445 million in development aid to India in 2004 and 2005.

'Unreliable' Information
Despite the new approach adopted by the Congress government, some health experts have warned that India's information concerning the HIV/AIDS epidemic is "unreliable," the Times reports (Financial Times, 10/6). Last month, Richard Feachem, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said that India likely has more HIV cases than any other country in the world, despite official statistics that cite South Africa as the country with the most HIV-positive people. Feachem said that he and other HIV/AIDS experts believe the actual number of HIV-positive people in India is much higher than the reported figure because the estimate fails to take into account the HIV-positive people in the country who are unaware of their HIV status or have not reported it (Kaiser Daily HIV/AIDS Report, 9/16). Although NACO "rejected" Feachem's statements, it plans to hire consultants to obtain more accurate information about the country's HIV/AIDS prevalence, according to the Times (Financial Times, 10/6).

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.