Don't be tense about my title for this article. even I don't know where bin Laden is. But my title is correct because I'm going to talk about a dangereous disease - AIDS. It's also a kind of terrorist and many countries have faced this type of terrorism and started their encounter against him. But India entered into a big encounter after South Africa because he deeply rooted into India. I want you to read the following quotes beofre I share the reason for AIDS in India.
"An estimated 1% of India's one billion population has HIV. There are also fears that the number of new cases could rise rapidly in the years ahead unless public awareness of the disease improves." - United Nations Report.
"The decisive battleground in the fight against AIDS, given its position as global trading center in the heart of the world's most populous region. If India succeeds, the pandemic can be stopped dead in its tracks. If India fails, then AIDS spreads to China, and the rest of Asia, and becomes the biggest problem of the 21st century" - Richard Feachem, Executive Director of the Global Fund to Fight AIDS.
"Number of HIV infections will grow to 9 million by 2010, and that 1.9 million will have died" - National AIDS Control Organization.
"Will India become the next Africa?" - Focus of 15th International AIDS Conference in Bangkok.
Before writting this article, I studied a lot of articles regarding AIDS in India, and the above are the findings I discovered along my way. Most of the articles point out many of the below mentioned factors as a major reason for the spread of AIDS in India.
1. Sex workers - Because most of them are poor and uneducated.
2. Truckers - since India has long Highway networks, and truckers need recreation during their long travel.
3. Men having sex with Men.(MSM) - I don't think this is a major reason. It is not similar to the "Down Low" culture of the black and Hispanic MSM community in the USA.
4. Uneducated populations.
5. IV drug use.
6. Low status of women. - So they don't have ability to protect themselves and negotiate safer sex.
7. Migrant workers. - who can carry the virus from urban areas, where they work, to rural villages, where their wives and children live.
8. Vulnerable Children. - They are orphans, abandoned children, child labor and children growing up in abusive homes who are are subject to sexual abuse by older men.
Most of the articles saying that these are the factors affected in South Africa and they also included that this same patterns are existing in India too. But i don't think these are the major factors for the spread of AIDS in India. By studying all the aricles, i found that all the articles has missed out to put the below mentioned points as the major cause for the spread in India.
1. People have limited knowledge about HIV/AIDS and lack the proper information.
2. Lack of Sex Education. Many males are unfamiliar with how to use condom, regardless of level of education, socioeconomic status or home.
3. Inadequate infrastructure of health care services.
4. IV drug use.
Now i'll justify my reasons...
1. People have limited knowledge about HIV/AIDS :
Everyone should accept this because even many impoverished people are not educated enough to understand the causes of AIDS and how it is transmitted. In 1991, India developed a National AIDS Control Program (NACP), focusing on blood safety, prevention among high-risk populations, raising awareness in the general population and improving surveillance.
By 1999, the program had succeeded in establishing a decentralized mechanism to facilitate effective state-level responses, although tremendous variation continued to exist in the level of commitment and capacity among states. Whereas states such as Tamil Nadu, Andhra Pradesh, and Manipur have demonstrated strong response and high level of political commitment, many other states, such as Bihar and Uttar Pradesh, have yet to reach these levels.
The biggest shortage today in HIV/AIDS control is not money but caring, committed, knowledgeable people who are willing to work with the marginalized and the poor. And knowledge of HIV is particularly weak in rural areas and among women.
2. Lack of Sex Education:
UN report says that 70 percent of commercial sex workers in India reported that their main reason for non-use of condoms was because their customers objected. And some studies give countless shocking responses supplied by youth questioned about condom use!!!. I think why this is because condoms were initially promoted as spacing method for married couples, not encouraged for prevention of STDs/HIV/AIDS. Most schools do not teach reproductive health or sexuality in any comprehensive way, so even if a lecture on HIV/AIDS is presented, people have little background, training or tools to translate the information into behavior. And a report by UN saying that
- About three-quarters of Indians over the age of 15 knew that using condoms can prevent sexual transmission of the disease.
- Indians who cannot read are six times less likely to use a condom during casual sex compared to those who finished secondary school.
- It found that just 39% of men who have sex with men regularly use condoms. One three of these men also said that they have sex with many women without using a condom.
I will point out it's the government's responsibility that has caused much of spread of AIDS in India. Government advertisements give half-baked information which say use a condom, but they dont provide the faintest idea why or how. Overall condom use is low. Special attention is needed to increase condom promotion activities.
My point is, condom vending machines must be introduced in many public places like offices, small shop and the main one in Petrol Bunk to avoid the transmission of disease by truck drivers. Also, "Condom should be available free of charge."
3. Inadequate infrastructure of health care services:
The collection and storage of blood is done by blood banks who do not have adequately trained people, equipment/ supplies and financial resources to provide the quality of services required from a blood bank. There is not enough blood to meet requirements every time. Taking advantage of such a situation, many commercial blood banks started mushrooming in the country, which added more lems for blood transfusion services. With this roblem, many people didn't have knowledge that they were infected by AIDS after getting blood.
It has become a common practice among doctors, nurses, and other health professionals to deny HIV positive patients treatment and admission into their health facilities. Because of the attitude of these health sector people, stories published in major newspapers regarding patients being turned away away from hospitals, refused treatment on account of seropositivity. Such articles often sensationalized accounts of HIV+ persons being refused free anti-retroviral medications; such treatment is not available since economically infeasible.
And also testing is expensive by Indian standards, nearly four pounds for the LISA test and thirty pounds for the more accurate western blot, which is well beyond the reach of most people.
4. IV drug use.
People who become addicted to intravenous drugs are desperate and create a culture of their own. The driver here is access to such drugs. India is sandwiched between the golden triangle (Myanmar, Laos, Northern Thailand, and South China) and the golden triangle (Afghanistan and Pakistan) which together produce 95% of world's heroin, much of which is trafficked through India. In addition, there is a very significant illegal sale of pharmaceutical drugs that is being used as narcotics. Spread of HIV through IV drug use is a much bigger problem than the 'official' claim that it is restricted to the North-Eastern states of Manipur and Nagaland.
Now we will see how society discriminayrd against the HIV/AIDS patients. Here i just want to put three incidents. By reading these, you can come to know how society is treating the AIDS patients.
1. Recently, in East Godavari district, Andhra Pradesh, a media report said that a 19-year-old youth was confined to a solitary cell and thrown morsels from a distance by his parents who didn't want to touch him for fear of getting infected. Social isolation and rejection is witnessed even in urban areas. People with HIV/AIDS continue to be refused admission in hospitals despite clear orders issued by the Andhra Pradesh government against discrimination.
2. "Once I tested positive for HIV, the treatment meted out to me changed drastically. When I protested, I was told to shut up since I brought it upon myself," says Nirmala (name changed). Reports said that villagers stoned her to death . Pounamma's family, which includes a mother and two brothers, buried her after her death according to the custom of their (lower) caste. As no one in her family wanted to touch her, fearing they would get infected, they allegedly paid three sweepers to wrap her in a mat, put her in a cart and take her to a dump for burning. By doing so, they believed they could prevent the spread of AIDS to others.
3. AIDS changed Nisha Chakravarty from middle-class mom to untouchable. Her husband denied having the disease until just before he died. By then, Nisha and her 4-year-old son had learned that they, too, were infected. After her husband died of AIDS, Nisha Chakravarty -- whom he infected -- was left an outcast, unable to find a job or a home. Her son, 4, was also infected and later died.
I'll say these deaths are only by Discrimination, Not AIDS. And these are only due to the first point I mentioned "People have limited knowledge about HIV/AIDS". Now the Government of India is coming up with many more projects to educate these people. And I just want to mention only 2 of those projects.
Projects by Government of India :
1. The Second National HIV/AIDS Control Project aims to implement selected parts of the second phase of India's national program, namely to reduce the rate of growth of HIV infection in India and to strengthen India's capacity to respond to HIV/AIDS. The project has two components:
The first delivers,
- targeting interventions for groups at high risk, specifically commercial sex workers, injecting drug users, migrant workers, men having sex with men, and sexually transmitted infection (STI) clinic attendees;
- providing locally appropriate information, communication, and awareness campaigns; voluntary testing and counseling; and a strengthened infrastructure for blood safety and hospital and occupational precaution programs
- establishing new sources of support for AIDS care in partnership with NGOs.
And the Second component
- finances institutional strengthening by enhancing planning, management, and implementation capacity at the national, state, and local levels;
- strengthens the leadership capacity of the health and family welfare ministry;
- conducts training; builds capacity for ongoing monitoring and supervision; supports operational research and research and development; and supports broad social mobilization and cooperation and information.
2. A Study titled, Understanding HIV-relevant stigma in India, undertaken by the National Aids Research Institute of India, the Indian Council of Medical Research, and Yale Universitys Center for Interdisciplinary Research on AIDS are planning a study that will investigate the stigma related to HIV patients in hospital settings and how it affects their treatment.
For all projects on AIDS, the Government of India is getting many international funds. And the number of major financers and the amount of funding available has increased significantly in the last year.
International Funds for India :
- Mr. Bill Gates recently came to India, and announced a gift of US $100 million for the control of HIV/AIDS in India.
- Beginning in 1991, the Government of India and the World Bank expanded their collaboration on infectious disease control programs. In that year, the National AIDS Control Project was launched with a World Bank credit of US$84 million, US$2 million from WHO, and US$14 million from the government. The project helped the government to broaden prevention efforts and to establish institutions and procedures necessary to curb the spread of HIV/AIDS. World Bank spending more in India than for any other south asian countries.
- Global Fund has approved US$26 million for Prevention of Mother-to-Child Transmission (PMTCT) and about US$7 million for TB/HIV co-infection.
- India receives technical assistance and funding from a variety of UN partners and bilateral donors. Bilateral donors including USAID, CIDA, and DFID. USAID has committed and partially provided more than US$70 million since 1992, CIDA US$11 million, and DFID close to US$200 million.
" A major challenge for India now is that of speedily increasing the coverage of HIV/Aids programmes to all vulnerable groups ". That's my conclusion.....
Hope that India will win in this battle and i pray to God for my country's success....
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