INDIA, grappling with the world鈥檚 second largest number of HIV infections, has finally approved its long-awaited national AIDS policy鈥�16 years after it detected its first case. But public health experts say it lacks the teeth to make it successful.
HIV infects just 0.75 per cent of the adult population in India鈥攁 lower prevalence than in Cambodia, Myanmar, Thailand and many African nations. But with 3.97 million HIV cases, India ranks second only to South Africa in numbers of people infected.
Worse, a recent report from the UN Development Programme warns that the Asia-Pacific region has overtaken Africa in terms of new infections, and South Asia is poised to become the next epicentre for the epidemic. A recent report in the journal Current Science estimates that HIV rates may treble within 15 years.
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In light of these predictions, India鈥檚 policy seems particularly ambitious. It aims to cut the rate of infection across the nation to zero by 2007, using a multi-pronged strategy geared to raising public awareness, controlling sexually transmitted diseases and improving the safety of blood products.
But public health experts say the 2007 goal 鈥渟eems epidemiologically impossible鈥� given that infection is spreading rapidly from high-risk groups to the general population. It is only in certain areas like Mumbai, Tamil Nadu and Manipur that infection rates have started to decline, says Ritu Priya from the Centre of Social Sciences and Community Health at the Jawaharlal Nehru University in New Delhi. And the government has yet to spell out exactly how it hopes to implement its plans.
India already manufactures and sells HIV drugs cheaply since its laws only recognise patents for processes, not products. But AIDS drugs are still too expensive for many of those infected. Meanwhile the government has said it can鈥檛 afford to follow Brazil鈥檚 example of providing a free supply of AIDS drugs. The situation is expected to deteriorate after 2005 when India has to comply with the Trade Related Aspects of Intellectual Property Rights agreement that recognises product patents (快猫短视频, 24 November 2001, p 4).
Without specific legislation, it is hard to see how the new policy can be made effective. Pregnant women are not routinely screened for AIDS and almost 80 per cent of India鈥檚 healthcare is privatised. Many hospitals and clinics simply turn away people with AIDS who can鈥檛 pay, according to a member of the AIDS support group Delhi Network of Positive Persons.