India told: Get grip on HIV in 2007 or lose control

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India told: Get grip on HIV in 2007 or lose control

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NEW DELHI, Nov 20 (Reuters) - India must get on top of its HIV

epidemic by next year or risk seeing it spiral out of control, the

man who controls the richest private anti-AIDS fund in the country

and a senior United Nations official warned.

" The signs are still ominous, " Ashok , the director of the

Bill & Melinda Gates Foundation's $258-million Indian HIV-prevention

project, told Reuters in an interview.

He said the rising prevalence of HIV in more than 100 districts in

which the foundation operates showed that a decade of government

efforts had not slowed the virus, which is now estimated to have

infected 5.7 million Indians.

" The huge challenge is scaling up prevention efforts. 2007 is when

we need to have done this by, " added , who has repeatedly

said India's epidemic is at a tipping point. " It's very urgent. "

, speaking at the foundation's New Delhi offices on Friday,

said old-fashioned and inefficient management within the

government's National AIDS Control Organisation (NACO) was the main

obstacle to success.

Denis Broun, India coordinator for the U.N.'s HIV-prevention agency,

UNAIDS, said that in the worst-case scenario, the virus could spread

to infect 3 percent of India's billion-plus population in the next 5

to 10 years, up from 0.9 percent now.

India already has more HIV-positive people than any other country,

UNAIDS says.

The AIDS-causing virus is presently thought to be largely confined

within a sexual triangle of poor, male migrant workers, the

prostitutes they visit, and their wives back home.

For that reason, the Gates Foundation spends much of its efforts

telling the first two groups to use condoms.

WIDESPREAD IGNORANCE

Broun said India must aim to get 80 percent of its prostitutes to

insist on their clients using condoms if the number of new

infections each year is to drop significantly below the estimated

400,000 annual deaths from AIDS in India.

Safe sex messages from the government and NGOs are currently heard

by about a quarter of Indian prostitutes, Broun said.

If India fails to convince many more of the importance of condoms,

the country's repeatedly delayed efforts to get ever more people

with AIDS on life-prolonging antiretroviral drugs are doomed to

forever lag behind new infections.

" We have slow growth -- it's not an explosion -- but it's enough to

make any expansion of the treatment programme unsustainable,

financially and technically, " Broun told Reuters by telephone.

, who worked at consultancy firm McKinsey & Co. for nearly

two decades, praised India's recently finalised HIV strategy, which

will see it spending $2.5 billion over the next five years on

prevention and treatment.

But whether it will be carried out effectively is far from assured,

he said.

He was not surprised by a recent poll of Indian parliamentarians

showing widespread ignorance of HIV, with nearly two-thirds wrongly

believing it could be spread by sharing clothes with an infected

person.

" The interesting counterpoint is that the same thing was done with

sex workers in Mumbai and they scored over 90 percent, " he

said. " Your average Mumbai commercial sex worker is probably the

most informed in the country when it comes to HIV. "

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