The woman with India's toughest job

Rao, an IAS officer with a long association with the health ministry, was disappointed that the discussion could not be fitted in the plenary session and was instead slotted into a breakout session at the Asia Society Conference.

She had hoped to reach out to corporates attending the conference but those in attendance before her were a handful of journalists, representatives of Non Governmental Organisations and interested individuals.

"We lost 500,000 people to AIDS last year. There are 5.2 million HIV infected people in India," she said.

"12,000 to 15,000 people in the world will be infected today -- around a thousand in India -- and 95 per cent will not know it till eight years later when it become a full blown AIDS case and they would have infected others," said Holbrooke, who runs the Global Business Coalition on HIV/AIDS.

If that doesn't hit you hard enough, think about this -- 35 per cent of all reported HIV infections in India occur among young people between 15 and 29.

It is estimated by 2010, 22 to 25 million people will be affected with HIV in India and considering the number of youngsters in the high risk group, AIDS will have a big impact on the economy.

And at a conference buoyant about India as growing business market, the talk on AIDS was a reminder that economic rationale made it mandatory to focus on its prevention and spread. For this to happen, a public and private involvement is necessary with corporates pitching in and initiating awareness programmes in companies and offices.

Holbrooke, a former United States ambassador to the United Nations, stressed the importance of testing and breaking social taboos about sexual health that existed in India. "Respecting the cultural taboos will kill the culture of India, you have got to test for prevention."

'Sex is not a cultural taboo in Bollywood films'

Giving the example of the president of Botswana who tested publicly for HIV, Holbrooke said Indian leaders should take the initiative and take the AIDS test so that people are encouraged to take the test.

"If you don't know your status, you can't stop it," he added.

In response, Rao said Indian society was most influenced by cricketers, actors and politicians and if they came out and joined the battle against AIDS it would go a long way in spreading awareness.

Holbrooke felt that testing should be done when it could affect another person -- like during marriage, pregnancy and for tuberculosis patients who are at a high risk of carrying the infection.

The discussion became impassioned when a member of the audience justified mandatory testing -- just as the Goa government has done for couples at the time of marriage.

Rao vehemently opposed mandatory testing and stood up for the need to respect Indian cultural sensitivities.

"Mandatory testing is stupid," Rao said with considerable vehemence. "What if you are tested today and contract the infection soon after you are married? And what happens if a girl is detected with HIV at the time of marriage, do you think she will be able to get married after that!"

She explained to the audience, which had a large component of foreigners including The Wall Street Journal Asia Managing Director Christine Brindle, that in an India where female foeticide was a big problem, a young girl's life could be made miserable if such were to be detected with HIV at the time of marriage.

While she encouraged testing, she certainly did not believe that I billion Indian people should be mandatory tested.

India is a very complex country, you don't know the realty in the village level, you have to work within the existing cultural taboos, she said.

The Manmohan Singh government, she revealed, is very serious in tackling the problem and the prime minister discussed the problem at a three-hour meeting with National AIDS Control Association officials and other activists recently. "So we are moving in the right direction and hope the private sector will do more than words of compassion."

Photograph: Jewella C Miranda