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India's AIDS problem

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April 11, 2007 02:19 IST

More than 150 people attended an interdisciplinary conference, 'What is Indian about HIV/AIDS' in India. Among those present were academics and experts from various institutions and agencies.

The South Asian Studies Program at Emory University in Atlanta, Georgia, sponsored the event that featured a dialogue on the problem among activists, academics, public health experts, representatives of various foundations, media personnel, and people living with HIV/AIDS.

The objective of the event, organized by SASP Director Deepika Bahri, was to discuss how India's economy, culture, policies -- and the rest of the world -- shape an epidemic that has caught the global community by surprise.

'In a country where many believed that culture would protect the population from HIV/AIDS, the number of cases today exceeds 5.2 million, surpassing South Africa, afflicting its most productive age-group, and posing a formidable threat to its galloping growth rate,' a spokesperson noted.

The immediate goal of the conference was to explore comprehensive, context-sensitive responses to public health threats through discussion on the 'Indian-ness' of HIV/AIDS.

Participants from India and the United States included those from the Centers for Disease Control, CARE, United States Agency for International Development, Department of Health and Human Services, the World Bank, the Center for Strategic and International Studies, and the Gates Foundation.

Physician and lawyer Vineeta Gupta, who is founder and director of the Stop HIV/AIDS in India Initiative, summarized the goal of the conference when she said, 'What's Indian about HIV/AIDS that gets lost?'

In the opening session of the conference, titled Local Epidemics, Global Responses, government officials, scholars, scientists, and physicians attempted to answer Gupta's question.

They discussed and analyzed the various ways the global community has reacted to the HIV/AIDS epidemic in India. 'Given that HIV/AIDS is debilitating the most productive segment of Indian society, it is not surprising that both India and the international community have taken several steps to curb the spread of the disease,' it was noted.

Despite the altruistic intentions of international actors, a review of the presentations in this panel revealed that anti-HIV/AIDS bilateral and multilateral programs can only succeed if they account for the unique social, cultural, political, and economic characteristics of India.

'We're talking about HIV/AIDS, and attacking it means getting into the most intimate parts of people's lives -- religious, social and cultural. India has 28 states, 17 major languages, 844 dialects. It is a multi-cultural, multi-religious society. The [health] programs have to be designed keeping the diversity in mind,' Gupta said.

Altaf Lal, regional representative for South Asia at the US Department of Health and Human Services, emphasized that effective, sound HIV/AIDS programs must include four elements: 1. people, policies, and political support; 2. environment, economy, and epidemiology; 3. institutions, infrastructure, and industry; and 4. commitment, collaboration, and cooperation.

Harriet Robinson, chief of the Division of Microbiology and Immunology at the Yerkes National Primate Research Center, a member of the Emory Vaccine Center, and the Asa Griggs Candler professor of microbiology and immunology at Emory University, stressed the need for more affordable and safe HIV/AIDS vaccines since existing ones are often too expensive and carry unintended, adverse physical side effects.

Her vaccine development program, a collaborative effort between scientists at the Emory Vaccine Center, the National Institutes of Health and the Center for Disease Control and Prevention led to the development of a vaccine that has been licensed by GeoVax Inc and is currently in early phase human trials.

To Sundar Sundararaman, former director of the AIDS Research Foundation of India and now the technical adviser to the Bill and Melinda Gates Foundation initiative aimed at preventing the spread of HIV/AIDS in India, the question which was most important for him was: 'How do people within these target communities understand HIV/AIDS?'

He focused on the socio-moral notions underlying the concepts of AIDS (that is, people who do bad things will get HIV/AIDS, or, that those who get HIV/AIDS are bad people).

He also stressed the traditional social and cultural constructs and the emerging frameworks, which enable those living with HIV/AIDS to assert their self-worth, join up, and articulate their dreams.

Sudha Sivaram, a scientist at Johns Hopkins Bloomberg School of Public Health, stressed the need for ethical data collection and information on sharing practices, while Bahri, a specialist in postcolonial studies, called for attention to live experience and narrative and artistic responses to HIV/AIDS.

The conference concluded with the panel, 'How many disciplines does it take to understand a global epidemic?' The answer seemed to be innumerable: biomedicine, anthropology, sociology, public health, political science, literature, film, nutrition. Such an epidemic called for creative means of intervention, tolerance, treatment, and empowerment.

However, it was not clear what makes Indian AIDS uniquely Indian. Probably the final word came from a man living with AIDS who spoke through a representative because he could not walk to the microphone. He told the gathering that if he had been in India, his doctors told him, he would be dead, a reminder that the stakes of such intellectual inquiry has material and moral consequences.

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