Doubts over India's Aids figures

[Bull]

India has more HIV infections than any other country, the UN says
Current estimates for the number of people in India with the HIV/Aids figures could be greatly exaggerated, a leading Aids worker says.
The UN says 5.7 million people in India have the HIV virus, the highest number in the world.

But Ashok Alexander, of the anti-Aids Avahan organisation says figures due out soon could be "substantially lower", the Associated Press reports.

The BBC has learned that the figure could be as low as three million.

Experts say that the discrepancy between 5.7 million and three million could only be explained by errors in the methods of calculating the numbers of people with the HIV virus.

India is about to embark on a new and expanded phase of its Aids control programme, with increased funding from the government and from international donors.

"The actual number we've come up with in aggregate is likely to be lower, and perhaps substantially lower," Ashok Alexander, director of Avahan, the Indian programme of the Bill and Melinda Gates Foundation, said, the Associated Press news agency reports.

Officials say the virus is spreading to low-risk groups

Mr Alexander said the new estimates were likely to be more accurate because they came from pre-natal clinics, high risk groups and from the government's National Family Health Survey.

He said that this was a far more accurate way of collating the figures than previous estimates which only relied on details provided by pre-natal clinics.

Mr Alexander declined to speculate on what the new total would be, pointing out that data is still being assessed and exact details will not be available for a few more weeks.

Last week, India health officials said they were alarmed by the growing numbers of pregnant women infected with HIV/Aids in the northern states of Uttar Pradesh (UP) and Bihar.

They are among India's most backward, with huge populations but poor literacy and health services.

Officials say workers who migrate to cities in search of work bring the infection back to the states with them.

They said that unless the state governments got serious about tackling the disease, there could be an Aids epidemic.

 

[Bull]

Finally some good news.

 

[SMC]

Let's see the name of the person who's saying this.. "Ashok Alexander".. well, what can you say. That ends the story right there.

 

[Neo]

This is good news indeed if true tough I remain sceptical about the weak counter argument used by Mr Ashok Alexander.
To counter esitmates by a professional and respected organisation as the UN you need data based on national nationwide surveys.

Where is the data?

 

[joey]

I dont care about all these estuimates, fact is there is mass scale HIV and it needs to be tacked period.

A few million less will only give our pious babus excuse to curtle funds for developement, we need to install more condom vending machines for truck drivers, prostution need to be made legitimate and tax needs to be imposed on them, which will greately reduce the risk of HIV than things being runned as illegal.

 

[Neo]

Well said Joey, I second that.

 

[Srirangan]

While this is good news, it shouldn't slow down anti AIDS efforts.

 

[Bushroda]

The survey is being carried out under International Supervision so it basically rules out any foul play. But still 3 million is a huge number

India may have millions fewer AIDS victims than thought
By Donald McNeil Published: June 7, 2007
International Herald Tribune

NEW DELHI: India, which has repeatedly been accused of denying the size of its AIDS epidemic, probably has millions fewer victims than has been widely believed, according to a new household survey that has not yet been released.

Early analysis of the figures in the survey suggests that the number of infected people in India is between 2 and 3 million, according to several sources, including American epidemiologists who know the data and the Health Ministry here. That compares with 5.7 million under the official 2006 estimate by the United Nations.

If the results of the survey - conducted under international supervision with American financing - are correct, India is no longer the world's supposed leader in AIDS infections. Instead, it would again rank behind South Africa, with 5.5 million infected people, and possibly behind Nigeria, which has 2.9 million cases.

"Everyone transiting through here says, 'This is a pandemic,' " Dr. Anbumani Ramadoss, India's health minister, said in an interview. "But I am very confident that we will not turn into a generalized epidemic."

A nation's AIDS epidemic is considered "generalized," meaning it is spreading throughout the sexually active population, when more than 1 percent of people are infected. India's official rate has hovered for years at 0.9 percent of its 1.1 billion people; the new survey suggests that it may actually be as low as 0.3 percent.

That implies that India has managed to keep its epidemic more like that of the United States, where the virus circulates mostly within high-risk groups rather than generally in the population. In the United States, the prevalence rate is 0.6 percent.

In India's case, the high-risk groups are prostitutes and their clients, especially truckers; men who have sex with men; and people who inject drugs, especially in the northeastern part of the country near the border with Myanmar.

Some experts on AIDS surveillance techniques have been saying the same thing for years, arguing that Indians do not have the same kind of sexual networks that are common in southern and eastern Africa, in which both men and women often have two or more occasional but regular sexual partners over long periods of time. Also, outside of prostitution, "transactional sex" between teenage girls and older men in return for money, food or clothes is much less common in Asia than in Africa.

James Chin, a professor of epidemiology at the University of California at Berkeley, has argued that the typical way of estimating AIDS prevalence rates - sampling the blood of pregnant women who come to urban health clinics and the blood of high-risk groups - greatly exaggerates national estimates.

He has been vindicated by more recent surveys, paid for by the United States, that take blood samples in randomly chosen households in rural and urban areas.

One of those, called the National Family Health Survey, produced India's new figures.

Such surveys, country by country, have led the United Nations to gradually reduce its world estimates of the total number of people infected with AIDS.

"This is a replay of what happened in Kenya," Dr. Daniel Halperin, an expert on AIDS infection rates at the Harvard School of Public Health, said of the India report.

When Kenya was more carefully surveyed in 2004, Halperin said, estimates of its prevalence rate were more than halved, to 6.7 percent from the 15 percent that the UN AIDS agency had estimated in 2001.

But Halperin said that AIDS-fighting agencies have such a stake in portraying the epidemic as an approaching Armageddon that they are hesitant to make significant downward revisions in estimates.

India's survey was finished last year, but Avahan, an AIDS group here financed by the Gates Foundation, refused to discuss the figures before their formal release, which has not been scheduled.

"If the total number of cases in the world is half of what you've been saying, that's a bitter pill to swallow," Halperin said. "So every year they lower the numbers a little bit, and retroactively change the estimates of what it used to be. It's sort of Orwellian."

In Africa, infection rates range as high as 30 percent. South Africa's is about 22 percent, and that figure is considered relatively accurate because the epidemic is older there than in India, and full population surveys have been conducted.

Claims in recent years by prominent experts that India was in denial about the scale of its AIDS problem have become a sore point for Indian health officials.

Richard Feacham, until recently the executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said in early 2005, when South Africa was thought to have slightly more cases, that "the official statistics are wrong." He warned that India's epidemic could shoot up to African levels, wiping out the surging economy and leaving a nation of orphans.

But S.Y. Quaraishi, then head of India's National AIDS Control Organization, took offense, calling such projections "technically incorrect and misleading."

In 2002, when Bill Gates visited India to donate $100 million to fighting its epidemic, the country's health minister at the time, Satrugan Sinha, accused him of "spreading panic among the general public" by suggesting that cases could reach 25 million by 2010.

Given the new survey results, Ramadoss, the health minister, was asked if India was owed any apologies. All he wanted, he replied, was "that the world acknowledge the efforts India is making."

Among them, Ramadoss said, was the $2 billion it is spending to fight the disease, the 75,000 people who now receive free antiretroviral treatment, the 2,000 centers around the country that provide sex education and condoms to sex workers and clients, and the 3,600 free testing centers.

India sends government workers to hand out condoms outside theaters showing pornographic films, even though the films are illegal. It has created a government condom brand called "Dipper," a play on the advice painted on the backs of many large trucks, "Use Dipper at Night," meaning that following drivers should switch to low-beam headlights.

"India is glaringly not in a denial phase," Ramadoss said, adding that he was grateful for the pressure on his country from critics because it had forced the country to move faster. "We need to work with the Global Fund, not contradict each other."

Anjali Gopolan, executive director of the Naz Foundation Trust in India, which runs an orphanage and fights stigmatization of AIDS victims, said she was skeptical of any estimate as low as 2 million. But whatever the correct figure turns out to be, she said, "the infection is here, and we have a huge burden - we are a very sexually active culture, contrary to what the politicians want to project."

AIDS is still a disease that carries tremendous stigma in India. In recent weeks, newspapers have carried reports of an AIDS patient left on the street outside a hospital to die, of five infected children expelled from school and of a woman beaten to death by her in-laws, who feared she would infect the family.

 

[Adux]

Let's see the name of the person who's saying this.. "Ashok Alexander".. well, what can you say. That ends the story right there.

would you prefer him to be mahommed farooq to get your seal of honesty