A Chronicle of Deaths Foretold

AIDS Awareness Ribbon

The 7th International AIDS Conference in Varanasi has just completed, after three long days. I wish I could report that the conference was a success – whatever that might mean. But by any measure, it was an unmitigated failure.

As far as my own, parochial interests were concerned, the conference failed to live up to its billing as a meeting of scientists and other researchers. I attended to learn of the latest applications of molecular analysis of HIV DNA. There was exactly one paper, out of 125 submitted for the conference, which even mentioned DNA. That paper found that North Indian populations have a greater susceptibility to HIV acquisition and AIDS progression as a result of reduced incidence of a single nucleotide mutation in the DC-SIGN gene, which would reduce the receptors to which HIV-1 attaches. It was the single scientific bright spot of the conference.

One of the co-authors of that paper, Anurag Rathore of the Sanjay Gandhi Institute of Medical Sciences in Lucknow, was quick to express his frustration at the way the conference had been organized – or, I should say, disorganized. Like me, he had been lead to believe that it was to be a scientific conference. Like me, he had tried-and-tried to get advance copies of the abstracts. Like me, he looked as often as he could on the conference website to get a list of the papers and a schedule for the conference. When the website was up, it showed only that those pages were “coming soon.” More frequently, however, the site was not up, since the conference organizers had hosted it on a server which allowed only minimal access before daily bandwidth usage constraints shut it down.

If the lack of scientific papers at the conference demonstrated what the conference was not, the papers that were presented were even more worrisome. Most were non-scholarly discourses about the fact that AIDS patients suffer social stigmatization and ended in pleas for people with AIDS to be treated as people. There is nothing wrong, of course, with either the premise or the entreaty. It’s just that nothing in these papers, which were written at about the level of a seventh standard book report, advanced anyone’s understand beyond where things were, say, 25 years ago.

Some of the presenters stressed the use of condoms and appropriate education in the schools. Again, these are hardly new ideas. But in India, they may still be fairly novel. These views were roundly shouted down by panelists and panel moderators, who time-and-again argued that “our Indian culture,” not condoms would save India from the epidemic. What, you may ask, is “our Indian culture?” “It is the tradition of self-control,” Professor G.P. Thakur, former president of the Indian Academy of Applied Psychology, explained to me.

This is really quite a shocking point of view to be enunciated at an AIDS conference in the country which saw its first AIDS case in 1986, and today reports (under-reports, actually) more than 5.7 million of them. It is not only naïve and fundamentally unscholarly, it is pernicious. Studies show that more than 90 percent of India’s long-haul truck drivers – a group generally held, along with female sex workers – to be principally responsible for the spread of HIV – understand that unprotected sex can transmit the virus. And yet 87 percent of this same group admits to having regular unprotected sex with prostitutes picked up at roadside dhabas. It seems they missed the lecture on “our Indian culture.” So have members of the military and police, two other groups thought to be largely responsible for the migration for the virus throughout India.

India is second only to South Africa in the number of reported AIDS cases. The South African epidemic grew out of control principally through the moralizing myopia of the government. For years, South African President Tabo Mbeki refused to sanction educational and medical programs to combat the spread of AIDS, claiming that there was no proof that the disease was caused by HIV. India has suffered from similar denial at the political level. When the Bill and Melinda Gates Foundation announced its gift to India of $1 million to support AIDS awareness programs in late 2002, Deputy Prime Minister L.K. Advani of the then-ruling BJP accused Mr. Gates of grandstanding. “India does not have an AIDS problem,” declared Mr. Advani. “We are a moral country.”

Mr. Advani was not the only Member of Parliament who didn’t get the word about the national AIDS crisis. A recent survey cited at the conference revealed that only one-in-six members of the Sansad knew enough about HIV and AIDS to correctly identify that HIV is the virus which causes AIDS, the disease.

Mr. Advani’s unconscionable refusal to acknowledge India’s AIDS problem is really no different in effect than the Pollyanna appeal to “our Indian culture” espoused by conference speakers like Dr. Thakur. The bad news is that the prevalence of this attitude among influential so-called scholars in India. If the experience of South Africa is any model, these elites will be responsible for the unchecked epidemic, consigning millions of people to needless deaths and creating social upheaval the likes of which haven’t been seen since partition.

The good new is that Dr. Thakur is the former president of the Indian Academy of Applied Psychology.

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