India sees cut in new HIV cases but battle not over

Radhe Shyam looks every inch the family man as he cradles his chubby, four-month-old baby in his arms and glances lovingly at his wife and two other daughters. Shyam, his wife and one of his three daughters, however, are HIV positive. The couple's youngest is also likely to be carrying the virus, although that will be confirmed only when she is tested once she is 18 months old. The 42-year-old and his family are among the estimated 2.3 million people in India living with HIV. Daily life for people with the virus is hard, particularly due to the stigma it still carries in the socially conservative country. "I was working as a cook and doing well for myself but my life changed for ever in 2008 when I was found to be HIV positive," said Shyam, who lives in the east of India's capital, New Delhi. "I lost my job and still can't find another one because the moment people come to know about my disease, they step back. My wife is illiterate and we have three children to take care of," he told AFP, fighting back tears. "The government does take care of our medical expenses but we need to have some source of livelihood. I don't know when our life clock will stop ticking. I shudder to think what will happen to our children." More than 60 million people around the world have been infected with HIV since 1981, according to a Unaids report last year based on 2009 figures. Nearly half of them have died from AIDS-related causes. In India, there has been a 50 percent decrease in new infections between 2001 and 2009, the report said. So-called "first-line" antiretroviral therapy (ART) - a cocktail of drugs to slow the effects of the virus on the body's immune system - have been widely available and free of cost in India's public health system since 2004. More expensive "second-line" ART is also free of charge, although access to it is limited to just a few centres across the country. Indian pharmaceutical companies have helped to drive down the cost of life-saving generic drugs to treat people with HIV in developing countries. But UNAIDS coordinator in India, Charles Gilks, said that while the authorities should be commended for tackling the problem, the country had not yet won the battle. "Fifty percent reduction (in new infections) is a very good figure. The challenge now is to ensure that the progress and momentum are maintained," he said. "There should be no reduction in political commitment otherwise the epidemic will rebound." Shyam and his family's predicament is a stark reminder of the work to be done. Activists warn that children with HIV are often abandoned by their parents or excluded from the society, while adolescents injecting drugs are being left out of the fight against the illness. A lack of awareness and testing could mean many more HIV cases are undiagnosed while the cost of affordable, Indian-made generic drugs could go up if a proposed trade agreement with the European Union goes through. "Children cannot access information or treatment on their own, which makes it very difficult," said Anuradha Mukherjee, programmes manager at the charity Naz Foundation, which works exclusively with AIDS victims. "They need the right knowledge and proper sex education, which is often not forthcoming, be it from parents, school or society in general. In such a scenario it is tough for the child to know what is right and wrong. "Also, the young often do not know the problem of drug-related issues and HIV. They might be using the same syringe in a party not knowing the possible consequences." More awareness across all age groups and every section of society is now needed, Mukherjee added. "You come across people who say mosquito bites cause AIDS. So there needs to be more awareness through media campaigns, more pre-natal check-ups and sex education classes for children. "It's a war out there and everyone must chip in."