AIDS: “The Greatest Weapon of Mass Destruction”

Mumbai has been adulated in many ways – in the 19^th century a British Governor christened it “the first city in India” and a recent biographer called it “the city of gold” for presenting opportunities to India’s teeming jobless. What isn’t mentioned is that it is also the country’s AIDS capital and is destined to become one of the world’s hot spots for this dreaded disease.

Due to heavy migration to Mumbai’s cotton mills and other factories from the 19^th century, there was a preponderance of males, which gave rise to a thriving red-light district around a road named, ironically enough, after another British Governor, Falkland. In this district alone, there are said to be upwards of 25,000 women in prostitution (to use the politically correct expression: commercial sex workers, according to the UN, implies choice in this obnoxious occupation), with minimal precautions.

Many Indians, presumably like men in other developing countries, believe that having sex with virgins will cure them of sexually transmitted diseases and therefore avoid using condoms. So young women are trafficked into Mumbai, many all the way from Nepal and Bangladesh, and once they are infected with HIV, transmit the disease to thousands of people. It is a sordid story which is repeated, with minor variations, in countless other cities in the global South.

India, like many other developing countries, also relies increasingly on heavy vehicles for transporting goods, and truck drivers, who spend days away from home, are highly at risk. There is a well-knit network of women in prostitution along the highways, which serves as a conduit for HIV/AIDS. Many Indian NGOs fighting against AIDS target lorry drivers.

The careless re-use of syringes for cheap drugs, like “brown sugar”, a crude form of heroin, is yet another source of the disease. And, although India, like other nations, likes to pretend that homosexuality is a Western affliction (“it can’t happen here” is a common refrain in such countries), the virus is transmitted through such intercourse.

Globally, when AIDS was first detected in the 1980s, the projected estimates of 9 million infected people were thought to be alarmist.  By the end of 2002, however, there were 42 million cases of HIV/AIDS, nearly five times as many. It is different from other communicable diseases because there is as yet no cure. There have so far been 20 million deaths and 14 million children orphaned due to it. As two South African researchers, Peter Ashton and Vasna Ramasar, observe: “In the absence of a miracle, perhaps in the form of freely available anti-retroviral drugs, most infected people are likely to die within the next decade.”

AIDS Is Only Part of the Story

This April, former US Secretary of State Colin Powell, said that “HIV/AIDS is the greatest threat to mankind today, the greatest weapon of mass destruction on the earth.” In India and elsewhere, however, there has been a fierce, and as yet unresolved, debate over whether the attention – and more importantly heavy funding – to AIDS has led to the neglect of other, much more widespread, communicable diseases, notably TB and malaria. There is a suspicion that because this disease first affected the West, particularly the US itself, it has aroused the concern of affluent countries who fear that unlike other such afflictions, it doesn’t necessarily impact poor people alone.

A look at TB does reveal such a story. According to the London-based Economist weekly, as many as 20,000 people contract it worldwide every day and it causes 450,000 deaths every year. It is also curable, with minimal expense on medicines, against upwards of $10,000 a year on drugs against AIDS.

Malaria has a similar saga, especially with a resurgence of the disease since mosquitoes, the vector, have acquired immunity against insecticides. While the Bill and Melinda Gates Foundation, for example, is prepared to give millions of dollars to NGOs that fight AIDS, it isn’t so generous with organisations that combat these far more widespread diseases – and these agencies are minuscule in number, to begin with.

AIDS and Poverty

HIV/AIDS is intimately related with poverty and other diseases. People infected are in turn more likely to die due to TB and pneumonia because their immunity has broken down. With a high prevalence of HIV/AIDS among women, life expectancy at birth is estimated to fall to as low as 30 years in some sub-Saharan countries between 2005 and 2010. Orphans are themselves vulnerable to many more diseases. At the same time, because people in the South are poor and illiterate, they do not take the precautions that are necessary to avoid contracting HIV/AIDS. It is the biggest cause of death in Africa and the fourth largest cause in the world.

The two poorest regions of the world are sub-Saharan Africa and South Asia. The former is by far the world’s biggest AIDS hot spot, with 70% of the world’s cases. To compound the tragedy, at the turn of this century, a quarter of the population in this region was between ten and 19 years old, the biggest number ever in history to reach adulthood, and very susceptible to HIV/AIDS. Researchers show that the apparent absence of a link between poverty and the prevalence of the disease isn’t correct because per capita incomes do not reveal the tremendous disparities within countries, especially in this region.

There is now also a growing concern over the relationship between water scarcity and this disease. Countries like Malawi, Namibia, South Africa and Zimbabwe are described as “water-stressed”, and due to this scarcity, people have lower immunity. The abysmally poor drinking water quality in particular is responsible for compromising human immunity. Once again, there is a two-way relationship, with people infected with HIV/AIDS more susceptible to a much wider range of common illnesses. As Ashton and Ramasar point out, “Families caring for sick members have less time to collect clean water or treat unclean water, thereby exposing themselves to greater risk.”

India on the Right Path

In South and Southeast Asia, on the other hand, the prevalence rate is low compared to Africa, but three out of every four people living with HIV/AIDS is an Indian. According to the Washington-based Population Reference Bureau, “ India’s large number of cases – about 4.6 million in 2002 – could easily lead to a runaway epidemic.” The impact could have been much worse in these countries had action not been taken when the first cases were detected.

Interestingly, India has three major companies – Ranbaxy, Matrix and Cipla – which have, thanks to laxer patent laws, offered anti-retroviral drugs for only US$350 a year provided these are given free, as against US$10,000 - US$15,000. Admittedly, these companies may be motivated more by profit than concern for world health, but their offer exposes the insensitivity of drug companies in the North. It also reveals how so many countries are prepared to waive patent laws in the case of AIDS, because it has also affected people in affluent countries, but will oppose tooth and nail any such moves for other diseases.

Reference:

Attaining Global Health: Publications on population, reproductive and child health, and HIV/AIDS, Population Research Bureau, Washington, May 2004 (www.prb.org)

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* Darryl D’Monte is the founder President of the International Federation of Environmental Journalists and is serving a second term until 2003. He is also the Chairperson of the Forum of Environmental Journalists of  India (FEJI) and a syndicated columnist and freelance writer. He has published two books: “Temples or Tombs? Industry versus Environment: Three Controversies”, Center for Science & Environment, New Delhi , 1985 and “Ripping the Fabric: The Decline of Mumbai and its Mills”,  Oxford University Press, New Delhi, 2002. He was previously the Resident Editor of the “Indian Express” (1979-1981) and of the “Times of  India” (1988-1994) in Mumbai. Your emails will be forwarded to him by contacting the editor at: ScienceTech@islam-online.net.