World Bank ramping it up on the HIV/AIDS front in South Asia

I attended a packed satellite session on Sunday on South Asia sponsored by the World Bank at the International AIDS Conference in Toronto, in anticipation of a new report released Monday. The sheer numbers that showed up in the audience for this session reflect the growing interest in the region as the epidemiology of the epidemics in each of the South Asian countries covered by the Bank indicates that urgent action is required in terms of prevention and treatment. India received greater attention than her neighbors in this session, but I was glad to see that Bank officials pointed to numbers and the dynamics of emerging epidemics in neighbouring countries such as Nepal and Bangladesh, among others. Highlights included the imminent availability of data from the National Family Health Survey (NFHS) that will have tested over 200,000 blood samples to provide better estimates of HIV prevalence at a national level, hopefully moving the debate away from whether prevalence is 5.2 million or 5.7 million. While better estimates matter for better programming, there are other issues of importance at hand that are not receiving the attention they should in India and the region at large. These include programs for intravenous drug users and MSMs, and ramping up the use of ARVs: currently there are drugs for 85,000 people but only 60,000 are receiving them according to Sujatha Rao, the head of NACO. Clearly, better mechanisms have to be put in to place to increase access to drugs, not just in terms of provision of services but also to reduce stigma, so that the demand can increase. Kudos to the Bank for "understanding and responding" to the epidemic in terms of gathering the necessary data and recommendations for a plan of action! It is now time for the Bank and the governments of each of these South Asian countries to deliver effective programs that respond to this evidence.