‘Parent-to-child transmission of HIV high in India’

BANGALORE - While India may have stemmed the AIDS epidemic “it miserably failed in prevention of parent to child transmission of HIV”, says the AIDS Society of India (ASI), a professional body of doctors in HIV care.

Health Minister Ghulam Nabi Azad told parliament on Nov 24 that nearly 53,000 children in the country are HIV positive. He admitted that the major source of the infection “is vertical transmission from their infected pregnant mothers”.

Quoting the National AIDS Control Organization (NACO), Ishwar Gilada, secretary general of ASI and founder of the Mumbai-based Public Health Organization, says that in 2009 alone 18,000 children got HIV from 65,000 HIV positive mothers despite the fact “there are strategies to prevent most of them, if not all”.

Till May this year, Tamil Nadu reported the maximum new cases among children with 2,651 cases, as compared to 2,446 in 2008. It is followed by Maharashtra where 1,269 cases were reported till May as compared to 2008 when it topped the list of new cases at 4,714, Gilada says.

“Shamefully, a meagre 10 percent of the pregnant women are covered under PPTCT (Prevention of Parent to Child Transmission) and the HIV positive women received only single-dose nevirapine, a strategy meant for Africa,” Gilada points out. “Who should be hanged for infecting the children with HIV — a failed PPTCT?” Gilada has asked in an open letter.

While the rate of infection in adults may have decreased, “the foetus continues to be neglected, as it doesn’t even cry,” says Gilada whose organization has been crusading against AIDS since 1985.

Estimates released recently by UNAIDS as a prelude to the World AIDS Day on Dec 1 showed the HIV prevalence dipping to 0.31 percent from 0.36 percent in 2006, 0.45 percent in 2002 and 0.9 percent earlier.

“Without getting into jugglery of statistics let us gracefully accept a stark reality, that HIV is widespread and has touched every corner of India,” Gilada says. He adds that UNAIDS has termed India with 2.5 million cases as the third worst HIV-affected country after South Africa (5.5 million) and Nigeria (2.9 million).

“AIDS is now a chronic problem, like diabetes and hypertension and nothing has been yet invented that kills this virus,” the AIDS Society of India says in its open letter.

In developed countries like USA almost 90 percent of HIV infections are reported as against only 20 percent in India. Moreover, half of the infected people do not know their HIV status.

Gilada points out studies by his organization have revealed a disturbing trend that pilgrim centers like Tirupati, Guruvayoor and Puri have become hubs for sex tourism, and children are the most vulnerable.

The AIDS Society of India urgently calls for a national level consultation involving all stakeholders. “We should provide subsidized medicines with quality care; reduce vulnerability of women and children; enforce PMTCT as an emergency; and focus on youth and de-addiction,” Gilada says.

“The AIDS virus moves more slowly than any infective organisms,” says Gilada. He reiterates the warning of Robert Gallo, co-discoverer of HIV, that a mutation - a virus more easily transmitted or more drugs resistant - could emerge that could trigger a second AIDS epidemic.

((K.S. Jayaraman can be contacted at killugudi@hotmail.com)