“Mr. Condom” will Save Lives

The Wire has reported, on a few occasions about the very real threat that HIV/AIDS poses to India’s well being and security. From recalcitrant state officials who passionately resist sex education programs to the growing prevalence of infected Indian military personell, it is safe to say that glimmers of hope are seldom encountered in the landscape of an epidemic. Still, when they do shine through, it is our duty as hopeful citizens to magnify their intensity. Such is the case with this installment of the Wire that highlights the work of the National AIDS Control Organization (NACO), an agency organized under the auspecies of India’s Ministry of Health & Family Welfare.

Searching for a Hero

In a June 29th article, the Times of India reported that K. Sujatha Rao, NACO’s program cheif, had just returned from a trip to Thailand with a new sense of purpose; he wanted to dub India’s very own “Mr. Condom”. Modelled after a revolutionary Thai senator, Mechai Viravaidya, Rao envisions this individual to be passionate about the cause. Mr. Condom, whoever he may be, has a tall order to fill according to Rao:

He has to quiten cynics and inspire leaders into promoting condom use. He has to devise and implement imaginative condom promotion techniques as was done in Thailand. He has to have a dynamic personality to change both government policy and public perceptions about HIV, AIDS, sex and condoms.

According to the Times, the World Bank credited Mechai’s creative and sometimes iconoclastic methods for stymieing Thailand’s AIDS crisis and preventing another 7.7 million infections. His methods, to name a few, included persuading traffic cops, Santas and toll-booth operators to distribute condoms, Buddhist monks to bless batches of condom packs in ceremonies and hiring farmers to spray-paint condom ads on their cows.

“He glued condoms to visiting cards, put them on key chains and named his restaurant Cabbages and Condoms.”

Mr. Rao has assembled a strategic team to help devise methods of promoting condom use in India. Recruits from the prestigious Indian Institute of Management are among those who will lead the quest for “Mr. Condom”. Perhaps a “Ms. Condom” or a dynamic-duo of the two would enjoy even more success.

Don’t Ask Don’t Tell: “Rapid Spread” of HIV/AIDS Seen in Indian Armed Forces

Today the FT reports that there is mounting concern within the Indian Army over growing number of servicemen infected with HIV/Aids. Officials indicated that this problem should not only be the concern of the military as disease is being passed on to the unsuspecting wives of infected soldiers when they return home from active duty.Many of India’s military personnel are stationed close to regional insurgencies in the country’s northeast. Unfortunately, two states in this part of the country, Nagaland and Manipur, are also classified as having an abnormally “high-prevalence” of HIV/Aids infection.

The growing infection rate within the Indian Army (one of the worlds largest), is now seen to represent a major peacetime threat to both the military and the nation as a whole. An officer in the Assam Rifles (pictured), “India’s oldest paramilitary force”, noted over two years ago that more soldiers were being killed by HIV/Aids than by enemy fire in the north-east. The article goes on to explain:

“During peacetime, military personnel are up to five times more likely to contract sexually transmitted infections – including HIV – than the civilian population. In times of conflict, when soldiers are away from home for long periods, the risk is even higher.”

The Wire has recently reported (here and here) on India’s anti-HIV/Aids campaign. Although recent reports suggest progress has been made, the military does not keep official statistics on infected personnel. If New Delhi is serious about combating the HIV/Aids epidemic, it should do a better job of monitoring infection within the ranks of the Indian armed forces. Additionally, it should encourage efforts that the recent defense ministry campaign to educate the wives of soldiers regarding the threat of sexually transmitted diseases brought home by their husbands.

Contraception: The Coy Leading the Blind

Two of the world’s largest democracies, India and the United States share more in common than their form of government. Both societies demonstrate a distinctive recalcitrance to programs that promote sex education and awareness despite being faced with significant populations of high at-risk, sexually active citizens. Today’s NYTimes article, “Pigs With Cellphones, but No Condoms” underscores this disfunction which is even prevalent in America’s top networks. Fox and CBS both rejected a Trojan condom commercial that, according to a written response from Fox, “addressed prevention of pregnancy” instead of stressing health-related issues. While an element of hypocrisy has always persisted in both American and Indian cultures when it comes to sex, those in the contraception business may find this development especially disqueiting if the networks’ reaction is any indication of how more conservative societies will respond to marketing by the prophylactic industry.

In a May 26, 2007 article, “Conservatives obstruct sex education in 6 states“, LiveMint reported that six of India’s twenty-eight states suspended a federally approved “adolescence education” program designed for 15- to 17-year-olds primarily due to conservative uproar that took issue with an illustrated flip-book depicting the changes an adolescent goes through during puberty. Among these states were Karnataka and Maharashtra, home to two of India’s largest sprawling metropolises, Bangalore and Mumbai. In such cities, young adults are leading increasingly independent and Westernized lifestyles free from the physical familial restrictions that historically made casual sex a dangerous and hence, less frequently embarked upon adventure. Condom manufacturers targetting these markets will be forced to strive for exceedingly creative ways to reach their consumers while satisfying the rightist groups (Hindu, Muslim and Christian) that decry the “corruption of their youth” to the high heavens.

Although a recent study suggested that India’s HIV infected population may be significantly less than once estimated, as the Wire noted in “Second Place is Better“, the fact remains that an epidemic is what we have to reckon with.

In this Case Second Place is Better: India Has Fewer AIDS Victims Than Thought

The NYT reports that a study financed by the Gates Foundation drastically reduces the number of Indians suspected of being infected with HIV. A previous 2006 UN report estimated that there were 5.7 million Indians infected, more than any other nation. However, the new study, yet to be released, puts the number between 2 and 3 million, putting India behind South Africa (5.5 million) and Nigeria (2.9 million) in the overall rankings.

Epidemiologists were quick to note that the findings, although encouraging, were no reason to decrease efforts at preventing the spread of the disease. India’s health minister expressed hope that India could keep its AIDS epidemic from becoming “generalized”, spreading through the main population as opposed to being mainly restricted to subgroups of the population. An epidemic is considered to be generalized more than 1% of the population is infected. The new data reduces India’s infection rate from 0.9% to as low as 0.3%.

Like the US, India’s AIDS cases tend to be restricted to specific socio-economic groups: “prostitutes and their clients, especially truckers; men who have sex with men; and people who inject drugs, especially in the northeastern part of the country near the border with Myanmar.” Moreover, researchers suggest that India has been spared the higher rates of infections seen in Africa due to differing “sexual networks”. As the article noted:

“In southern and southeastern Africa … both men and women often have two or more occasional but regular sexual partners over long periods of time. Also, outside of prostitution, “transactional sex” between teen-age girls and older men in return for money, food or clothes is much less common in Asia than in Africa.”

Indian officials have been criticized by international health organizations for not taking the country’s AIDS epidemic seriously enough. When Bill Gates donated $100 to fighting the disease, former heath minister “Satrugan Sinha, accused him of ‘spreading panic among the general public’ by suggesting that cases could reach 25 million by 2010″.

Even with the welcome decrease in infected Indians, experts stress the need for continued vigilance and government involvement in sexual education. Anjali Gopolan, executive director of the Naz Foundation (India) Trust, noted that despite the new figures, “the infection is here, and we have a huge burden — we are a very sexually active culture, contrary to what the politicians want to project.”

http://www.nytimes.com/2007/06/07/world/asia/07cnd-aids.html?hp=&pagewanted=all