Women's and Girls' Health in South Asia: Challenges for Global Policy

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A woman suffering from HIV/AIDS uses a stick to walk back to her bed in hospital. Cambodia. (© Masaru Goto / World Bank)

We know from other places that if India does not take forceful measures now, while its HIV population is limited to 1%, but 1% of a billion is an awful lot of people, but if they don't take forceful measures now, HIV could reverse the great strides that India has made in recent years as a modernizing, strong nation. Left untended, AIDS could destroy that dream. We have seen in other places that leadership is the critical variable. We have seen the remarkable turnaround in Uganda, in Thailand, in Senegal, when leaders commit at the highest level and launch nation-wide campaigns - in effect declaring war on this killer. The problem has to be attacked by every sector: public, private, NGOs, the media, the corporate sector. Every sector has to attack from its own base. But above all what is needed is the political will and it has to be attacked now because though it is contained in India, it cannot stay contained.

What our trip to India made crystal clear to me is that India's top priority at this stage should be the destigmitization of AIDS. But given that AIDS has spread in India through sexual contact and only to a small degree through needle use, it is very tough to get Indians to talk about it, and yet they must. My husband and I met with the President of the country, Dr. Abdul Kalam, who told us that he was placing a great deal of faith in the development of an anti-HIV vaccine. When I mentioned to him that that vaccine, as far as I know, was possibly a decade away, he really didn't engage on what else India ought to be doing at this stage. So there is still this widespread feeling among those in positions of power in India that it's a rather small problem.

But no disease can be contained in the age of globalization. We saw how quickly SARS spread from a low-income housing project to paralyzing all of Hong Kong. But then it was contained because the Chinese leadership acted with great force and energy and brought it under control. That's what it takes.

AIDS spread to India most likely through South Africa, where there is a very large Indian population and as Adrienne already pointed out, workers move where the jobs are, leaving their wives behind and that is how this invisible disease is spread.So in India, prevention needs to be the focus. Treatment of the thousands already ill is also vital; I don't mean to underrate that. But without prevention, the situation will soon be catastrophic. And women must get special attention, as they are the most vulnerable population in India. They are also the core of the family so that when a mother is stricken, it is the entire family that implodes. My husband and I have traveled to 11 African countries that are at a far more advanced stage of AIDS and we have seen what happens to families when the mother is infected with HIV. And we have also seen what happens to economies when AIDS is left untreated. We have seen economies where for every job opening, two people have to be hired because of the certainty that one of them will succumb before too long, to HIV. Those economies are now in a state of collapse.