India risks backsliding on success against HIV

India risks backsliding on success against HIV
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Highlights

New HIV infections in India could rise for the first time in more than a decade because states are mismanaging a prevention programme by delaying payments to health workers, the United Nations envoy for AIDS in Asia and the Pacific said.

HIV infections in India could rise, UN envoy fears

New Delhi: New HIV infections in India could rise for the first time in more than a decade because states are mismanaging a prevention programme by delaying payments to health workers, the United Nations envoy for AIDS in Asia and the Pacific said.

India's efforts to fight HIV have for years centred around community-based programmes run for people at high risk of contracting the virus, such as sex workers and injecting drug users. The results won praise globally - annual new infections fell consistently and, overall, were reduced by more than half between 2000 and 2011.

But Prime Minister Narendra Modi in February cut the federal AIDS budget by a fifth and asked states to fill the gap, even though their poorly-run bureaucracies were already slow in releasing funds to their AIDS prevention units. As a result, staff salaries have been delayed for months and prevention activities have slowed down.

The decision was part of a wider strategy to decentralize social spending and focus central government resources on building roads and railways to boost economic growth.

In an interview with Reuters, the UN Secretary General's Special Envoy for AIDS in Asia-Pacific, JVR Prasada Rao, warned "primitive" management by states would "ruin the programme". "When the new infections start rising, all the good work that has been done will be washed away," said Rao, who said he based his view on interactions with several federal and state AIDS officials in the last six months.

Reuters reported in March that government data and letters obtained under right to information legislation showed state treasuries were delaying payments and thousands of health workers had gone unpaid for months.

In the western city of Mumbai, Manoj Jani, project director of an organisation working with sex workers under the AIDS programme, said his 23 staff were demoralised because they have not been paid for four months. AIDS tests have been curtailed. "Workers are not able to travel for testing activities due to funding issues," Jani said. "We never thought we would see such a day."

India's free HIV/AIDS drugs programme, launched more than two decades ago, has been highly successful. The World Bank estimates India's policy of targeting sex workers averted 3 million infections with HIV, the virus that causes AIDS, between 1995 and 2015. Still, UNAIDS estimates India accounted for most of the 340,000 new infections in the Asia-Pacific region last year. India's last nationwide AIDS estimates were released in 2012. Data for the next assessment is still being collected.

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