June 22, 2001
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'India Needs a Manhattan Project'

Ela Dutt
India Abroad Correspondent in Washington

World Bank officials believe India should be fighting the scourge of HIV/AIDS on a war footing or its very existence is at stake.

Concerned Indian activists and officials believe the war should be fought like the pre-war Manhattan Project in the US that focused on building the Atom Bomb.

On the eve of the United Nations General Assembly Special Session on HIV/AIDS in New York, World Bank President James D. Wolfensohn in a statement, called on nations, corporations and non-governmental organizations to fight together against "a catastrophe for development."

HIV/AIDS, the Bank says, is reversing life expectancy by decades in some countries. More than 36 million people are now living with HIV/AIDS worldwide, 95 percent of them in developing countries. 21.8 million people have died already from the disease, 4.3 million of them children. Last year alone, 5.3 million people became newly infected with HIV.

India has estimated it has 3.9 million people infected with the virus.

Richard Skolnik, Chief, Population and Natural Resources, in the South Asia Regional Office at the World Bank in Washington, told India Abroad that New Delhi had a "gigantic unfinished agenda" in the struggle against AIDS.

While there were several achievements over the last decade, he said, "no way are steps so gigantic as to deal with the problem."

He said India should treat the scourge "on a war footing because India's very life could depend on it."

In his 16 years of working on India, Skolnik said, the problem is still getting worse though over the last 10 years, the country had developed a "careful and well-designed AIDS program," to raise the response capacity.

"India has to act like its life depends on it,"Skolnik emphasized, and noted that Tamil Nadu was moving on a war footing.

"My Indian friends believe that AIDS should be treated by the government like building a bomb," Skolnik said, adding, "If you wanted to build a bomb you would have a Manhattan Project. What could stop the Prime Minister from saying that and bringing in the best people. Otherwise India will look like another Zambia, or Botswana, or Swaziland."

AIDS was now a global development problem, threatening to reverse many of the gains made over the last half century, Wolfensohn said. "There is simply no reason why generations of people should disappear as a result of AIDS when a determined global movement of governments, communities, private companies, development agencies, and civil society groups can make a dramatic difference."

The Bank estimates that annual per capita growth in half the countries of sub-Saharan Africa, the region worst hit by the epidemic, is falling by 0.5-1.2 percent as a direct result of AIDS and that by 2010, per capita GDP in some of the hardest hit countries may drop by as much as 8 percent.

Although dramatic reductions in prices of anti-retroviral drugs are key to treatment, at $400-$500 a year, down from $10,000, they are more affordable, but still well out of reach for the vast majority of infected people in developing countries where per capita income is less than $500 per year, and where many governments spend less than $5 per person on healthcare.

Making these drugs available free in India would not necessarily take care of the problem, he said. . "People in India are giving serious thought to this all the time. They are desperately worried that even if the anti-retroviral drugs were free, managing the distribution of these will be extremely difficult - with blood tests, other lab tests, and the potential of developing drug-resistant strains of HIV."

He said the Bank is hoping it can help India have an open debate "very quickly" on anti-retroviral therapy so that priorities can be set. At the same time, the use of Neviprin against mother-to-child transmission was certainly a good idea because it was cheap and effective.

The Joint United Nations Program on HIV/AIDS (UNAIDS), of which the Bank is a co-sponsor- estimates that a basic HIV/AIDS program in all developing countries would cost at least $9.2 billion per year, six times the current level of investment which is approximately $1.5 billion a year.

This estimate does not include the additional costs involved in improving the health infrastructure in developing countries.

"In throwing their weight behind a global trust fund for the prevention and treatment of HIV/AIDS and other communicable diseases, rich countries must ensure that their pledges of financial support represent genuinely new money over and above existing volumes of foreign aid", says Wolfensohn, adding that to reallocate existing funds would "simply be a shell game."

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