NEW DELHI: India is sitting on an HIV/AIDS "time-bomb'' and the epidemic could soon become like it is in Africa unless immediate steps are taken to accelerate efforts to stem it. This is the warning from the head of an international funding agency.

Grave situation
Addressing a press conference on Wednesday, the Executive Director of Global Fund to fight the Acquired Immuno Deficiency Syndrome, TB and Malaria, Richard G.A. Feachem, said: "The HIV/AIDS epidemic in India is extremely grave. It is a ticking time-bomb. The epidemic is rising rapidly and could soon get out of control, unless the response was scaled up massively.''

Efforts to stem the epidemic, he says, are no doubt being taken. But, they are way behind what is required. The trajectory of the epidemic in India is the same as that in Africa and though the current level of the epidemic here may be 10 to 15 years behind that in Africa, it may not be long before it catches up. The catastrophic situation being faced in Botswana and other parts of southern Africa "is just a vision of the future" that India could face. "India had the policy, ideas and programmes to deal with the epidemic. What was needed was more and quicker response.''

Joint effort
There is, Dr. Feachem says, particularly the need to involve the corporate sector, the NGOs and the community-based organisations more effectively in anti-AIDS programmes as the Government would not be able to tackle the problem all by itself.

(The Fund is a global public-private partnership set up two years ago to attract and disburse funds for preventing and treating AIDS, TB and malaria. It has so far committed $3 billion to over 300 programmes in 130 countries. For India, it has so far cleared grants worth $413 billion for seven projects, each of five-year duration).

Asked about his recent statement expressing dissatisfaction that the Central Coordination Mechanism (CCM) — which clears proposals for funding from the agency — has rejected a proposal from the Tata group, Dr. Feachem says it is "highly disappointing." But the Centre has since restructured the CCM, including representatives of NGOs working in the area of AIDS control.

Doubts on estimate
Dr. Feachem, who has been heading the agency since its inception two years ago, is doubtful about the official estimate of 5.1 million HIV cases in the country.

The numbers, he says, must be much more, going by reports from the field.

The estimates, he says, are probably not able to capture the ground situation properly as they are based on inadequate data because of the huge gaps in the network of sentinel surveillance networks and the problem of systemic under-reporting as the disease took a long time to develop. In Bihar, for instance, no one knew how many persons are affected.

The problem is, however, not unique to India. There is under-reporting in several countries, including China and Indonesia.