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June 29, 2006

India’s Minister of Health Talks about Control of HIV/AIDS

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Anbumani Ramadoss, MBBS

Video of Dr. Ramadoss' presentation
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The man responsible for the well-being of one-sixth of the earth’s inhabitants—Anbumani Ramadoss, India’s minister for health and family welfare since 2005—says that the vastness of India’s HIV/AIDS epidemic has turned this serious public health problem into an economic, social and development crisis as well.

In a June 28 talk at the Bloomberg School of Public Health, Ramadoss, MBBS, said he is putting 80 percent of India’s money for AIDS into care and treatment. He rates India’s response to AIDS up to now as “pretty good,” but not “very good.” India saw its first case of AIDS in 1986; today, over 5 million of its citizens are HIV-positive. And of the estimated 5.2 million Indian people infected with HIV, only 100,000 have been identified so far, largely because of the stigma attached to admitting one’s HIV status. The good news, however, is that 90 percent of those 100,000 will be in treatment by next month.

Ramadoss emphasized that besides treatment, massive education and prevention plans must be implemented: 50,000 counseling and testing centers; 5,000 parent-to-child transmission centers; 3 million condom-dispensing machines; a community health worker in each of India’s 620,000 villages; and trained peer leaders in every school and university (right now, “only” 65,000 schools and 23,000 colleges currently have peer leaders).

Since sexual activity accounts for 85 percent of India’s HIV transmission, Ramadoss has been busy organizing a massive condom-promotion program. He expects 100,000 condom-dispensing machines to be in place by the end of the year. This safe-sex campaign, however, is sure to raise eyebrows if not hackles, he noted, since Indians can react strongly to frank talk about sex. “India is a very sensitive population,” he said, “and people are still stunned if the subject of sex comes up, especially in rural areas where 73 percent of our population lives. But we are going there.” Beyond these cultural barriers, India’s 90 official languages, 256 dialects and 3,000 subdialects can also complicate any educational campaign.

Ramadoss said his country currently has just 2,300 of the 50,000 integrated counseling and testing centers it needs. The Bloomberg School, whose collaborations with India began with international health expert Carl Taylor’s involvement in the 1950s, has agreed to collaborate with India’s Ministry of Health in the creation of a number of public health schools, which can train such counselors, among other public health professionals.

Although his talk was about India’s response to HIV/AIDS, Ramadoss also mentioned the other huge public health crises facing his nation, including rural health; chronic diseases like diabetes, stroke and cancer; mental health; and the aging of the population. He is also gearing up to reduce road traffic injuries, a significant public health crisis in the developing world that often goes unrecognized. One of his plans: to open trauma centers every 700 km along all major highways in India.

Facing all these problems, Ramadoss said he is heartened by the fact that the Indian government supports virtually all of his programs. Lawmakers, for instance, are working to pass an HIV Stigma Act, forbidding discrimination toward people with AIDS.

“Every ministry in the government—transportation, commerce, and so on—is contributing financially to the battle against AIDS.” And he is cautiously optimistic and indeed relishes the challenges ahead. “If India succeeds against AIDS,” he said, “the world succeeds.” —Rod Graham

An video interview with Dr. Ramadoss is available in the Media Archive section.