DURBAN WORLD AIDS CONFERENCE
Durban, South Africa
July 9, Sunday
Reported by Jules Levin

Report 2

Satellite Conference on HIV/AIDS Issues In India

As mentioned in an earlier report today was a satellite symposium on HIV in India that lasted from 12noon to 7pm. There was a series of speakers and panelists, and I was one of the panelists. Mark wainber, the outgoing Presisent of the IAS (Intl AIDS Society) said India needs a prevention and education program to prevent what happened in Africa. Arthur Amman said there is a window of opportunity to prevent India from becoming like Africa. Wainberg talked about the decision made 3 years ago to hold this World AIDS Conference in Durban. Although there has been criticism about choosing Durban and Africa he said the choice was a good one. Africa and the developing world is benefiting from this choice. And I agree wholeheartedly. Durban was selected because no other city in South Africa had a convention center and hotels able to handle the size of this meeting. Particularly because of President Mbeki comments and positions I think the choice of South Africa was an excellent one. Certainly, the economy in Durban and South Africa was helped by this conference. Sunday at the opening session for the conference, Mbeki is expected to make a statement. It was reported that Mbeki's government may not be willing to accept Beorhinger Ingelheim's offer of free nevirapine for use in prevention of mother-to-newborn transmission due to toxicity reported in recent study performed in South africa. But I suspect the reason is that he and his government are more concerned that demand for use of nevirapine might grow for general HIV treatment. And that people might start demanding access to treatment. I think Mbeki just doesn't want to spend the money required for treatment. 

Wainberg, Amman, and Stefano Vella (the President elect of the IAS) said "india needs to be a part ofึึ", the debate of the century is --what are we going to do about the world gap between rich and poor regarding HIV". Mr. Prasado Rao, the Director of the National AIDS Control Organization in India said although discussion about HIV in India was once taboo "the slince is now broken". Denial has been lifted. People will now talk about HIV, but a meeting like this one could not have been held in India. The participants had to come to Durban to hold such a meeting. Still, HIV IN India is now recognized as a deep social and economic problem, unlike in Africa. Rao said change is occurring in India, although slowly. There are a number of community AIDS organizations. Nonetheless there was discussion about the prohibitive cost of HIC drugs. Also discussed was even if drugs were free the infrastructure is not prepared yet to offer treatment on a wide scale. What about adherence, the overcrowded and undertrained medical providers In India? They talked about the high rate of HIV among those with STDs, and the STD rate is relatively high. 

I was told today that there are 1 billion people in India. It was estimated that 3.5 million people win India have HIV. I think it's agross underestimate. They have not designed good tracking and reporting systems. The range of prevalence estimates reported today was 1% to 15%. The number of AIDS orphans and migration were discussed as major problems. Truckers travel throughout the country contracting HIV in one place and transmitting it in other places. Dr. Subha Raghavan, a HIV clinical nutritionist at Harlem Hospital, deserves immense credit for planning and organizing this brilliant meeting. Many attendees committed themselves to helping India. Tomorrow, before the conference opens, are Satellite Symposiums held by Roche and Abbott, where T-20 and ABT-378 (Kaletra) are expected to be discussed.