The Rs 30 Cr HIV lie

The whopping amount of public money spent on AIDS survey over the past 10 years could have been wasted, as Govt suspects NGOs may have inflated HIV figures

For the past 10 years, the government has been taking the help of several NGOs to map HIV trends in the country.

Over Rs 30 crore of public money has been spent on this massive annual exercise so far. But this could all be money down the drain if the government's suspicion that NGOs have been "faking" HIV figures comes true.

The National Aids Control Organisation (NACO) carries out a sentinel survey each year to check the incidence of HIV in various populations and trends of the infection.

It helps NACO to devise new strategies on handling the epidemic.

A part of the survey used to be carried out by NGOs (see box). But that is likely to change.



Random selection

"We wanted to be sure that the sample selected is on a random basis," said Dr S Venkatesh, joint director, NACO.
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So, this time rather than asking NGOs for a sample list of people who have been tested, NACO has asked for their complete list, from which people will be randomly selected.

While the NGOs aren't paid anything to carry out the survey, inflated numbers can mean that they get huge funds from international and domestic organisations to fight HIV and Aids.

But it's too soon to say that the earlier surveys were useless. "For now, we don't know.

If our results show that there is a huge discrepancy in the 2008 report as compared to previous years, it means the earlier method had certain faults.
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If not, it means we were on track," said Dr Sanjay Mehendale, deputy director, Pune's National Aids Research Institute, who is coordinating the sentinel surveillance programme across eight states.

Added Mehendale, "We decided to do the sampling ourselves to be 100 per cent sure the sampling was random and clients were not selectively chosen to portray a particular scenario."

'It's too late'

The 2008 report has not been released because the government now wants to release it early next year with its own survey.

Experts working in the field of HIV and Aids say that the report holds little value now, as the figures may come in too late and may not even reflect trends.

"The rate at which the infection is moving, two-year-old data will not be an appropriate indicator of the current situation.

The survey report is useless even if it does come out, and by relying on them we would be playing with lives," said Dr Anjali Gopalan, founder and executive director of Naz Foundation, a Delhi-based organisation that works in the field of HIV. The foundation is not associated with the government survey.

Welcome move

The only spark of good news in this initiative is that the government will not have to shell out any extra money to take over the reins.
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"There is no extra cost involved. Only the procedure has been changed because we wanted a 100 per cent reliable report and the NGOs were in a position until now to manipulate data," said Harish Pathak, deputy director of Mumbai District Aids Control Society (MDACS).

Currently, NGOs have been eliminated in Gujarat, Maharashtra and Karnataka. The new process will be implemented in other states soon.

Manish Pawar, coordinator of Asha Mahila, that runs three projects for sex workers in Kamathipura funded by MDACS, said, "This is a good initiative, it will help bring in a clear picture. There was scope for manipulation in the earlier module."

Added Mahesh Shinde, project manager of Humsafar Trust, which also runs three projects for MDACS, "We welcome the move and have readily shared our list with the government."

NGO Help

The survey has been carried out every year since 1998 across three places at hospitals' antenatal clinics where pregnant women come for treatment, at clinics to treat sexually transmitted diseases and in high risk groups such as sex workers, couples, homosexual men, etc. NGOs help out in the third category.

The goof-up of 2006

In 2006, based on the government's sentinel surveillance data collected the previous year, NACO calculated that there were 52 lakh people living with HIV in India.

But on June 6, 2007, Anbumani Ramadoss, the then union health minister, released the results of the third National Family Health Survey, which arrived at an HIV burden of only 25 lakh, half the figures estimated by NACO.

It was later agreed that the HIV numbers were highly "overrated" and the NFHS-3 figures were accepted as correct.

Did you know?
Maharashtra, Andhra Pradesh, Karnataka, Tamil Nadu, Nagaland, Mizoram and Manipur are the worst affected states

Rs 3 Cr
The amount the govt has spent every year since 1998 to carry out the survey

25 Lakh
The number of people living with hiv in india

546
The number of pregnant women diagnosed as hiv positive in mumbai in 2009 as compared to 756 last year