Slowing the Spread of AIDS in India

By BILL GATES

EW DELHI
India is well on its way to becoming a global economic superpower. Its economy has significantly outpaced much of Asia in recent years, its internationally competitive information technology and pharmaceutical industries are projected to grow dramatically this decade, and the country's purchasing power is now the fourth largest in the world, after the United States, China and Japan.

But much of this progress will be threatened by AIDS. India already has at least 4 million people living with H.I.V., and the United States National Intelligence Council predicts that the number of people infected in India could jump to between 20 million and 25 million by 2010.

There is still time, however, to prevent a widespread AIDS epidemic in India. H.I.V. infection rates are low — less than 1 percent of the adult population is infected. Having failed to prevent enormous human suffering already experienced in Africa, the international community has an opportunity to support India's efforts to stem its AIDS crisis before it's too late.

The humanitarian imperative for action is undeniable. But there are other reasons for the West to be concerned about India's future. It is the world's largest democracy and a crucial ally in an unstable region. With one of the largest scientific and technical work forces in the world, it is also an increasingly important business partner for many countries.

India's leaders are well aware of the risk AIDS poses — they are beginning to speak out, breaking powerful and longstanding taboos about discussing sex, drug use and this disease. The prevention efforts being made here are already starting to show measurable results.

In fact, with its vast human resources and burgeoning pharmaceutical industry, India may be one of the developing nations best positioned to contain the epidemic and offer global leadership in confronting AIDS. By vigorously pursuing H.I.V. prevention, and by marshaling its impressive scientific research sector to develop the vaccines, microbicides and treatments that could help stop the epidemic worldwide, India can make a significant contribution well beyond its borders.

Over the years, I have developed close professional and personal ties to India. India's rapidly growing software sector has made the country a critical partner to many American companies, including Microsoft. India's teachers, scientists and business professionals are laying the foundation for extraordinary economic and social change that would be threatened by AIDS.

Much more needs to be done now to reach the populations that fuel the spread of the disease in India. For example, mobile populations — truckers, soldiers and migrant laborers — have H.I.V. rates up to 10 times greater than the national average and serve as a bridge from high-risk groups to the general population. Other nations — including Senegal, Thailand and Brazil — have demonstrated that H.I.V. rates can be reduced, sometimes substantially, through programs that reach those most at risk.

The Bill & Melinda Gates Foundation is in India this week to make a long-term commitment to Indian partners for a major new prevention initiative aimed at mobile populations. The initiative will focus on proven prevention strategies, such as voluntary counseling and testing, condom distribution, and treatment of sexually transmitted diseases as well as public education programs to reduce the fear and stigma of AIDS.

India cannot face the challenge of AIDS alone. Wealthy nations, businesses and the philanthropic world must contribute to efforts to contain India's AIDS crisis before it expands. Far greater resources and expertise must be devoted to prevention programs, training health care workers and supporting research into new medical advancements.

We know how to prevent the spread of H.I.V. and AIDS. The choice now is clear and stark: India can either be the home of the world's largest and most devastating AIDS epidemic — or, with the support of the rest of the world, it can become the best example of how this virus can be defeated.

Bill Gates is chairman and chief software architect of Microsoft and co-founder of the Bill & Melinda Gates Foundation.