World AIDS Day: Why India Should Urgently Focus on Migrants

The epidemic (AIDS) in India is growing very rapidly. It is out of control. There is nothing happening in India today that is big or serious enough to prevent it.

Richard Feachem, Executive Director, Global Fund to Fight AIDS in April 2005

These words from Feachem had sparked off a debate, with the then government rejecting his claims.

Ten years later, India fares no better. Recent data has only confirmed some of the worst fears of health experts – India is sitting on an AIDS time bomb.

India had the third highest number of HIV infected people according to a 2014 UN Report. With 2.1 million people living with HIV at the end of 2013, India accounted for “4 out of 10 people living with HIV in the Asia Pacific region”, according to the report.

HIV Prevalence Among Migrants

One of the core groups with high HIV prevalence – other than sex workers – is migrants. Lakhs of people migrating from their hometowns to industrial hubs such as Surat, Mumbai and Delhi, leaving their families behind, are vulnerable both due to unprotected sex and from having more than one sexual partner.

In India, HIV prevalence among people who have migrated from rural to urban areas is estimated at around 0.9 per cent, which is almost four times the national figure of 0.27 per cent. A NACO (National AIDS Control Organisation) report released in 2010, gives an insight on the huge volume of migrants that make a move across three inter-state industrial corridors viz., Ganjam-Surat, Darbhanga-Delhi and Azamgarh-Mumbai.

Fallout of Migration

The problem is compounded when these men, on returning back, infect their wives. Lack of knowledge coupled with social stigma as well as difficulty in accessing proper healthcare services makes these women intensely vulnerable to AIDS. A study conducted in select districts indicates more than 75 per cent of women who tested HIV positive had migrant husbands.

Lack of Awareness

In fact, despite large scale efforts by the government to create awareness regarding the disease – particularly urging the use of condoms – it’s the lack of knowledge that is at the heart of problem even today. Sample some of these quotes that are mentioned in the comprehensive 2011 UNDP report which was conducted in select districts:

I had no idea about AIDS before I came to the centre…I had not even heard the name….

32-year old HIV negative woman from Ganjam district in Odisha

A counsellor at one of the government-run testing centres in Ganjam district, Odisha had this to say:

Though we talk about the universalisation of knowledge, many people who come to us have not even heard the name of the infection. In fact, most women come with lots of misconceptions which is more dangerous…and most of them are from remote rural areas.

What is the Govt Doing?

While the numbers and the on-ground-situation are far from optimistic, no alarm bells seem to be ringing for the government yet. On October 30, 2015 Union Health Minister JP Nadda, on the sidelines of the India-Africa Summit, re-affirmed India’s commitment to end AIDS by 2030. The promise comes in the backdrop of the Centre slashing the 2015-16 central AIDS budget by 22 per cent in February this year.

The states which now enjoy a greater pie of revenue as per the 14th Finance Commission Report were asked to re-structure the spending on healthcare programmes accordingly, something that has had a sluggish pace so far.

(On World AIDS Day, The Quint is re-publishing an article from its archives that explores the plight of migrants who are prone to contract AIDS as they stay away from their families for a long time. The article was originally published on 1 December, 2015.)