Speeches and Remarks
Remarks by U.S. Ambassador David C. Mulford at the First National Conference of AIDS Society of India
New Delhi
April 2, 2005
As prepared for delivery
Honorable Minister Reddy, Dr. Quraishi, Dr. Wainberg, ladies and gentlemen: I am pleased to be here today to address the First National Conference of the AIDS Society of India. Dr. Solomon and Dr. Gilada, thank you for inviting me to participate in the conference. You and your colleagues at the AIDS Society of India should be proud of your hard work organizing this important event.
These are exciting times for U.S.-India relations. Thanks to the vision and leadership of President Bush and Prime Minister Manmohan Singh, relations between the United States and India have never been better. The transformation that has occurred has its roots in our common values and interests. This was particularly apparent last week when Secretary of State Condoleezza Rice visited India - her first destination in Asia as America's most senior diplomat. Her visit has been called a landmark event in U.S.-India relations, and the bilateral cooperation on a broad base of initiatives including energy and strategic matters will continue to grow in the weeks ahead.
The U.S. India relationship has begun realizing its potential. As Secretary Rice said in New Delhi, the relationship "is based first and foremost on the fact that we share common values, and there are no stronger relationships than those that are based on common values." Our countries are the two large, vibrant democracies, committed to political freedom, tolerance and representative government.
While our cooperation in such areas as law enforcement, counter-terrorism and joint military exercises is relatively recent, health cooperation between India and the US has been ongoing for over four decades.
India and the United States boast cooperation in biomedical research and public health programs that are important to citizens of both countries and the rest of the world.
Currently there are a host of collaborations between United States and Indian government agencies. Our Department of Health and Human Services agencies, the Centers for Disease Control and Prevention, the National Institutes of Health, the Food and Drug Administration, the United States Agency for International Development, the Department of Defense, and the International Narcotics and Law Enforcement Affairs, are all engaged in joint HIV/AIDS programs in India.
These agencies work with the Indian Government and NGOs for HIV/AIDS prevention, care and treatment and support the joint efforts of Indian and U.S. researchers in important areas such as the development of vaccines and finding ways to prevent parent-to-child transmission.
It is particularly heartening for me to see here many professionals from different parts of India, the United States and other countries. This is the kind of partnership -- on the working level between civic leaders, doctors and NGOs - that offers real opportunities to make significant advances in combating the scourge of HIV/AIDS.
HIV/AIDS devastates beyond the scope of other infectious disease. Because of its rapid spread, resistance to treatment and the highly stigmatized status of those infected, HIV/AIDS affects not just individuals but whole societies and nations. The pandemic has killed at least 20 million of the more than 60 million people it has infected thus far and has left in its wake grieving families, millions of orphans and damaged economies. This is more than just a health crisis because besides the individual and family suffering it could threaten the world economy and conceivably undermine the stability of the world.
The United States government is determined to counter these threats. This is as true here in India as it is anywhere in the world. It is impossible to understate the gravity of HIV/AIDS epidemic in India. Look at the facts:
According to recent estimates by the UN, India has the second largest number of individuals living with HIV/AIDS, just below South Africa. Without action now, India could soon have the largest number of HIV/AIDS infections in the world.
The disease is not limited to urban areas; it is spreading to rural areas as well.
Although there are six high prevalence HIV states in India, widespread migration means, in effect, that no state is safe from the spread of the disease.
The majority of those infected are age 15 to 44 - the core of India's work force.
The economic consequences to the spread of HIV/AIDS are hard to measure.
A recent World Bank report warns that HIV/AIDS causes far greater long-term damage to national economies than was previously thought. Studies of the macroeconomic costs of AIDS, as measured by reduced GDP growth rate, have shown GDP reductions in Africa of as much as 1.5 percent annually.
In Zambia and South Africa, the incomes of AIDS affected households, mostly poor, rural families, fell up to 80% due to coping with AIDS and related illnesses. In Zimbabwe, where lack of response to the disease allowed the disease to afflict a quarter of the population, AIDS robbed the county of up to 10% of the agricultural workforce.
As these tragedies in Africa show, AIDS can reduce a country's economic growth to the point of collapse; AIDS destroys people's lives in their prime, and impairs health.
The data available suggest that India is still in a relatively early phase of the epidemic, with the full economic impact not yet realized. This means the time to act is now.
The United States has taken a global leadership role in the fight against HIV/AIDS. President Bush has made confronting HIV/AIDS a top priority. He has budgeted over $2.8 billion for fighting AIDS globally in fiscal year 2005, which more than triples the annual level of investment since the previous Administration. In his 2003 State of the Union Address, President Bush announced the Emergency Plan for AIDS Relief, a five-year, $15 billion initiative to "turn the tide in the global effort to combat HIV/AIDS." This initiative, through which India is receiving resources, is the first global effort to provide advanced retroviral treatment in the most HIV/AIDS afflicted countries. Projections under this plan show we are making progress: by 2010, seven million new infections will be prevented.
You will be hearing more about President's Emergency Plan and the efforts of various U.S. agencies in India over the next three days of this conference.
Here in India, Prime Minister Manmohan Singh has called for a national movement to check the spread of HIV/AIDS. In his address to the National Student and Youth Parliament, he declaired that "HIV/AIDS is no longer just a public health issue, but one of the most serious socio-economic and development concerns". He established and now chairs the National AIDS Council. I applaud the Prime Minister's initiative on this issue. His administration is breaking new ground and opening a new, and critical, front in the battle against the disease.
There has been progress made in India, but more is needed.
Proactive and aggressive actions with significantly increased funding will limit the spread of HIV and minimize the negative impact that HIV/AIDS has on economic growth.
Even though the Government of India has doubled funding for HIV/AIDS this year, the budget is still far from sufficient to meet the challenge. Those countries which are succeeding in controlling the spread of HIV/AIDS, such as Thailand and Uganda, have spent between 5 to 18 times more, per capita, than India.
Additional funding is essential to expand and replicate some of the promising approaches underway in India, as in Tamil Nadu, where some recent studies show that the infection rate has been halved over the last five years. I believe that it is no coincidence that in Tamil Nadu there is a foundation of significant and effective cooperation between the State Government, NGOs, and USAID programs.
Progress at both the federal and state-levels is essential and must be effectively coordinated. Political leadership from the Center, such as that exhibited by the Prime Minister to guide the national movement against HIV/AIDS. But actual implementation of prevention and support programs must be at the local level, within villages, communities, and families. This is a virtuous circle: local leaders endorse HIV/AIDS awareness and care programs, which reduces the stigma of infection, which in turn leads to more testing and treatment and ultimately curbs the spread of the disease.
There is also a need to integrate HIV/AIDS prevention and treatment with other national programs such as reproductive health and school education, so that the messages of prevention and treatment can be provided to those who need them.
The government cannot combat HIV/AIDS alone. One area in which there is much unrealized potential is in the private sector. All employers - public and private - can set an example by developing HIV/AIDS policies for their employees in the workplace. The U.S. Embassy and Consulates, which employ over 1,800 people throughout India, launched our own workplace HIV/AIDS policy on World Aids Day at the end of last year. Workplace policies can be powerful statements to both employees and to society that "our people matter to us and that we plan to protect our valuable human resource and the families they support." We hope that our U.S. Mission policy will serve as a model to businesses and other organizations in India in creating their own policies. Details of our workplace policy are readily available through our Public Affairs section and the U.S. Embassy website.
This First Conference of the AIDS Society of India is an important event. This meeting provides a forum in which to seek effective strategies to confront HIV/AIDS, and also engage and maintain public focus on the issue. In the struggle against the disease, persistence and political will are as necessary as medical progress to defeat HIV/AIDS.
I wish you success in your endeavor.
(The speech was read by Dr. Altaf Lal, Health Attaché and HHS, U.S. Embassy New Delhi.)