Political leaders have always had lots to say about HIV/AIDS in India. In recent times, first Mr Shatrughan Sinha and now Ms Sushma Swaraj have both mastered the swadeshi rhetoric on AIDS, alternating between a mindlessly optimistic denial of the local realities and an equally mindless concern for sexual morality. Naturally, none of this made the slightest difference for Pavanamma from rural Andhra Pradesh — a single mother with AIDS who was regularly beaten and then thrown out of her home by her nearest family. She suffered alone, beaten up until her last moments and then taken to be cremated when she was probably still alive. Pavanamma’s isolation from her community, the healthcare system, local administration and the non-governmental organizations serving her area was complete. This, in spite of Andhra Pradesh HIV/AIDS programme receiving Rs 20 crore every year. A combination of collective ignorance, brutality and administrative failure is responsible for Pavanamma’s wretched death. But such cases are happening everywhere in urban and rural India, in spite of the president, prime minister and sundry political leaders regularly signing all sorts of high-minded and more or less utopian declarations. New HIV infections are increasingly concentrated among the illiterate and the poor, especially among young, poor and illiterate women. Such lives have little value among the Indian political leadership between elections.
Hence, social workers and activists will regard with mixed feelings the recent national convention for elected representatives in New Delhi, organized by the Parliamentary Forum on HIV/AIDS. This convention was apparently the first of its kind, getting together more than a thousand political leaders from across the country — ministers, parliamentarians, legislators and mayors. The director of the joint United Nations programme on HIV/AIDS considers political leadership a “vital tool” in turning back the epidemic. HIV/AIDS cannot be regarded any more as an isolated, narrowly defined public health intervention, separate from the mainstream of development efforts, domestic resource allocation processes and poverty reduction strategies. Moreover, a gender-sensitive and human-rights-based approach that includes anti-discrimination laws to protect people living with HIV/AIDS is becoming imperative in India, as Pavanamma’s case indicates. Awareness at the highest levels of decision-making is, of course, vital. But implementing this awareness to reach out to India’s poorest, most illiterate and improperly networked rural and urban areas is the real problem that these leaders will have to work out very soon.