South Asia lags way behind Africa in confronting the AIDS epidemic and is passing up money set aside for the battle because it lacks strategy and leadership, a World Bank official said on Wednesday.
Praful Patel, the World Bank president for Asia, told journalists that much of the problem stemmed from the unwillingness of Asian nations to admit that they may have something to learn from Africa.
"The situation in Asia is now like it was in Africa seven or eight years ago," Patel said.
"Politicians have a high level of discomfort talking about it," and think their ministries of health are taking care of it, he said.
His remarks were part of preparations for the 15th annual International AIDS conference, which will be held for the first time in Southeast Asia for four days from next Sunday in Bangkok.
While Thailand is recognized worldwide for taking major steps toward containing spread of the HIV virus, South Asia -- which includes India, Pakistan, Afghanistan, Nepal, Bhutan, Bangladesh and Sri Lanka -- was the particular focus of Patel's remarks.
He said the World Bank had set aside US$380 million a year for the AIDS battle in the region, but much of the money went unused because of a lack of programs.
"There's a lot of money," he said, but little capacity to use it.
India is projected in a year or so to have the world's largest population in sheer numbers of HIV-positive people -- between 8 million and 20 million victims -- yet interest groups in the country have wasted time arguing over the numbers rather than getting programs in place, World Bank officials said.
African countries south of the Sahara, where three quarters of the world's 40 million HIV-positive and AIDS patients live, spent the last decade learning the lesson the hard way.
African leaders have finally stepped in to provide leadership from the top, openly discussing AIDS, condoms and other preventive measures at public appearances, with Uganda and Botswana taking the lead. AIDS experts have actually become more hopeful that the situation can be turned around there.
In a recent example of such leadership from the top, US President George W. Bush, who has been upset when his top officials such as Secretary of State Colin Powell mentioned condoms in public, just recently broke the ice and mentioned the "C" word.
Jean-Louis Sarbib, World Bank vice president for development, said the consequences of failed leadership could set back economic development for decades in South Asia, adding there is no replacement for engagement by the entire political leadership. The World Bank has warned that the epidemic could pull down economic growth by up to 1 percent, and health expenditures could increase by 1 to 3 percent.
"Nothing spreads HIV faster than silence," World Bank spokesman Philip Hay said.
Avoidance of the topic in Africa saw HIV spread from a 1 percent to 10 percent infection rate and much more over a short time, and Patel said he sees "exactly the same pattern" in South Asia.
Exact figures for the South Asia region were not available. According to the UNAIDS programme, India has an estimated infection rate of 0.7 percent in its adult population, and Bangladesh has less than a 1 percent infection rate.
Currently, Eastern Europe and Central Asia are experiencing the fastest growth of the disease worldwide, estimated at least at 20 percent, experts have said. About 1.5 million people -- or 1 percent of the population -- were estimated to be currently affected in those regions, compared to 30,000 in 1995.
Botswana had an infection rate of less than 1 percent 10 years ago, which mushroomed to more than 30 percent in recent years.
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