At the beginning of a four day trip to India, Bill Gates has announced that the Bill and Melinda Gates Foundation will give $100 million to support HIV prevention and care efforts in India. The grant will be administered by the India AIDS Initiative, and will target prevention with migrant workers, treatment of sexually transmitted infections, public education and reduction of stigma
On Saturday Gates highlighted the need for international partnerships to stem the spread of HIV in India in a New York Times opinion piece. "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," he declared.
According to the Wall Street Journal, the Foundation will tackle aspects of the HIV/AIDS epidemic that are "difficult" for the government to be associated, including programmes for men who have sex with men. Yesterday, Bill Gates visited the Naz Foundation, which recently ran into trouble over distributing condoms to men who have sex with men; four workers with the Foundation currently face criminal charges in Lucknow for distributing condoms.
The New York Times reports that social conservatism is also hampering prevention efforts among heterosexual men and women; whilst many experts believe that India is at a pivotal point in the growth of its epidemic, it remains very difficult to talk about condom use, particularly in rural areas.
The Gates donation has sparked controversy however. Health Minister Shatrughan Sinha, who is supposed to chair the Initiative, is reported to be angry over American estimates that India will have 25 million people with HIV by 2010. The Indian government currently estimates that the country has around 4 million people with HIV, and was annoyed by a speech last week from US Ambassador Robert Blackwill, who said that India must face up to its AIDS crisis and act decisively, or risk a major epidemic. US government concerns are fuelled by increasingly pessimistic projections on the course of the HIV epidemic in Asia, and the economic and geopolitical impact it could have.