Thursday 19 February 2009

Spread of AIDS - Condoms and ABC, NACO and Bindaas Bol Condoms, CAG castigates NACO on airtime purchase

I am a data junkie. It perhaps started with a orientation towards trivia and quizzing but essentially now I am more and more of a Quant person. Show me the numbers.

So, this amazing talk by Harvard economist Emily Oster from TED.com debunks many of the "known" truths.




In the talk Emily mentions about Uganda which has the best track record in controlling AIDS by using a tool called ABC - which is

A Abstain
B Be Faithful
C Use Condoms

Emily also has a short article on this which you must read here.

During the 1990s HIV infection rates in Uganda fell, from around 15 percent to around 6 percent, a success that is unique on the continent. In 2000, researchers at USAID began to question why HIV infection rates had fallen only in Uganda and not in other African countries such as Zimbabwe and Malawi, where the epidemic had been raging for almost as long.

The difference, they concluded, was that most countries relied too heavily on condom promotion alone, whereas Uganda had a range of programs that encouraged abstinence and faithfulness as well as condoms a strategy that came to be known as ABC.

Also there are other cases of success in controlling AIDS where in the Maulavis (or the Islamic religious teachers) were used to spread the message of single partner sex. Because the Maulavis were respected in their local community and served as counsellors as well, when they spread the word about Being Faithful controlled AIDS and prevented your death, people listened.

In India, the positive intervention of Muslim clerics has played a vital role in eliminating Polio from a number of pockets.

In USA, the Bush Govt. was spending ~ USD 1 Billion per year on promoting abstinence. Partly it was because of George Bush being hardliner Christian and promoting Evangelical organizations and partly due to the success of strategy in Uganda.

And pray, what is the Indian response ?

In India, the National Aids Control Organisation - a part of the Union Ministry of Health and Family Welfare.

NACO's website does mention use of FBO (Faith Based Organisations) or Religious groups to promote AIDS awareness but no data in mentioned unlike their work with NGOs about which NACO talks in great detail.

Shouldn't Abstinence be promoted more in a country where people routinely abstain for long periods of time for religious reasons (40 days abstinence by SabariMala devotees, 9 days by Goddess devotees).

But what you get instead is "Bindaas Bol" condom campaigns at any and all times on TV and Radio.

Sure, the guys who purchase airtime from private channels would be making huge cuts / kickbacks buying airtime inventories (they were recently castigated by the CAG or the Comptroller and Auditor General of India).

NACO’s use of the electronic media highlights “utter whimsicality and selective patronage in decision-making,” the report observes.

...........-- Rs 4.27 crore on sponsored telecasts of classical music and dance concerts at a particular cult shrine for short-message inserts; Rs 2.24 crore on just two chat shows. “Poor viewership,” is the CAG’s assessment.

Similarly, the audit notes, there is poor listenership for radio programmes that cost Rs 5.78 crore. Some programmes like the NACO Film Hit Parade are not even evaluated. On family health awareness campaigns, the CAG observes: “Short notice and wrong selection of places failed to attract even 20% of the targeted population.” As for information and broadcasting field media units, Rs 5 crore was spent with no monitoring, the audit reveals.


But spare us the embarrasment of crudely made, inappropriate Condom commercials.

And now some talk about AIDS data.

In her talk, Emily also mentions about how her use of statistical tools, led her to the conclusion that AIDS deaths were actually 2/3 LESSER than what was being claimed by UNO.

So, examine the data for number of deaths attributed to AIDS in India and the estimated HIV infected people .........

Indian Express article mentions that India already has become the nation with highest AIDS related deaths in the world.

The question is how are these numbers being arrived at. And what is the level of truth in these numbers.

This is not a trivial question.

On the NACO website, you will find amazing figures.......

The 2006 estimates suggest national adult HIV prevalence in India is approximately 0.36 percent, amounting to between 2 and 3.1 million people.

If an average figure is taken, this comes to 2.5 million people living with HIV and AIDS; almost 50 percent of the previous estimate of 5.2 million.


Excuse Me.

We are talking of errors of 50% ???? After 10 years of running the AIDS programme, the Govt. wakes up and says sorry, we miscalculated.

And got it wrong by only 26, 00, 000 people.

This seriously impacts or atleast should impact the kind of funding being pumped to eradicate AIDS.

Again quoting the NACO website, the fund outlay for the current anti AIDS programme is 7009 crores.

Let me write that out for you. Rs. 7009, 00, 00, 000.

Man are'nt we rich.

This huge amount of money would not have been flowing into NACO programme if everyone thought there were lesser AIDS patients.

AIDS is sexy, cool, hip. There is money pouring into it. So it makes sense to inflate numbers of HIV infected people and the AIDS affected people.

Call for Action : Examine Data. God is in Details.

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