India's top government agency responsible for tracking HIV infection has admitted it has published inaccurate figures of new HIV cases detected in the country over the past three years. The disclosure follows allegations by a non-government association that the agency, the National AIDS Control Organisation, has played down numbers in several states and that its reports “do not reflect reality.”
Surveillance centres across the country have detected just over 98000 HIV cases on the basis of tests, but India is believed to have the largest number of HIV infected people worldwide. The National AIDS Control Organisation has estimated that 3.5 million people are infected, based on a sentinel screening programme aimed at determining the HIV prevalence rates among high risk communities and the general population. The organisation's surveillance figures suggest, however, that three Indian states—Kerala, Punjab, and West Bengal—have detected no new cases of HIV over the past two to four years.
In Kerala, for example, the number of HIV infected people has been reported as static at 215 since 1996, and in Punjab the number has remained unchanged at 65 for more than two years. The National AIDS Control Organisation has been “consistently churning out unreliable figures, while claiming that it reflects the HIV scenario in India,” said Purshottaman Mulloli, an official of the Joint Action Council, the non-governmental association that has been monitoring the government's HIV programme. Doctors familiar with HIV infection in these states have called the figures “ludicrous.”
Senior officials at the National AIDS Control Organisation are blaming the surveillance centres in the states for inaccurate reporting. “We've decided to stop publishing figures that we get from surveillance centres,” said J V Prasada Rao, the organisation's director. “Beginning this year, [our organisation] will publish only prevalence figures from the sentinel screening programme,” he said.
The Joint Action Council has also questioned the widely varying estimates of people infected with HIV in India suggested by UN agencies. The estimates range from 4 million to 8 million. The differing estimates also prompted the Indian government last week to ask United Nations agencies to accept its own estimate of 3.5 million as authentic and to stop issuing their own figures.
“Conflicting information can affect the credibility of the national effort towards prevention and control of HIV,” Dr Chandreshwar Prasad Thakur, the Indian health minister, said. “[The National AIDS Control Organisation] is the only organisation collecting field data through sentinel surveys, and it would be advisable for UN agencies to adopt epidemiological data generated from these sentinel surveys,” Dr Thakur said.
The National AIDS Control Organisation has objected to a suggestion by UNAIDS (the joint UN programme on HIV/AIDS) at the recent Durban AIDS conference that up to 300000 people may have died as a result of AIDS in India. The recorded figure in India is less than 12000. “There is no evidence yet for a spurt in tuberculosis or any other opportunistic infection from anywhere in India,” said Mr Prasada Rao. Epidemiologists have long suspected that thousands of infected people may be dying of HIV related illnesses but are being missed by India's poor death recording system.