A senior international health official warned Tuesday that HIV/AIDS is growing into a "catastrophic epidemic" in India, the world's second most populous country.
India is also poorly prepared for the "tidal wave" of the disease the country is facing, Richard Feachem, executive director of the Global Fund to fight AIDS, Tuberculosis and Malaria told journalists.
"The Indian epidemic is rapidly becoming the largest epidemic in the world," Feachem said.
"There is nothing in place in India today which is of a scale or of a seriousness which will prevent a catastrophic epidemic unfolding."
About 3.8 to 4.6 million people are estimated to be HIV positive in India, according to official estimates cited by the WHO, but in private some officials fear the figure is much higher and the virus is spreading rapidly.
"We need to do a huge amount more in prevention, in testing, in treatment if India is going to turn around the tidal wave of HIV/AIDS which is breaking over it," Feachem said.
More than one percent of the population in six Indian states are infected with HIV/AIDS and the course of the epidemic in India, as well as in China, will have "a decisive influence on the global pandemic," according to a global World Health Organisation (WHO) report released here on Tuesday.
One percent is regarded as a very high prevalence rate.
Efforts to scale up treatment in India faced "immense difficulties" according to the WHO report, particular because of the huge population.
"It is one of the great areas of concern, clearly," WHO Director General Lee Jong Wook said.
India, along with six African countries, accounts for about half of the six million most seriously affected HIV/AIDS victims who are in urgent need of complex and costly anti-retroviral therapy, the report added.
The global fund was set up by the governments, international organisations, and private companies to bring together funding to fight the global AIDS pandemic. Feachem also highlighted profound shifts that could occur in Indian society if HIV/AIDS continues to grow.
He pointed to recently published research in The Lancet medical journal, which compared infection rates in uncircumcised Hindu men and those among circumcised Muslim men in India. Hindu men were 6.7 percent more likely to be infected with HIV, according to the article.
"We're going to see an added dynamic in the Indian epidemic and a very differentiated epidemic between the Hindu majority and the Muslim minority - you can appreciate the seriousness of that as well," Feachem added. With China, estimates of 800,000 people infected in the world's most populous country were reasonably accurate, said Peter Piot, head of UNAIDS, the main agency co-ordinating the international fight against the disease.
"The order of magnitude of the figure is true. The data are quite good for some provinces but not for others but I think it's sufficient to say that it's definitely not like 10 million. It's safe to assume it's around one million."
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