Action: Report of the Commission on AIDS in Asia and Policy Lessons for India

On 30th June 2008, Dr. Manmohan Singh, Prime Minister of India will formally receive the report of the independent Commission on AIDS in Asia ("the Commission") from Dr. C. Rangarajan, Chairman, Economic Advisory Council to the Prime Minister and Head of the Commission. Drawing on extensive studies, data review, specialist inputs and other contributions, the report entitled – Redefining AIDS in Asia: Crafting an Effective Response" is a first ever assessment of the epidemiology and impact of HIV in Asia. Its lessons are timely; in light of impending policy change before the Government of India.

Asian countries have a window of opportunity to avert large scale HIV epidemics. Unlike Africa, HIV in Asia is concentrated among specific population groups – sex workers and their clients, injecting drug users and men who have sex with other men. Among these, unprotected paid sex is the primary source of HIV infections in Asia including India. According to the report, men buying sex are the single largest group infected with HIV; with the potential of infecting wives, prospective wives and other female partners, in other words, to the rest of the population.

At the same time, it is possible to break this chain of transmission by implementing large scale prevention programs, covering more than 80% sex workers and clients. The Commission concludes that use of condoms in commercial sex will do more than any other intervention to prevent HIV in Asia.

Countries such as Thailand, Cambodia and the state of Tamil Nadu have successfully contained HIV through rigorous condom promotion in sex work. The Commission attributes this to structural interventions, that is, condom use policies in brothels and/or mobilization of sex workers – strategies supported by definitive evidence.

The Commission also observes that in all jurisdictions, criminalization of sex work nullifies effective HIV prevention. Police clamp downs on sex work disrupt efforts to reach and inculcate safer practices. Punitive practices were found unhelpful as they weaken sex workers’ organizing for health and prevention. Effects of penal measures are already visible in Cambodia, where a new law against sex work is severely undermining sex workers’ health and civil rights.

It is against these findings that the Commission advises Asian governments to ensure HIV prevention among sex workers and clients. It especially urges authorities to introduce pragmatic, non judgmental interventions for men buying sex aimed at encouraging condom use. Alongside, the Commission recommends a legal environment of decriminalization that supports health and safety in sex work.

Contrary to this, the Government of India is considering Amendments to the Immoral Traffic (Prevention) Act, 1956 ("ITPA") that intensify criminal sanctions against sex workers and clients. Despite objections from the Ministry of Health and the National AIDS Control Organisation, ITPA Amendments have neither been withdrawn nor sufficiently modified to address health concerns.

It is hoped that there will be more to the event than rhetoric; that findings and recommendations of the Commission will not be lost on the Prime Minister and the Government of India.

The report can be downloaded at:

http://www.unaids.org/en/KnowledgeCentre/Resources/FeatureStories/archive/2008/20080326_asia_commission.asp

Tripti Tandon, for Lawyer’s Collective