High-risk Behaviour

ONE AFTERNOON IN JUNE LAST YEAR, the union health minister, Dr Harsh Vardhan, paid a visit to the offices of the National AIDS Control Organisation, or NACO, in the heart of central Delhi. He was received by Dr VK Subburaj, then the secretary of the health ministry’s Department of AIDS Control, under which NACO functioned. The senior officials of the organisation who were present assumed that the visit was a routine meet-and-greet and photo opportunity with the new minister.

Some of the gathered officials made a presentation about the AIDS programme, after which Vardhan addressed the group. The staff expected him to make a standard statement about the ministry’s commitment to the organisation. To their surprise, however, the minister took the opportunity to air his own views on the matter of AIDS control, some of which diverged distinctly from NACO’s approach.

“It was a strange meeting,” a senior NACO official who was present told me. “The entire time he used words like ‘abstinence’ and ‘loyalty’ as a counter to AIDS.” While the organisation has in the past included abstinence as a part of its prevention programme, its primary focus has always been on condom distribution—a decision backed by its finding that about 86 percent of AIDS cases in India are a result of unprotected sex. “He stopped short of saying that NACO’s thrust on condoms was ill-advised,” the official said, “but his ideology on the matter was clear to all of us.”

On 23 June, the minister’s notions received wider publicity in a story on the New York Times’ India blog. “The thrust of the AIDS campaign should not only be on the use of condoms,” he told the reporter. “This sends the wrong message that you can have any kind of illicit sexual relationship, but as long as you’re using a condom it’s fine.” The remarks drew widespread condemnation from public health experts and activists. Anjali Gopalan of NAZ Foundation, a leading NGO in the field of sexual health, was widely quoted as saying, “Just because condom is available, not everyone starts having sex. Either ways you need to promote condom use.” Sujatha Rao, the former secretary of the department, who later served as India’s health secretary, agreed that the minister’s remarks were unfortunate. “It’s absolutely foolish to bring morality into the picture when dealing with public health,” she told me.