India's other virus: human trafficking and the spread of HIV.

• Author: Parker, Michael

INDIA'S LOOMING HIV DISASTER terrifies the rest of the world, and its potential to outpace Africa as the world's largest reservoir of the virus has brought out the big money to contain it. World Bank funds are flowing into HIV-prevention programmes. The Bill and Melinda Gates Foundation has committed $200 million to galvanize leadership at the institutional level and change behaviour among high-risk groups. The Clinton Foundation is assisting India's National AIDS Control Organization to train large numbers of doctors in the basics of HIV medicine and broaden access to treatment.

And change is happening. Programmes to distribute free antiretroviral (ARV) drugs have been established and safe sex campaigns are gradually entrenching condom use in Delhi's GB Road and Mumbai's Kamatipura red-light districts-notorious epicentres of infection. But the spread of HIV is not merely a practical problem that enough condoms, drugs and doctors can bring under control. For underlying this epidemic is a phenomenon of greater magnitude and complexity which threatens to overwhelm the impact the Clinton and Gates Foundations' combined expenditures might make. This is India's vast, murky, semi-criminalized, semi-tolerated trafficking of girls from economically marginalized States into coerced marriages, forced labour and prostitution.

Trafficking is an issue that struggles for attention in India's overburdened social policy arena. While HIV/AIDS funding is becoming something of a "cash cow" for better positioned agencies in the field, according to a Times of India article, trafficking is an area of under-resourcing and government inertia. Yet, to the extent that trafficking is a direct contributor to the pattern of infection, HIV-control strategies require a distinct set of policy measures targeting its underpinning organizational structures. Identifying those targets and how to act on them has relevance for curbing the link between HIV and trafficking, not just in India but elsewhere in the Asian region, particularly in Myanmar, Thailand and Cambodia, where there are substantial movements of young women from circumstances of poverty into prostitution. How this transfer is effected may vary from country to country, but the mechanisms at work in India are far more widespread, recurring in neighbouring countries as well.

Take the case of Seelu, a girl in her early twenties who had been trafficked four years earlier to Delhi from Maharashtra. She had fallen ill with tuberculosis and was being monitored by Shakti Vahini, a non-governmental organization (NGO) active in anti-trafficking, HIV prevention and health outreach on GB Road. A seemingly unremarkable...