Today, the most deadly disease affecting the population in India is HIV/AIDS, and the most prudent solution to this problem is to fast track the creation of a preventive HIV vaccine targeted for this population.  There are over 5 million people living with AIDS in India, the second most populous nation in the world with continuing high population growth rates, and more and more people are becoming infected each day.  Major advances in the reduction of the HIV/AIDS burden in India, as can only be accomplished through a preventive vaccine, will help reduce world averages of the same.

The fact is that India must focus on continuing to do preventive HIV vaccine trials and to bring this effort to fruition so that its population will not suffer tremendous setbacks as a result of disease propagation.  Though epidemiological and demographic transitions are well underway in India, the lack of a comprehensive healthcare infrastructure, particularly in North Indian villages, predicates that a preventive HIV vaccine will be essential in furthering the forward growth of this nation.  The barriers to providing adequate testing and long-term therapies to infected individuals are simply too tedious to overcome, and will bring the nation to a halt if a preventive HIV vaccine is not simultaneously developed while therapeutic initiatives are being implemented.  Now more than ever, a strong push toward research for a preventive HIV vaccine will help, in many ways, to determine the future status of India as either a “developing” or “developed” nation.

Though the world keeps getting smaller, a result of the rapid advances in information technology and the associated technology infrastructures, we cannot lose sight of the fact that all healthcare across the globe is still simply not created equal.  India is fast becoming the IT expert and the major metros- New Delhi, Mumbai, Calcutta, Chennai, Bangalore, Hyderabad- are redefining themselves as technology centers that rival those in other cities throughout the world.  However, left behind are the hundreds of thousands of villages that make up the heartland of India and are still pitifully behind in the provision of health care services.  It is true that these villages will enjoy wireless networking and advances in technology frameworks well before they will experience access to comprehensive hospital facilities, and this fact will continue to haunt the population affected by HIV.  Furthermore, gender disparities and cultural norms will further hinder healthcare administration for those infected with HIV.  This inherent disconnect between technology reform and healthcare reform in this nation is one that could very well lend to huge detriments in the future. 

Specifically, the prevalent culture and tradition within India must be taken into account when considering the importance of a developing a preventive HIV vaccine.  Furthermore, when examined critically, the benefits of a preventive HIV vaccine far outweigh any potential monetary or policy risks associated with the same.  Ideally, treatment should be provided for all infected individuals, but in India there are only 5.2 doctors available for every 10,000 people, and although 710,000 people require anti-retroviral treatment, only 21,000 people are actually receiving help.  Clearly, while the ambitious PEPFAR proposal (President's Emergency Plan for AIDS Relief) will help alleviate these shortcomings, there is no adequate short-term solution to this epidemic, but there is one long-term solution that will revolutionize the direction of healthcare in India- and that is the preventive HIV vaccine. 

In India, nearly half of the 2.9 million prostitutes are infected with HIV, and are at the top of the vulnerable group, along with truck drivers, migrant workers, and gay men.  In 1994, there was a large epidemic of AIDS throughout the entire country, spreading from this vulnerable group, to the general population, and now in rural areas of India.  Referring back to the truck drivers of India, a majority of these men seek out sexual encounters during their long journeys for work, through so-called “road wives”.  Many times, these men are already married, and then return home to their wives and pass on the virus.  This is almost the same case with gay men in India, a result of the conservative culture.  Furthermore, because of gender disparities, it is inappropriate for women to speak out against or accuse their husbands of these unacceptable behaviors, and 1% of all pregnant women in India are also infected with HIV.  This cultural conservatism not only affects the helpless women, but also a majority of India’s youth.  In India, 35% of all reported AIDS cases come from the ages 15-24.

So, the math is simple: the barriers to treatment for HIV in India- inadequate healthcare facilities and cultural disparities- result in more people becoming infected with HIV than are treated for the virus.  Accordingly, though the solution offered by creating a preventive HIV vaccine seems to be a clear winner, it cannot be ignored that overcoming policy initiatives in creating an effective, preventive HIV vaccine will be huge.  There is simply not enough money or incentive for Big Pharma to invest in such a large-scale initiative without the active support and push of the stakeholders, the stockholders, and the general public. 

Non-Resident Indians, who make up an influential portion of the government, the private, and the public sectors, must then recognize the tremendous burden of HIV/AIDS, and realize now before it is too late that the improvements in public health as a result of a preventive HIV vaccine in India will lend to beneficial transitions across the globe.  The onset of the technology industry boom has left India stuck between two worlds.  Financially and industrially the country is developed and thriving, but in terms of healthcare India is simply not handling its burden.  With a total population exceeding one billion people, India cannot afford to be situated on the list of developing countries with high burdens of communicable disease.

In order to get through this AIDS epidemic and lower the number of people affected and dying from the disease, the government of India needs to address its poverty, the discrimination among castes and classes, the lack of education about the virus and prevention, gender disparities, the lack of communication in families, and the overall lack of resources throughout the country.  However, India also must move toward creating a preventive HIV vaccine as a priority, before the aforementioned political and cultural environments lend to further increasing HIV rates in this country.  With the window of opportunity fast closing in addressing this disparity, policy-makers and health officials must continue to work towards achieving these goals.