First of all, there are populations in India and China with very high HIV prevalence rates—among them sex workers in some areas in Karnataka and Andhra Pradesh in India, and injecting drug users all over China and East Asia. We're also seeing new, very rapidly rising epidemics among gay men and men who have sex with men [MSM].
India's overall prevalence rate is relatively low, which gives the impression that there's no problem, but HIV doesn't have a normal distribution in the statistical sense. As I said, it's concentrated among groups such as MSM, sex workers, and injecting drug users, and there the numbers are bad. In Asia, we need to take a long view of the epidemic. The growth of the epidemic in Asia has been slower than we anticipated, that's true, and we haven't gone into an African type of scenario in the short term. But with a denominator of one-third of the world's population, one percent in China is 13 million people and 10 million in India—more than the total population of some African countries.
One of the lessons that we've learned about AIDS is that we must expect surprises. The new epidemics among MSM all over East and Southeast Asia are a surprise but they shouldn't be. What I think is key is that the response to AIDS in both India and China has been quite good, after initial denial and hesitation. Who would have thought even five years ago that China would now have maybe 500 methadone clinics? In India, these clinics have had real, measurable results. The evolution of the AIDS epidemic is something that depends on many complex issues, one being the political context.
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