One of the most distressing aspects of the HIV/AIDS problem in India is that reliable numbers are extremely difficult to come by. According to UNAIDS, the Joint United Nations Programme on HIV/AIDS, there were 5.7 million Indians living with the virus in 2005, which is the largest absolute number for any country. But the government, perhaps looking to underplay the scale of the problem at a time when the country is claiming it is eradicating poverty and other disabilities, believes that this is an overestimate. The official National AIDS Control Organisation (NACO) puts the figure a little lower, at 5.2 million, based on the latest surveillance data, which is still large enough to cause major concern. The difference may be accounted for by the fact that official data is restricted to the 15-49 age group, while UNAIDS, for the first time, covers those below 15 years and above 49 as well.

According to a paper prepared by Patralekha Chatterjee for the international organisation called FXB India Suraksha, although the incidence of HIV/AIDS is less than one per cent of the population, two trends are observed that provide significant cause for alarm. Firstly, the HIV and AIDS epidemic is not just confined to populations considered as 'high-risk' groups, such as sex workers, truckers and drug users who inject themselves but "is spreading steadily among the general population in the rural hinterland". Secondly, the epidemic "is steadily getting feminised" with implications for children. In 2001, there were 55 women for every 100 males infected, which climbed to 60 by 2005.

FXB is an acronym for Francois-Xavier Bagnoud, a young helicopter rescue pilot who died tragically when only 24 on a mission in Mali, West Africa. His mother, Countess Albina du Boisrouvray, a well-known journalist and film-maker, sold most of the assets she possessed and founded the Foundation Francois-Xavier Bagnoud to commemorate her son's commitment. Today FXB International, an affiliate, runs 87 programmes in 18 countries in Africa, Asia Europe, Latin America and the US, working in close collaboration with national AIDS programmes. Its headquarters are in Switzerland.

FXB India Suraksha has been engaged in work with HIV/AIDS infected people in all the states of India for seven years, mostly in small demonstration projects. It invests in creating self-sustaining communities as a long-term prophylactic. Currently, it is pioneering low-cost solutions to care for those both infected and affected by AIDS. It has reached over 235,000 people directly, while more than 876,000 people have benefited indirectly. Thus, the total number of beneficiaries of its HIV/AIDS programmes number over one million in India alone. More than 44,000 pregnant women have been counseled as part of FXB's programmes for the prevention of mother-to-child transmission. Its India head is Gourisankar Ghosh, who was until a few months ago the Executive Director of the Water Supply and Sanitation Collaborative Council in Geneva.

Countess Albina was in Delhi recently for consultations with some experts on where the foundation should direct its activities in future. It was during these deliberations that experts highlighted the plight of orphans. There are an estimated 200,000 children with HIV who are under 15 years old in the country, while some 50,000 to 60,000 children are born with HIV each year, according to NACO estimates, despite the fact that drugs now exist to immunise such children from the threat of contamination from their mothers. However, there are no estimates of the number of children who have been orphaned by AIDS, which is itself a telling comment of how this enormous human, social and psychological problem has been neglected. They are stunted in their growth - often physically and certainly socially.

Globally, there are 2.3 million children under 15 who have been infected with HIV, 15.2 million under 18 who have lost one or both parents to AIDS, and millions more at risk, according to UNICEF. Such children are very vulnerable, not least due to their stigmatisation. In Kerala, for example, parents have been known to remove their children from school when they find out that a classmate is infected with HIV. If this can happen in the most literate society in the country, the fate of those in other states can well be imagined.

Worldwide, nearly a third of infected children die before their first birthday. Those who survive but lose one or both parents to AIDS face tremendous obstacles in life. In sub-Saharan Africa, where the epidemic is the most widespread, it is common to find grandparents looking after children who have been orphaned. If the extent of the problem has still not surfaced in this country, it is due to the stronger extended family ties that still exist here.

In October 2005, President Abdul Kalam launched the Unite Against AIDS Campaign for Children, with pledges to protect these most vulnerable age groups. The government has finally recognised this need, with a National Paediatric HIV/AIDS Initiative last year. This campaign, spearheaded by NACO, will provide free child-specific dosages of life-saving antiretroviral drugs, which have till now only been available in adult does to children above nine years old. FXB has made more than 32,000 school children aware of HIV/AIDS, which is a major taboo in most homes.

There have been many complaints that AIDS attracts more resources than other epidemics, particularly with the involvement of large foreign donors like the Bill and Melinda Gates Foundation. Critics have alleged that it is because AIDS first affected people in industrial nations that it attracts more attention than widespread diseases in developing countries, like TB, cholera and malaria. The annual budget of NACO, for instance, is Rs 700 crore, while that for TB and malaria together is just Rs 400 crore. However, with the increasing convergence of these epidemics - HIV infected people may more likely contract TB and malaria, due to their lower immunity - there is a growing need to tackle all of these simultaneously.