Indian health workers and activists are accusing international agencies of inflating HIV/AIDS statistics, which in turns skews priorities in the area of public health.

The issue of inflated figures for HIV/AIDS victims in India has been the subject of controversy ever since Health Minister C P Thakur took exception to ''inflated projections'' released by the Joint U.N. Programme on AIDS (UNAIDS) of deaths and infections caused by the virus in this country.

Exasperated at a UNAIDS report which claimed that four million Indians had died of AIDS in 1999, Thakur said that only his ministry and the National AIDS Control Organisation (NACO) have the machinery to gather statistics and the authority to publicise them.

Admitted UNAIDS country representative David Miller: ''The mortality rate does need some scientific basis. We are looking at a number of alternatives to arrive at some accurate number.''

However, statistics released by the Health Ministry's NACO are no better and recently, the organisation scaled down the number of HIV/AIDS cases from 8.1 million in 1998 to 3.8 million.

Significantly, the number of HIV-positive people in southern Kerala has remained static for several years while incidence in north-eastern Manipur state has dropped from a high 18 percent, the highest in the country, to 0.4 percent currently.

''There are scores of NGOs which exist on paper and have made a fortune out of the AIDS scare. Go to anyone who knows the situation in Manipur and the north-east,'' said Sanjoy Hazarika, a well-known writer from the north-eastern region.

Tropical diseases

Hazarika has suggested that the rise in the number of HIV cases in Manipur, as projected by NACO for several years, has more to do with generous funding coming in from international organisations than with actual infections.

Unreliable figures and statistics on public health are not new in India, and field workers have long complained that they are being manipulated to support policies or programmes being pushed by certain groups.

But inflated statistics for the HIV/AIDS programme stick out because of the vast funds available, while money for pressing public health problems are conspicuously missing. This is evident, for example, in the neglected state of primary health care centres.

A case in point is hepatitis, which is yet to find a place in the vaccination schedule although millions of Indians die of it annually or are permanently crippled by a virus which is passed, as with HIV, through sexual contact or through blood transfusions.

NACO's high-profile second phase , which has more 350 million dollars worth of loans available to it from the World Bank alone, has certainly dwarfed programmes for ordinary tropical diseases that continue to kill people and these include malaria, tuberculosis and kala azar.

Last week, panic spread through the northern states of Himachal Pradesh and Uttaranchal following an outbreak of pneumonic plague which killed four people and sent 20 others to hospital before authorities moved to contain in it.

It then turned out that a surveillance system for plague set up in the region, a known focal point for plague, was dismantled a decade ago for lack of funds.

Huge new market

According to Purushottaman Mulloli of the Joint Action Council (JAC), which leads a group of health and human rights non governmental organisations (NGOs), the statistics are being deliberately skewed in a way that helps both the World Bank and the Health Ministry but to the detriment of real and pressing health concerns.

''The people who run the Health Ministry now have access to large loans from the World Bank and in return, the Bank gets to interfere in India's health policies in a way which would not have been possible a few years ago, '' Mulloli said.

Mulloli said that if four million people are actually suffering from HIV infection in the country, then annual treatment costs would run into several billions of dollars.

This would create a huge new market for the pharmaceutical industry, while basic public health issues fall on the wayside.

NACO launched a pilot project in the national capital this month to try out the efficacy of zidovudine (AZT) in preventing mother-to-child transmission of HIV, although mechanisms for administration and close monitoring of ante-natal cases are missing.

According to Chhabra, a member of the Independent Commission on Health in India, flawed estimates in HIV/AIDS could result in ''enormous public expenditures and claims of averted infections when such high levels of infections never existed in the first place''.

Others like Amit Sengupta of the Jana Swasthya Abhiyan (People's Health Movement) and Ramesh Sharma of the prestigious Gandhi Peace Foundation are seeing a deeper, bigger game in what they say is the apparently undue emphasis given by the Bank and the U.N. agencies toward containing HIV/AIDS.

Said Sharma: ''This is an attempt to recolonise this country. Last time they came in with weighing scales saying all they were interested in was trade this time around they are coming in saying they want to fight HIV/AIDS.'' (IPS)