hope wanted; Exacerbated by stigma and denial, India's mounting AIDS catastrophe may now be the biggest in the world.

Byline: Janine Di Giovanni

One night in April 1986, Suniti Solomon, M.D., an American-trained microbiologist working for the Indian government in Madras, received a late-night phone call. She assumed it was an emergency for her husband, a cardiac surgeon. But the call was for her. And it was one that would alter not only the course of her life but ultimately the future of India.

On the phone was Nalini Ramamoorthy, Solomon's research assistant at the Madras Medical College. For six months, ever since the news of AIDS had burst upon the international medical horizon, the two women had been hunting for evidence of HIV in India. That night Ramamoorthy confirmed that six prostitutes-sex workers, as they are more correctly called-were HIV-positive. None of the women had had sex with a foreign client. The implication was clear: the disease was well rooted inside the country.

Solomon is now 65 years old and runs the Y. R. Gaitonde Centre for AIDS Research and Education (YRG CARE), the largest AIDS clinic in southern India. She has devoted the past two decades not only to research but also to enlightening the Indian public about AIDs, trying to destroy a stigma so fierce that even doctors and health-care workers often refuse to treat HIV sufferers. In a country where a televised kiss is shocking, it's difficult to get people to talk about sex, let alone AIDS.

The AIDS problem in India is now catastrophic, not just for Asia but for the entire world. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), India ranks second only to South Africa in the number of people infected by HIV. There are an estimated 5.1 million people in India infected with HIV, the virus that causes AIDS. Of that figure, approximately 1.9 million are women aged fifteen to 49. And those may be low estimates-some experts believe the real number of cases now exceeds South Africa's. Because of the stigma, many people are too ashamed to come out and report their illness.

The situation is so grave that on the eve of Indian elections last April, The Economist reported, "Indians start voting next week to choose a new government. Its first priority should be AIDS." At the XV International AIDS Conference in Bangkok last July, AIDS in India was one of the main topics. (Sonia Gandhi, president of the Indian National Congress party, was a featured speaker at the closing ceremony.) And according to Judith Auerbach, Ph.D., the vice-president of public policy for the American Foundation for AIDS Research (amfAR), "with India poised to overtake China as the most populous nation on Earth in the next 30 years, its AIDS epidemic has the potential to jeopardize the stability of the region, indeed the world."

World economic growth is increasingly dependent on India, Auerbach points out. Solomon feels this oppressive weight on her slight shoulders. At one time, she was named India's Woman of the Year, and Richard Gere publicly called her a hero, but Solomon still gets teary when she talks of the HIV-infected children who are left abandoned at her clinic, or mothers who beg her "to kill their AIDS-infected son, who makes the room smell." Hers is the sort of work for which one never really feels a sense of accomplishment. Since the virus was discovered, Solomon says, she has finished only one-quarter of what she set out to do.