Enhancing the evidence base for HIV/AIDS control in India.

An optimum evidence base is necessary for the effective control of HIV/AIDS in India, as the lack of an adequate evidence base on critical issues leads to controversy and hurdles. To assess the trends in the HIV/AIDS evidence base for India, a PubMed literature search for publications from India in 2002 and 2003 on HIV/AIDS was done, and abstracts from India in one major international HIV/AIDS conference in 2002, and presentations at one major HIV/AIDS conference in India in 2003 were reviewed. The PubMed search revealed 145 papers with abstracts on HIV/AIDS from India during this period, which was 1.4% of the worldwide HIV/AIDS publications. Of these 145 publications, 124 (85.5%) were based on original research and, of these, 27.4% were in the basic sciences, 62.9% in the clinical sciences, and 9.7% in the public health sciences; 53.2% of the original research papers were published in journals with impact factors ranging from 0 to 1. Many vital issues for HIV control, such as validation of the methods used to assess HIV burden in the population, large-scale impact assessment of HIV prevention programmes, cost-effectiveness of HIV interventions, and critical evidence-to-policy issues, were not covered. Of the 8824 abstracts accepted for presentation at the XIV International AIDS Conference 2002 at Barcelona, 8% were from India--a fair representation given that India has about 10% of the world's HIV burden. However, the utility of this information is severely limited with the majority of it not getting translated into detailed papers in the peer-reviewed literature for widespread scrutiny and use. The views expressed by many experts at the Fourth International Conference on AIDS India 2003 at Chennai were impressive, but the presentation and discussion on original research data from India were sparse. From these various sources, it is estimated that the available evidence base for HIV/AIDS control in India is suboptimal. Using certain assumptions, it is estimated that to provide an adequate evidence base for the control of HIV/AIDS in India, quality original HIV/AIDS research in India would have to double in the basic and clinical sciences, and increase by more than 5 times for the public health sciences. Enhancingthis evidence base to an optimum level would require optimizing its demand, systematically planning its supply locally in India and creating an environment suitable for its development. To effectively control HIV/AIDS in India, strategic planning is needed to develop an evidence base that covers all critical areas where information is needed. Formation of a Society for HIV/AIDS Research in India by involving all the major stakeholders could help build up momentum towards establishing a comprehensive, relevant, dynamic and long-term evidence base that provides rigorous and timely information needed for HIV/AIDS control.