Postscript: Suniti Solomon

As H.I.V. swept across the world, in the mid-nineteen-eighties, no country possessed a more menacing mix of conditions, predilections, and the kind of poverty likely to hasten an AIDS epidemic than India. Hundreds of millions of people lived without running water, let alone access to the costly drugs necessary to treat the infection. Annual health-care spending was less than ten dollars per capita, and by the end of the century the country had a hundred thousand long-haul truck drivers, more than two million prostitutes, two hundred and seventy-five thousand brothels, and tens of millions of seasonal workers who moved in and out of the cities each year.

Many researchers predicted a crisis unlike those in any other nation. But it never happened—in part because India had Suniti Solomon, the AIDS-treatment pioneer who died on Tuesday, at the age of seventy-six. In 1986, Solomon, a microbiologist then teaching at Madras Medical College, diagnosed the country’s first cases. She was trained partly in the United States and England, and the first time I met her, in 2001, Solomon told me that she had been reading a lot in international journals about the growing epidemic.

The Indian government was attempting to ignore the problem, so Solomon decided to test a hundred sex workers in Chennai (which had previously been called Madras). What she found shocked her and the nation’s public-health leadership: six of the women tested positive, a prevalence that, had it been typical, would have meant millions of deaths. (India today has the third-highest number of people living with H.I.V., after South Africa and Nigeria, according to the Joint United Nations Programme on H.I.V./AIDS. But that is a reflection of its enormous population; the rate of infection has remained at less than half a per cent, remarkably low compared with other middle-income countries.) In 1993, Solomon, a small, warm woman who spoke so softly that you had to strain to hear her, opened India’s first voluntary H.I.V. testing and counselling facility, Y. R. Gaitonde Center for AIDS Research and Education. The staff at Y.R.G. has educated thousands of people about the risks of AIDS and treated thousands more.

Solomon was eloquent in explaining the impact of the epidemic on traditional Indian society. One story in particular, which I related in my article about her, remains indelibly in my mind—and it’s worth quoting again. It was late on a sweltering day in her clinic and she spoke slowly, as if every word hurt:

“One day, this man came to see me,” Solomon told me. “A nice man, caring. He is a landlord and owns acres and acres. His only son is positive. Of course, people came to him and sought to arrange a marriage, and he kept telling everyone, ‘No, no, my son has to study and isn’t ready for marriage.’ And finally his own sister brought her daughter, which in south India is very common. She said, ‘You can’t do that, my brother, you have to marry your son to my daughter. It’s only right.’ So he told her the truth: ‘My son has H.I.V., and I don’t want your daughter to get sick.’ He saw the change in his sister’s face, and she walked away without a word. His wife, who had been hiding behind the door, heard what he said, and she told their son. The mother and child dressed in their best clothes and went out and bought poison powder in bulk. They drank it together and got into the car. Then the son drove as fast as he could into a big tree and killed them both. After that, the father came to me—his life was ruined. He said, ‘All I have done is try to save my niece from getting H.I.V., and now I have lost everything.’

“It was a very, very hard moment for me. I just left the office and went home. I have a dog, and I tell him things I would never say to a human being. So through my tears I told him all about the man who tried to save his niece.”

I have been writing about AIDS for nearly thirty years, and, perhaps partly as a defense mechanism, some of what I have seen and learned is difficult to recall. But not Suniti Solomon.