June 28, 2005

High risk, uphill fight for Asia in AIDS epidemic

By Elaine Lies

TOKYO (Reuters) - AIDS could spiral out of control in Asia,
home to more than half the world's population, unless
authorities step up their fight against the disease, experts

Prevention and access to cheap medicine will top the agenda
at the 7th Asia-Pacific AIDS Conference in the western Japanese
city of Kobe from July 1 to 5. The main concern is to ensure
that the disease does not proliferate in Asia as it did in

One in four new infections occurs in Asia, which includes
economically booming China, where the virus has spread to all
provinces, and India, with the world's second-highest number of
AIDS/HIV patients after South Africa.

Even affluent, well-educated Japan could face an explosion
of the disease over the next decade, experts say.

"If nothing is done, some 10 million people in China could
be infected by 2010," said Takashi Sawada, a Japanese doctor
who works with NGOs on AIDS prevention in Thailand and

"It is clear that Asia has arrived at quite a point of
danger," Sawada added. "Prevention needs to be practical, and
prevention policies must be carried out now."

The United Nations estimates that 8.2 million people live
with HIV in Asia, some 5.1 million of them in India alone.
Worldwide, about 39 million people have HIV/AIDS, including 25
million in sub-Saharan Africa.

Asia's vast cultural and political differences complicate
the fight. Blood-selling scandals were initially covered up in
China, where fear of stigmatisation has prevented many victims
from getting tested -- a situation echoed across many parts of

There are other common threads, such as a need to promote
the use of condoms, educating sex workers and injecting drug
users to the dangers of the disease, and empowering women, who
make up more than half of the new HIV infections worldwide.

In addition, politicians are often reluctant to tackle the


"Politics really gets in the way," Sawada said. "In
particular, there aren't big efforts being made to work on
women's rights and the rights of minorities."

Beijing, which says China has only 840,000 cases, has only
recently stepped up its fight against the disease but many
officials are suspicious of the volunteers and non-governmental
organizations considered best placed to fight the virus.

"Even if you have the motivation and desire, there are a
lot of unseen influences that limit your movement," said Hu
Jia, an AIDS activist who has been harassed by police.

Worse, some experts say the cocktail of treatment drugs
used in China have side effects so severe patients shun them,
Hu said.

In India, HIV/AIDS has moved beyond traditionally high-risk
groups such as prostitutes, drug-users and homosexuals into
families, infecting mothers and children.

Experts say the number of those infected could quadruple by
2010, becoming the single largest cause of death in the world's
second most populous nation.

The dire predictions have led to awareness campaigns,
especially in red-light districts, and a huge drive to use
condoms in rural areas, where infection is rapidly spreading.

As a result, the increase in numbers may be slowing.

"In some areas, AIDS has reversed, but in some areas it has
increased worryingly," said Denis Broun, a UN AIDS coordinator
for India. "There is no possibility for being complacent."


Even Thailand, long a model of prevention, cannot be
complacent, as waning political commitment leads to problems.

Annual new HIV infections fell from nearly 143,000 in 1991
to 21,260 at the end of 2003, thanks to mass education and
condom programs aimed at sex workers and other high-risk

But infection rates among injecting drug users remain as
high as 33 percent, activists say, while many sexually active
young Thais shun condoms, believing the risk of infection is
now low.

"It's the status quo. The situation is not getting worse
but its not getting better either," said Prapan Phanuphak,
director of the Thai Red Cross Aids Research Center.

"Everyone says Thailand is doing well but the commitment
from policy makers needs to be there," he said.

(Additional reporting by Sugita Katyal in Delhi, John
Ruwitch in Beijing and Darren Schuettler in Bangkok)