UN Warns Asia It Faces AIDS Catastrophe

by Marwaan Macan-Markar

(IPS) BANGKOK -- With one in four new HIV cases being reported from Asia, the sprawling continent is on the verge of an AIDS epidemic that could dwarf the devastation wrought by the killer disease in Africa, experts are warning.

"Asia now is facing life and death choices when it comes to the epidemic," Kathleen Cravero, deputy executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), said here Tuesday at the launch of a global report on the pandemic.

If the region fails to implement effective prevention programmes, "we will see an epidemic the likes of which we never imagined despite what has happened in Africa," she said.

By the end of 2003, Asia had an estimated 7.4 million people living with HIV out of the 38 million adults and children infected with the human immunodeficiency virus (HIV) world-wide, the '2004 Report on the Global AIDS Epidemic' revealed.

During that year, close to half a million people are estimated to have died by the virus that causes AIDS, while 1.1 million people became newly infected, the 231-page report added.

Such a grim picture has been fed by the rapid increase in HIV infections from two of Asia's most populous countries -- China and Indonesia - and nearby Vietnam.

"In China, 10 million people may be infected with HIV by 2010 unless effective action is taken," the UNAIDS report warned, while in Indonesia six of the country's 31 provinces "are badly affected."

These three country's are among the region's most populous, with China being home to 1.3 billion people, Indonesia having 203 million and Vietnam 77 million.

To compound that is the report's remarks on India: it has "the largest number of people living with HIV outside South Africa - estimated at 4.6 million in 2002."

Yet it is a picture that is deceptive and can result in complacency, given the criteria used - percentage of population -- to calculate if a country's HIV prevalence rate has reached a point to be deemed an epidemic.

In this light, countries like China, India, and Indonesia appear marginally affected when set against the high percentages in African countries reeling under the AIDS epidemic.

According to the UNAIDS report, China and Indonesia have 0.1 percent of their population aged between 15 - 49 years infected with HIV, as opposed to Botswana, which has 37.3 percent of the population infected with HIV, South Africa having 21.5 percent of HIV prevalence and Zimbabwe, with 24.5 percent HIV prevalence.

Of the Asian countries, only Cambodia, Thailand and Burma have the percentages to be considered facing an AIDS epidemic, with Cambodia being the worst affected with 2.6 percent of its population suffering from HIV and Thailand with 1.5 percent.

Such low percentages, though, cannot be glossed over, asserted Cravero, since Asia is "potentially worse than Africa because of the numbers."

What are also setting the two continents apart are the factors that have fuelled the rapid spread of HIV. In Asia, injecting drug use has been a major contributor, states the report.

"Among injecting drug users, HIV prevalence is 35-80 percent in Xinjiang, and 20 percent in Guangdong," the report notes in reference to two provinces in China.

HIV prevalence rate among Indonesia's 125,000-195,000 injecting drug users "has increased three-fold - from 16 percent to 48 percent between 1999 and 2003," the report states.

"In 2002 and 2003, HIV prevalence ranged from 66 percent to 93 percent among injecting drug users attending testing sites in the capital city, Jakarta," it adds.

Furthermore, sex between men has also been identified as a reason for the escalating HIV rates in Asia. "HIV transmission through sex between men is a major cause for concern in many areas of India," the report states.

South Asian sex workers are also vulnerable to the spread of HIV due to low condom use by their male clients. In Bangladesh, the report notes, "most of the men do not use condoms in their commercial sex encounters and female sex workers report the lowest condom use in the region."

Yet HIV/AIDS activists say that this reality will not change unless the region's government pursue a more enlightened approach, particularly in policies to bring those who inject drugs into the fold of AIDS prevention and care.

Most detrimental to the region would be punitive polices such as the one pursued in 2003 by the Thai government of Prime Minister Thaksin Shinawatra against drug users, Paisan Suwannawong, director of the Thai Treatment Action Group, told IPS.

That year, the Thaksin administration launched a harsh 'war on drugs' to rid the country of its amphetamine addiction, but this nine-month campaign resulted in over 2,200 people being killed by police for allegedly being part of the country's narcotics trade.

"The 'war on drugs' forced intravenous drug users underground out of fear that they would be killed or be put on a list of being a drug user," Paisan added. "Many drug users stopped going to the treatment centres."

On Tuesday, HIV/AIDS activists announced the plans they would pursue during the 15th International AIDS Conference to be held in Bangkok from July 11-16 to lobby governments to see vulnerable groups in Asia in a more sympathetic light.

"Governments must not use violence against drug users, and should encourage peer driven approaches to help these vulnerable groups," said Kamol Uppakaew, chairman of the Thai Network of People Living With HIV/AIDS.