AIDS Pandemic In Asia Could Match Africa's

by Zofeen T. Ebrahim

(IPS) -- She had no qualms whatsoever of putting the harsh realities on the table -- especially on World AIDS Day. And for anyone listening to Nafis Sadik, a medical doctor who is also the UN special envoy for HIV/AIDS in Asia and the Pacific, the prognosis is alarming.

She warns that Asia-Pacific societies could collapse like some in Africa as a result of the pandemic.

"We can't afford to be complacent. AIDS is transmitted in the same way in Asia as it did in Africa -- the dynamics are not all that different," she told the opening of a regional Women, Girls and HIV/AIDS Best Practices Conference in Islamabad.

"HIV/AIDS is the greatest long-term threat to human security, human rights and economic development that the Asia-Pacific region will face in the next decade," warned Sadik.

Asia-Pacific is now about 13 years behind Africa, where societies in the worst affected countries, including prosperous Botswana, are collapsing and economic growth is disappearing, said Sadik.

"It could happen in this region; it will happen, unless we act," cautioned the special envoy of UN Secretary-General Kofi Annan.

Speaking at the regional Women, Girls and HIV/AIDS Best Practices Conference in the Pakistani capital, Sadik said same high-risk behavior is being displayed in the Asia- Pacific as in Africa.

"The same factors (are here) and yet we don't recognize them. We keep saying our value systems are going to protect us...I heard all that in Africa," she pointed out. "Asia Pacific countries need to act against HIV/AIDS, and they need to act now."

"There is no cure for AIDS and none in sight. The cost of treatment for large populations living with HIV/AIDS is beyond the reach of any government in the region," added Sadik bleakly.

The regional HIV/AIDS organized by the Amal development Network, with help from the National AIDS Control Program, was opened by Pakistan's Prime Minister Shaukat Aziz on Nov. 28 and ends on Wednesday to coincide with World AIDS Day.

The first of its kind to be organized by a Muslim country, the conference drew over 400 participants from Bangladesh, Burma, Cambodia, China, India, Iran, Nepal, Vietnam and Britain. The three-day conference is also the region's first to examine best practices in controlling the spread of HIV.

Seven million people in Asia-Pacific countries are currently infected with HIV/AIDS, according to UN figures. One third are women, and four million of them are in India. More than half a million people die each year and the cost to the region in 2001 was $7.5 billion.

In South Asia, women and girls are most vulnerable. Young women on the subcontinent account for 62 percent of infections in the 15-24 year old age group. In India, 90 percent of HIV-positive women are married and monogamous.

"The complete answer to the suffering of married women lies first in empowering women with health care, education and the power of the purse; and second in changing the behavior and underlying attitudes of men," she said. "A widening pandemic will mean the end of efforts to eradicate poverty, and empower women and girls, who are most of the poor."

Added Sadik: "As a matter of human rights it is intolerable to expose Asia Pacific's women unnecessarily to HIV/AIDS; as a matter of practical economics, it is insupportable."

But is anyone listening to these alarming details?

"Yes," insisted Sadik in an interview with IPS. "People are listening. Every time there is a response."

"We've moved from denial to trying to grapple with the reality," she said talking about the situation of South Asia in general and Pakistan in particular.

The UN special envoy, however, said that the onus of responsibility was with the top leaders. "Leaders must be willing to challenge entrenched attitudes and ingrained ideas."

HIV/AIDS, according to Sadik, must be addressed as a development issue rather than being mainstreamed at all levels as an ailment. "HIV/AIDS is not a health issue, it only becomes one when you get the opportunistic infections or you get the full-blown AIDS. It's a socio-cultural issue; it's about behaviour and attitudes. You have to get everyone on board."

She also underscored the importance of leaders talking about the issue more and "not just restricting themselves to talking about the topic at HIV/AIDS conferences."

"The more you talk, the less controversial it becomes and it breaks the communication barriers," said Sadik.. "Most leaders don't want to talk about sex; I recognize that and feel very strongly about finding a way to make it easier. We need to devise a vocabulary that is easy to understand and which everyone is comfortable with."

But Sadik also acknowledged the way statistics are being used by international bodies to gain public attention in their fight against the pandemic.

"In countries where the quality of surveillance systems are better -- like India, where they have estimated five million cases -- the numbers increase every time the surveillance sites are increased," she pointed out.

"The numbers also increase when care and treatment is introduced as more people begin to seek treatment. This is both a good and a bad sign," added the UN envoy.

"Good because people are realising finally and coming out of the closet, and bad because the problem is there and needs to be taken care of on an urgent basis," she explained.