High risk for AIDS epidemic in Asia

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 say.

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.

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 Africa.

“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 Cambodia.

“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 stigmatization has prevented many victims from getting tested -- a situation echoed across many parts of Asia.

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 epidemic.

Political apathy
“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.

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

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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.”

Flagging efforts
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 groups.

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.