Aids in Asia remains invisible

Marina Mahathir and Nafis Sadik, Kuala Lumpur

Mai found out she was HIV-positive after her husband of ten years died of AIDS. She decided not tell her family, not even her own young children. A bubbly articulate young woman, Mai feared she might lose her job without which she cannot support her children. "My parents asked me if I was infected after my husband died," she said, "but I told them no. They're not ready to know about my status yet."

Mai is one of the close to 20 million women who are living with HIV worldwide. But what is unusual is that she is not African but Asian, one of the growing number of Asian women infected with the virus.

In Asia, the AIDS pandemic suffers from many stereotypes. While drug users and sex workers are particularly vulnerable to the virus in many Asian countries, they are not the only ones. Yet many awareness campaigns have focused on certain social groups that are often already stigmatized in society. As a result, much of the population in these countries believe that only drug users, sex workers and homosexuals are infected with HIV. Discrimination against these groups, already prevalent, only hardens with these beliefs.

Nobody could be less stereotypical than Mai. For a start, she is Malaysian and a Muslim. Malaysia is one of the more developed Asian countries but still has a growing AIDS epidemic, fueled largely through the sharing of contaminated needles among drug users. Most of Malaysia's drug users come from the Malay Muslim community, a fact not fully studied nor explained. Mai is also educated, speaks English and works outside the home. Unlike many of her infected sisters in Africa and elsewhere, she is not what you would call disempowered and disenfranchised. As she herself says, adjusting her headscarf, "Do I look like an infected person to you?"

But she is, along with thousands of women in Asia and the Pacific. However AIDS in the region remains invisible, despite recent publicity about the magnitude of the Indian and Chinese epidemics. Few Asians, beset with many other problems including the recent aftermath of the tsunami, have much awareness or are concerned with HIV and AIDS. Many still think it is an African disease that is too distant from their shores. But, as with the recent polio cases in Indonesia, in this globalised world, nothing remains remote for long.

The biggest problem with AIDS in Asia and the Pacific is still the reluctance of many governments to admit to the urgent need to deal with the problem. In 2001 the Heads of Governments of the ten Association of Southeast Asian Nations (ASEAN) issued a leadership declaration against AIDS. But since then, nothing much has happened not least because of changes at the top in some of the member countries. The political will to deal with AIDS early in the most realistic way, especially on issues that cross borders, has been lacking. It is no wonder that countries like Malaysia succeed in achieving every Millennium Development Goal except for Goal Six on reversing AIDS.

In 2004, the seven member states of the South Asian Association for Regional Cooperation adopted a declaration calling for easy and affordable access to HIV prevention and treatment. But that commitment has yet to be turned into action.

In July, the 7th International Congress on AIDS in Asia and the Pacific -- the main forum for activists, scientists, governments, academics and community organizations to gather to discuss the regional pandemic -- will be held in Kobe, Japan. The potential for Japanese leadership for more effective regional efforts against the pandemic is there, but lukewarm Japanese government support makes this doubtful.

Prohibitive costs prevent many activists and community workers, including people living with HIV, from around the region from coming to the conference to interact and to lend their voice to the efforts. The invisibility of women, within the larger invisibility of the Asia/Pacific AIDS pandemic, will only be enhanced.

Yet the conference promises to discuss the most current and pertinent issues surrounding AIDS in the region, many centering on ethics, religion and morals. As funding policies become driven by ideology rather than empirical data, what will it mean for prevention in Asia and the Pacific where so many issues are still taboo and controversial? What will the future of the pandemic in the largest continent when in many countries not just condoms and harm reduction, but also human rights including women's rights, are still anathema?

Mai is not expecting to go to Kobe. She cannot afford to nor does she know how to get sponsorship to go. In any case, she can't see how she can explain to her employers and her family why she would suddenly want to go to Japan. She just hopes that other people will bring up the issues of women and AIDS in Asia. Meanwhile at home, Mai wants to start becoming a little less invisible at least to other women like her. That's the way she feels she can make a difference.

Marina Mahathir is President of the Malaysian AIDS Council and Nafis Sadik is Special Envoy of the UN Secretary-General for HIV/AIDS in Asia and the Pacific.