China, India, Indonesia become the focus of AIDS battle in Asia

China, India, Indonesia become the focus of AIDS battle in Asia

Stephanie Wong Agence France-Presse/Hong Kong

Three Asian countries that are alone home to 40 percent of humanity are at risk of seeing the HIV/AIDS epidemic jumping from narrow risk groups into the broader population, experts warn.

The World Health Organization (WHO) and the Joint UN Program on HIV/AIDS (UNAIDS) have warned that India, China and Indonesia are in danger of seeing serious HIV outbreaks among their more than 2.5 billion people.

The warning will be among the issues to be discussed when some 20,000 top researchers, policymakers and activists gather in Bangkok this week.

They will be taking part in one of the biggest conferences in the 23-year history of AIDS, to assess the pandemic that is poised to ravage Eastern Europe as well as Asia's most populous countries.

"There are increasing warning signals that serious HIV outbreaks threaten in several countries (in Asia)," the two UN agencies said in their annual report, AIDS Epidemic Update, released in November.

"Injecting drug use and sex work are so pervasive in some areas that even countries with currently low infection levels could see epidemics surge suddenly," the report said.

HIV prevalence in the region remains under one percent of the adult population, which may seem small compared to the AIDS- ravaged countries of southern Africa, where more than a quarter of adults aged 15-49 have the virus.

"That figure ... can be deceptive," the report said. "Several countries in the (Asian) region are so large and populous that national aggregations can obscure serious epidemics in some provinces and states."

An estimated 40 million people worldwide are infected with AIDS or the human immunodeficiency virus (HIV) and around 7.4 million live in Asia and the Pacific. A million people in this region will have caught the virus this year, and half a million will have died, the report predicted.

China, with the world's largest population of 1.3 billion, has seen a sharp rise in HIV/AIDS cases in recent years. The number of new cases has doubled to 21,000 from 10,000 in 2002.

The health ministry estimated there were 840,000 HIV carriers in China, of whom about 80,000 had AIDS. International agencies and the United Nations, believe the actual number could be much higher.

China's HIV/AIDS epidemic has been mostly concentrated in the poorest and most marginalized populations such as farmers in central provinces who had to sell blood to make a living, or drug addicts in Yunnan in the southwest.

But health experts say the problem is likely to spread to China's booming cities. Vice Minister of Health Wong Longde said the most pressing issue was finding and testing those infected who are unaware they have the virus.

"We have to find these HIV-infected people as soon as possible and find out if they need immediate treatment. Only this way can we further our work of preventing and controlling HIV/AIDS," Wang said.

In India, up to 4.6 million people in its population of more than one billion are estimated to be HIV positive.

"The main problems in India are that almost 80 percent of people with HIV do not know their status of HIV," said I.S. Gilada, secretary general of the People's Health Organization in India.

Free treatment is provided for AIDS patients but few tend to take advantage of it, he said.

"...once HIV is detected, there is hardly anything we can offer to them by way of comprehensive treatment. The government had announced free treatment for 100,000 AIDS patients from April 1 in six worst-affected states. Hardly 500 people are getting the treatment," he said.

Although India has the lowest-priced HIV drugs, Gilada said not enough effort had gone into curbing the epidemic.

"It requires a cohesive effort at the national level to utilize these strengths. This can only be done by the government or a very large non-governmental organization but such a cohesive effort is not there," he said.

In Indonesia, poor resources and a lack of funding make it hard to control the spread of AIDS.

The main drivers of HIV/AIDS in Indonesia are intravenous drug users, among whom there is an infection rate "consistently around the 40 to 50 percent mark in a lot of urban areas," said Jane Wilson, country coordinator of UNAIDS.

There are an estimated 160,000 intravenous drug users in the country, of whom 43,000 or 25 percent are infected, she said. Although the government has put in place good policies, they cover a limited amount of people, Wilson said.

"At this stage, the implementation of the policies is limited to less than 10 percent of those with high-risk behavior," she said.

More international funding and better resources could help, Wilson said but acknowledged, "it's a very large country to coordinate in."