China, India, Indonesia tread road to AIDS disaster

China, India, Indonesia tread road to AIDS disaster

Agencies, Barcelona, Spain

Denial, stigma and discrimination are three horsemen driving
China, Indonesia and India toward a potential AIDS apocalypse,
the world AIDS conference here was told on Monday.

The three highly populated countries "face one of the greatest
challenges, and risks, in the global battle against HIV/AIDS,"
Irene Fernandez, a Malaysian human rights campaigner, told the
conference's plenary session in a keynote speech.

She blasted "denial and fear" for making many Asian countries
"a ticking time bomb for the pandemic."

A report issued by the UN agency UNAIDS last week said that
around 6.6 million people had HIV in the Asia-Pacific at the end
of 2001, an increase of one million over the previous year, but
cautioned that the tally could be a big underestimate.

Between 800,000 and 1.5 million Chinese have HIV, and the
number of diagnoses had soared by 67 percent in the first six
months of 2001 alone, UNAIDS said.

Around 150,000 people, many of them in the provinces of Henan,
Anhui and Shanxi, became contaminated when they sold their blood
to collection centers that used infected needles, it said.

India with an estimated total of four million infected people,
has more people with HIV than any other country in the world
except South Africa, and the epidemic is spreading beyond high-
risk groups and into the main population, it warned.

In Indonesia, estimates are that up to 140,000 people have
HIV/AIDS in a population of 215 million.

"Indonesia is an example of just how suddenly an HIV/AIDS
epidemic can take off," said Bernhard Schwartlaender, director of
the HIV/AIDS department at the UN's World Health Organization
(WHO).

"We knew that the ingredients for a sizeable epidemic were in
place here for a long time," he said.

"After years of silence, even the more cautious
epidemiologists like myself started to wonder if Indonesia was
indeed somehow immune.

"It was right at that moment that prevalence shot up among
injection drug users and among sex workers. It then moved into
the population at large, as shown by a steep increase in HIV
prevalence among blood donors since the late 1990s."

Of the 40 million people globally with HIV, 70 percent of them
live in sub-Saharan Africa.

The epidemic, which began its march around the world more than
20 years ago, made its inroads in Cambodia, Myanmar and Thailand
in the 1980s among prostitutes and intravenous drug users, and
only recently took a grip in the big-population countries.

At infection rates of 1 percent or less of their population,
the Big Three are still a long way from the crisis in southern
Africa, where in some countries more than a quarter of the adult
populace is infected.

"But even extremely low rates of infection can be
devastating," Fernandez said, noting that China and India account
for one-third of the world's people and Indonesia is the planet's
fourth most populous country.

A senior advisor on HIV at the UN Development Program, Hakan
Bjorkman, suggested that the situation "is even worse in Asia
than elsewhere... the silence around Asia is deafening."

The problems are not just official indifference or
stonewalling about the epidemic, or paltry investment in
diagnostics or treatment, he and others said.

There was stigma against people with HIV at the workplace and
among family and friends, and laws against prostitution or drug
use that left many infected people isolated and bitter -- a
powerful motor to spread the pandemic.

Efforts to bulldoze away such discrimination have yielded good
results in "Cambodia and Thailand and more recently in Indonesia,
but we still have a long way to go," UNAIDS head Peter Piot said.

Meanwhile, a top health official warned on Monday that some
African countries could lose a quarter of their workforce to AIDS
in the next 20 years.

But news that a vaccine may be available by 2005 offers a ray
of hope.

In another development, a revolutionary AIDS drug that stops
the HIV virus from entering cells may offer new hope to thousands
of patients resistant to current therapies but the high cost
could limit its use.

Data released on Monday by drug makers Roche Holding AG of
Switzerland and U.S. biotech firm Trimeris Inc. showed T-20
slashed the amount of virus in the blood of many patients running
out of treatment options.

The injectable drug, which could reach the market in the first
quarter of 2003, is the first in a novel class of medicines known
as "fusion inhibitors" that work in a completely new way to
outwit HIV, the virus that causes AIDS.