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.