by Marwaan Macan-Markar
(IPS) BANGKOK --
in Asia and the Pacific could witness the explosion of HIV/AIDS from a marginal disease to a regional pandemic, experts here warned July 2.
"The epidemic is concentrated among many vulnerable groups in the region, those on the margins, yet the conditions are there for it to easily cross into the mainstream," Anthony Lisle, head of the South-East Asia division of the Joint United Nations Programme on HIV/AIDS (UNAIDS), said at the launch here of a new UNAIDS report on HIV/AIDS.
There are already traces of the disease spreading in previously-spared rural areas, added Swarup Sarkar, former head of the UNAIDS South Asia division. "It is the case in Burma and parts of India. No area is immune."
Experts say there is a lamentable lack of political will or resources dedicated to fighting AIDS by many governments in Asia, the world's most populous region.
For instance, many governments have made public pledges to fight the disease, but have not shown a sense of urgency in translating such words into concrete action.
Another factor, they say, is the inadequate resources being put into fighting the pandemic in the region. Governments are still slow to spend money for public health programs with full community participation to halt the march of HIV, the virus that causes AIDS.
AIDS killed 435,000 people in the region last year, according to UNAIDS' "Report on the Global HIV/AIDS Epidemic."
Asia-Pacific was home to more than 6.6 million people living with HIV/AIDS at the end of 2001, the highest number for a region after sub-Saharan Africa, which has 28.5 million people with HIV/AIDS.
The figure includes 1.1 million adults and children who were "newly infected" last year, which means there were about 3,000 people infected every day.
The number of children orphaned by HIV/AIDS also rose last year to 1.8 million in the South and Southeast Asia and to 85,000 in East Asia and the Pacific.
"The factors facilitating the rapid spread of HIV/AIDS epidemics are present throughout the region," the UNAIDS report declares. "This is reflected in the fact that many countries are experiencing high HIV infection rates among some population groups -- mainly injecting drug users, sex workers and men who have sex with men."
In Vietnam's Ho Chi Minh City, for instance, UNAIDS researchers have evidence of the sharp increase in the number of sex workers with HIV since 1998 -- one in five by 2000.
"Upwards of 50 percent of injecting drug users already have acquired the virus" in Nepal, Burma and the Indian state of Manipur, the report states.
The region's two most populous countries -- China and India -- have fuelled the rapid rise in infection rates. China has 1.2 billion people and India, 1 billion.
China has an estimated 850,000 people living with the disease, with "reported HIV infections having risen more than 67 percent in the first six months of 2001," according to the report.
India has an estimated 3.97 million people living with HIV, which, the report notes, makes it the country with the second highest number of people with HIV in the world after South Africa, home to five million adults and children with HIV/AIDS.
Three countries in Southeast Asia -- Thailand, Cambodia and Burma -- have HIV prevalence rates above the benchmark one percent of the population aged 15 to 49 that UNAIDS classifies as very high. Thailand has 670,000 people with HIV/AIDS, Cambodia has 170,000 and in Burma, unofficial estimates put the rate to around 500,000.
Among the Pacific island countries, UNAIDS says Papua New Guinea has the highest infection rates. In Port Moresby, the capital, recent studies have revealed a 17 percent HIV prevalence rate among female sex workers.
Meanwhile, the report singles out Indonesia as an example of how HIV rates can explode after years of negligence. "The country is now seeing infection rates increase rapidly among injecting drug users and sex workers, in some places, along with exponential rise in infection among blood donors."
In Indonesia, which has 120,000 people with HIV/AIDS, one drug treatment center in Jakarta, the capital witnessed HIV prevalence rise from 15.4 percent in 2000 to more than 40 percent in 2001, according to the report.
"This shows the epidemic can appear suddenly and spread rapidly," said Sandro Calvani, East Asia and Pacific regional representative of the United Nations Office for Drug Control.
"We can't predict the nature of the epidemic and where it is going," added Lisle. "We don't know when the prevalence rates will peak."
The pandemic is also affecting food security in parts of Asia. In four countries -- Cambodia, China, Laos and Burma -- the UN World Food Program had to "coordinate a food donation scheme for families affected by HIV/AIDS," the report states.
Other implications are gradually becoming visible. The report sheds light on a study in northern Thailand that revealed how "41 percent of AIDS-affected households reported having sold land, 57 percent used up their savings and 24 percent had borrowed from a cooperative."
However, the UNAIDS report says Asia has its own success stories that countries could draw lessons from. "Thailand and Cambodia have shown that the 'natural' course of the epidemic can be changed," it states.
"Early, large-scale prevention programs, which include efforts directed at both those with higher-risk behavior and the broader population, can keep infection rates lower in specific groups and reduce the risk of extensive HIV spread in the wider population," it adds.
Thailand, for instance, has undertaken an aggressive campaign to encourage regular condom use, a factor that helped reduce the number of new HIV cases each year.
But many countries are still to see the well-funded program that the Thais have mounted, according to the regional experts, who estimate that Asia-Pacific needs some $3.7 billion a year to mount a successful battle against HIV/AIDS.
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