The Associated Press - Sunday, December 08, 1996 08:52:00 PM.
Eric Talmadge, Associated Press Writer

Now 20, his liver weak and the side-effects of his medication growing harder to bear, Kawada knows he is slowly losing his battle with AIDS.

But unlike hundreds of anonymous victims before him, Kawada's plight has helped spark a national debate over how thousands of Japanese hemophiliacs were given transfusions more than a decade ago with blood that officials knew might be tainted with the AIDS virus.

Overcoming years of bureaucratic stonewalling and public apathy, Kawada and other AIDS activists have won a series of belated victories over the past few months in their battle for recognition.

With the help of a powerful political ally, former Health Minister Naoto Kan, their efforts have led to the arrest of five key men in Japan's early AIDS policy, won AIDS sufferers compensation and brought formal apologies from the government for years of negligence.

Because of the social stigma they still face, it is difficult for Japanese to acknowledge they suffer from AIDS or have been infected with the AIDS virus. The government says there were 3,748 such people as of September.

But Kawada's decision to come out last year and his ceaseless public appearances helped put a human face on the issue for many Japanese and dramatically increased pressure on the government to come clean.

As one example of how much public opinion has changed, Satoru Ienishi, an AIDS-infected activist, was elected to Parliament in October.

"I didn't run and get elected to die," he said in his acceptance speech. "I did it to live."

Prosecutors are also getting into the act.

Charges of negligence resulting in death have been filed against three former chief executives of Green Cross Corp., which supplied tainted blood products for hemophiliacs. Charges also were filed against a top Health Ministry official and a doctor who treated the first AIDS sufferers in Japan and headed a government advisory committee on the disease.

The five allegedly allowed blood products they knew were at risk of being contaminated with the AIDS virus to remain on the market even after safer alternatives became available in the mid-1980s. Foreign firms had learned heating blood products killed the AIDS virus, but Japanese companies did not use that technique yet.

Approval of the safer blood products was allegedly delayed to give Japanese companies time to avert costly recalls and develop their own versions for sale.

In the meantime, about 2,000 Japanese hemophiliacs -- of 4,500 nationwide -- may have been infected with the AIDS virus. Four hundred have died.

The scandal is not unique to Japan.

In the United States, 9,000 hemophiliacs were infected with AIDS-tainted blood, and lawsuits seeking hundreds of millions of dollars in damages are pending.

Charges of complicity in poisoning as many as 1,200 French hemophiliacs deeply shook the French government two years ago, with allegations reaching all the way to a prime minister.

But Japan's handling of the problem and the years of denial that followed are seen by many here as symptomatic of wider problems of "Japan Inc." -- the often cozy mesh of big business and government.

Marii Goto, who heads a private group that counsels AIDS victims, notes there have been several similar cases of the government failing to protect the public against corporate excesses.

She herself suffers from one -- an incurable, progressive nervous disorder caused by the side-effects of drugs used in the 1970s.

"The real problem here is the system," she said. "Corporate Japan is too concerned with profits. There is no one acting as a strong enough ombudsman."

One of the main criticisms of the system is "amadukari," which means "descent from heaven" and refers to top-ranking government officials retiring to accept executive jobs in the private sector.

Critics say the practice has become so common it has blurred the borders between government and business. Officials are less willing to crack down on private companies because that could offend a former superior or risk a lucrative post-retirement job, the critics say.

Doctors are also said to be susceptible to corporate influence.

Dr. Takeshi Abe, the physician who has been arrested in the AIDS scandal, allegedly used his clout with the Health Ministry to stall imports of safer blood products because of his own close ties with drug companies. Several were major contributors to a foundation created in his honor.

Goto said one step toward solving the problem would be to make it easier for the public to get access to government documents, an often impossible task under current law.

Until earlier this year, Japan's Health Ministry had maintained it did not know that Japanese blood products were risky until it was too late, and was thus not responsible.

In one of his first acts as health minister, Kan ordered the release of documents that ministry officials had claimed were lost.

When released in March, the files indicated the government did know of the dangers of tainted blood and was planning an emergency importation of the heated products in 1983. Those plans were suddenly called off, however, and heat treatment of blood products was not approved until 1985.

That same year, health officials designated a homosexual man as Japan's first AIDS sufferer, although they were aware of doctors' reports that two hemophiliacs had probably already died of it.

"They wanted it to be a gay disease," Goto said. "If they had admitted a hemophiliac was the first, they would have had to explain why. Because blood products are under their supervision that would lead to the question of responsibility."

Since the release of the new information, the government and drug companies have agreed in an out-of-court settlement to accept some of that responsibility by paying lifetime support to hundreds of hemophiliacs infected by the tainted blood products.

The Health Ministry, meanwhile, has opened up its decision-making process to include the participation of a broader range of outside experts -- including AIDS patients, civic leaders and lawyers. Goto, for instance, has been named to a key AIDS subcommittee.

But Kawada remains skeptical.

"I am afraid there will be some scapegoats and then the whole thing will be declared over and swept under rug again," he said. "I hope I'm wrong."

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