InterPress News Service (IPS); Tuesday, 9 July 1996.
Cecile Balgos

Up to two-thirds of the estimated 21 million people worldwide that are counted among those that have AIDS and/or the HIV virus that causes Acquired Immune Deficiency Syndrome are today found in Africa.

But health experts warn that the disease is fast spreading across South and South-east Asia and that by the turn of the century, the region would surpass the rate of infection in Africa.

For while Thailand, currently home to 800,000 of the region's 4.7 million HIV/AIDS infected persons, is reaping some success in its aggressive anti-AIDS campaign, the epidemic is expected to next hit hard the neighbouring Indochina region. In populous India, the situation is already fast spinning out of control.

"We are about to see a major impact of AIDS in South and South- east Asia, and we are not prepared for it," says health expert Dr Daniel Tarantola of the Harvard School of Public Health.

Tarantola is among participants at this week's 11th International AIDS Conference taking place in Vancouver, on the Canadian west coast.

Of the number of reported cases of AIDS in the adult population of Asia, more than 90 per cent of these live in India, Thailand, Burma (also known as Myanmar) and Cambodia.

The World Health Organisation (WHO) estimated that at the end of 1994, there were 1.75 million HIV infected persons in India. Today, WHO believes the figure could be anywhere between two and five million.

"India already has more infected people than any other country in the world," says Peter Piot, executive director of UNAIDS -- the joint United Nations Programme on HIV/AIDS.

What is of particular concern to health experts is that while the Thai government's anti-AIDS campaign is well established, in India, the authorities have only recently been jerked into action and it will take time to reach all of its target groups.

Prostitutes are a main target group, particularly as many of those working on the streets and in the brothels of India's big cities, have traveled over from Nepal. Many earn a living in the commercial district in Bombay and some return home unaware they have contracted the disease.

Prostitution and injected drug use are also the main types of transmission in Thailand, but the Bangkok government has with the assistance of non-governmental organisations (NGOs), managed to get the message of caution across to much of its target audience.

Projected estimates indicate that the Bangkok government's campaign, has reduced the number of new HIV infections by almost four-fold a year since 1991 when the campaign was launched. In particular, it promotes the use of condoms, while awareness programmes have also been carried into the schools and workplace.

The government's new five-year anti-AIDS campaign will zoom in on the socio-economic pressures that push the impoverished and vulnerable into sex-worker and drug-related activities.

"Thailand is the best example of national commitment to HIV prevention because it has replicated successful model prevention programmes and has at the same time doubled its annual funding commitment" in the past two years, said Peter Lamptey, head of the U.S.-based AIDS Control and Prevention (AIDSCAP) Project.

AIDSCAP, the Harvard School of Public Health and UNAIDS hosted a two-day symposium at the weekend which focused on a published report titled 'The Status and Trends of the Global HIV/AIDS Pandemic'.

But while experts laud the Bangkok government's commitment to the fight against the spread of the deadly virus, they note as well that the Thai formula may not work as well in other countries.

"We must look for the answer in our own community," Piot told reporters on Monday, cautioning other countries against "blindly" trying to imitate what Thailand has done. "The solution will not come from outside," he said.

The Indochina region for example, now embarking on economic reforms after years of international isolation, will have to devise its own methods, and quickly, to halt what experts fear will be a rapid spread of the virus.

More than 500,000 Burmese are believed to be infected with HIV, "but in two years time, the number may double or exceed Thailand's projected figures", says Tarantola.

According to Tarantola, the military regime in Burma has adopted a standardised, sentinel surveillance programme. The government has also sponsored a number of anti-AIDS advertisements and promotes condom use.

But he worries that Rangoon regime's campaign may not be reaching the rural communities, home to millions of ethnic minorities. "We have to look for the people who are highly vulnerable, but cannot be easily reached by the government."

Indeed, Burmese health officials have themselves reported a regionally comparatively high number of AIDS related deaths in Shan State, until recently lorded over by the drug kingpin, Khun Sa who earlier this year surrendered to the authorities.

The area forms part of the 'Golden Triangle', a region notorious for opium production and an illegal narcotics trade straddling the borders of Burma, Thailand and Laos. (END/IPS/AP-HE-PR/CB/CPG/96)

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