InterPress News Service (IPS); Sunday, 14 July 1996.
Cecile Balgos

At last week's 11th International Conference on AIDS here, Thailand received special mention for its aggressive anti-AIDS campaign that has resulted in a drop of HIV infection levels among the country's young men. But the twin horrors of India and Burma, and their implications for the region have not escaped many experts.

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

Tarantola was among those who presented a report that summarised the status and trends of the global pandemic. In the past few years, experts have noted the fast spread of the disease in Asia, which now has more than 4.7 million adults living with HIV/AIDS.

More than 90 percent of HIV-infected adults in the region live in India, Thailand, Burma, and Cambodia. The predominant routes of transmission on the continent are heterosexual contact and injecting drug use, according to the Joint U.N. Programme on HIV/AIDS (UNAIDS).

The sheer number of estimated HIV infections in India has raised alarm bells among experts. While the World Health Organisation (WHO) pegged the number of HIV infections there at 1.75 million by the end of 1994, the report Tarantola presented said the real figure may have already reached "between two to five million in mid-1996".

As UNAIDS Executive Director Peter Piot told delegates at the Jul. 7-12 conference, "India already has more infected people than any other country in the world."

India's high prevalence rate is worrisome because of its porous borders. The country, for example, has a considerable number of Nepali women employed in Bombay as commercial sex workers.

At the same time, experts point to Burma as another AIDS time bomb. More than 500,000 Burmese are believed to be infected with HIV, but Tarantola said he would place the country "at the same level as Thailand", which now has some 800,000 people with the AIDS virus.

In two years, the number might even double and exceed Thailand's projected figures, Tarantola told IPS.

He said that while Burma's military leaders began a standardised sentinel surveillance for HIV/AIDS in 1992, promoting condoms and sponsoring anti-AIDS advertisements, "we have to look for the people who are highly vulnerable but cannot be easily reached by government." Indeed, Burmese health officials themselves have reported a comparatively high number of AIDS- related deaths in rural Shan state.

Tanrantola expressed concern that the AIDS crisis in Burma was being overshadowed by the critical situation in Thailand. At the same time, though, experts agree that the South-East Asian country's response to the AIDS problem may be helpful to other Asian nations battling the disease.

In 1991, Thailand launched an aggressive campaign toward 100 percent condom use, coupled with public awareness programmes that included school- and workplace-based AIDS education. The efforts apparently reduced the number of new infections per years almost four-fold since 1990, according to UNAIDS. But Thai officials are not about to let up on their campaign.

Indeed, they already have another five-year plan against AIDS, this time emphasising how social and economic development can contribute to the control of the dreaded disease.

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

Lamptey said prevention efforts work when there is early recognition of the magnitude of the problem, political commitment and adequate allocation of resources, and implementation of innovative and quality programmes on a large scale.

But UNAIDS' Peter Piot cautioned other countries "not to imitate blindly what Thailand has done."

"We must look for the answer in our own community," said Piot. "The solution will not come from outside." (END/IPS/CB/YJC/96) ITEM CLOSED

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