InterPress News Service (IPS); 7 July 1997.
Suman Pradhan

Health experts see a link in the region between economic liberalisation, the lifting of state controls on the economy, and the spread of the deadly infection, which causes the fatal Acquired Immuno Deficiency Syndrome (AIDS) disease.

According to Sally G. Cowal of the U.N AIDS programme, the infection became a serious health problem in the 1990s in South Asia when cross-border movement of goods, services and peoples has increased dramatically.

"HIV does not need passports, nor do they require visas to cross international borders," she said at a regional meeting last week in Kathmandu, in preparation for the Asia-Pacific Summit on HIV/AIDS in Manila in October. "They can sneak across borders without anyone knowing. This makes the problem all the more daunting."

South Asia which includes India, Pakistan, Nepal, Maldives, Sri Lanka, Bangladesh and Nepal, is the world's most populated region, poorer than even sub-Saharan Africa which it trails in child health, maternal mortality, illiteracy and gender inequality.

Now it is also the world's most vulnerable to the HIV infection. The number of cases in India, for instance, has grown in a decade to between three to five million cases -- which is relatively small considering its population of 900 million.

But the risk of transmission from high-risk groups will only grow with the region's huge floating population of people -- economic migrants from its villages, who move to urban areas, across countries and abroad.

It is impossible to screen the migrant population because borders are open or easily infiltrated like those between Nepal and India, which have no border controls on people, and Bangladesh and India.

Tens of thousands of poor Nepalis work all across India, while their families stay on in the villages. Hundreds of trucks laden with goods for the land-locked kingdom arrive in Nepal from India every day. Migrant workers and truckers, along with sex-workers and commercial blood donors are considered high risk groups.

These factors have led AIDS-fighting agencies to call for stricter monitoring of cross border zones. For it is in these areas, they say, that the battle to check HIV will be won or lost.

"Cross border zones are especially vulnerable to the threat posed by HIV/AIDS pandemic because of the flexibility of movement," says Dr Asha Rao of the Bhoruka Public Welfare Trust, a pioneering Indian NGO that works among truckers on the high density routes between India and Nepal to raise awareness.

"Border towns usually have cash driven economies and a lot of flesh trade abounds in these areas. As a consequence, cross border transmission of HIV is a fact ... that needs to be tackled with a pragmatic and constructive approach," she adds.

Population movements aside, the threat posed by drug abuse and sex trade in the region have also been identified as other important causes of HIV spread. Studies have found that injected drug abuse in India's north-east have led to HIV infection in over 80 percent of drug abusers in the area.

Along with this is the growing menace of sex tourism and paedophilia. "As sex hubs in the east, notably Thailand, begins to close its doors on Western sex tourists, they are increasingly turning to South Asia," says Kunda Dixit of the Panos Institute.

Trafficking in women is a serious problem in Nepal. Close to 300,000 Nepali women are estimated to be working as commercial sex workers in brothels in India's cities. Many of those who have been sent back home are infected with HIV.

All these factors have gone into making the fight against AIDS much more difficult for anti-AIDS agencies. At a regional seminar held between Jul 3 and 5 in Kathmandu, Nepal's capital, most delegates said the fight could be won only if South Asia tackled the problem together.

"It is not enough for nations to have anti-HIV policies," says Dr Prakash Aryal, chief of Nepal's Aids Control and Prevention Programme. "What is needed is a concerted regional approach to deal with the virus."

Taking note, the United Nation's Development Programme (UNDP), which supports anti-AIDS campaigns for Asia and the Pacific from a regional office in New Delhi, has resolved to implement regional strategies this year.

Timothy Mackay, regional HIV/AIDS programme operations manager of the UNDP said in response, "National efforts will be limited unless specific collaboration on the wider socio-economic issues that have true cross border dimensions can be adequately addressed through inter-governmental collaboration." (End/IPS/sp/an/97)

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