Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

Reuters NewMedia, Inc. - Wednesday, 6 November 1996.
Tom Wright

"The global AIDS epidemic is now spreading in Asia faster than anywhere else in the world," Dr Stefano Lazzari, the WHO's Jakarta representative, said in a keynote address to the First Asian Conference on Healthcare Insurance.

"By the turn of the century, most new HIV infections in the world will probably occur in Asia," Lazzari said. "Soon more Asians than Africans will be getting infected each year."

HIV is the virus which causes Acquired Immune Deficiency Syndrome, or AIDS. HIV kills or impairs cells of the immune system, destroying the body's ability to fight infection.

Currently the WHO estimated that 25.5 million adults and 2.4 million children in the world were living with HIV, Lazzari said. Of this total, 19 million cases were in sub-Saharan Africa, five million in South and Southeast Asia and 1.6 million in Latin America.

But proven high-risk sexual behaviour in Asian countries, coupled with a much larger population than in Africa, meant the WHO expected an HIV explosion in the region.

"Although HIV was introduced much later in Asia than in the rest of the world...the WHO estimates that while the annual number of HIV infections will peak in Africa by 1995-6, infections in Asia will continue to increase well into early next century," Lazzrai said.

If the current trends continued, the total of HIV cases in Asia by 2000 could reach 8-10 million, he added. India alone was expected to have five million cases by 2000, making it the world's most infected country, Lazzrai said.

Official tallies of HIV/AIDS in the region were much lower than the WHO's estimates, a divergence which Lazzrai put down to under-diagnosis and incomplete reporting.

"The current (WHO) estimate of more than five million HIV infections in Southeast Asia is nearly 18 percent of the global total, while the proportion of reported AIDS cases is less than two percent," he said.

Lazzari said the average time for HIV to develop into full-blown AIDS was around 10 years. This would lead to increased health costs in the region and create a separate problem for health insurers.

"Life insurance premiums are bound to rise with the increasing number of deaths from AIDS," he said.

The cost of treating those suffering from full-blown AIDS could also be very steep, he added.

Estimated lifetime treatment costs of an HIV-infected person in Thailand could be anywhere between $5,000 and $8,000, Lazzari said. New AIDS-combating drugs, such as protease inhibitors, could cost as much as $15,000 to $20,000 a year.

Sivam Subramaniam, editor of the Asia Insurance Review who organised the conference, said these costs created a huge problem for insurance companies operating in the region.

"Insurance companies have to take safety measures to protect against AIDS, but they must balance this with sensitivity," Sivam said, adding that there was a limit to how far insurers could intrude into someone's personal sexual behaviour.

But Lazzari said that in Asia, people who held insurance policies were normally from rich sectors of society which were not necessarily the groups most at risk from HIV infection.

"Not many people have private insurance in Indonesia. Those that do won't be the most at risk to HIV," he said.
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