World's Highest Rate of HIV Infection Puts Region's Economic and Social Fabric at Risk : Asia Begins to Grapple With Its AIDS Problem
International Herald Tribune
October 25, 1999
Thomas Fuller

A recent surge in the number of HIV-infected people in Asia will have serious implications for the region's economies as medical costs swell and the work force shrinks, economists and AIDS experts said here Sunday.

More than 7 million Asians are now believed to be infected with the human immunodeficiency virus that causes AIDS, according to Unaids, the United Nations agency charged with tracking the deadly virus.

While countries such as Thailand have grappled with AIDS for more than a decade, over the past few years the disease has spread to parts of the region that were previously untouched, specialists on the disease said at a conference on AIDS in the Asia-Pacific region.

The number of Asians infected with HIV rose 70 percent from 1996 to 1998, faster than on any other continent, according to Unaids.

In China, where 400,000 people are believed to be infected, the disease is spreading among intravenous drug users. In India, where anywhere from 2 million to 8 million people are infected, the sex industry is a primary conduit. India now has more HIV-infected people than any other country in the world.

The spike in HIV cases means that the disease has gone from being a scourge centered in Africa to a more broad crisis of the developing world, experts say.

"There was some hope that Asia would be saved," said Peter Piot, head of Unaids, "but that's turned out not to be true." On Saturday, Malaysia's prime minister, Mahathir bin Mohamad, proposed that Asian leaders convene soon for an AIDS summit. But he added no further details to the proposal.

"What one hopes is that Asian countries won't wait until people start dying in massive numbers before responding with the vigor that is necessary," Mr. Piot added.

Economists at the conference said the virus would soon have severe economic consequences for countries in Asia, where AIDS is spreading fast.

"The AIDS epidemic will overwhelm health finances," said Mieko Nishimizu, the World Bank's vice president for South Asia. "But it will not stop there — the entire public finances will come under enormous pressure.

"AIDS threatens to reduce, halt and even reverse the economic growth of Asia. It threatens to kill the people of Asia at the prime of their productive years."

While the overall rates of infection in Asia do not come close to levels in Africa, AIDS specialists say recent data are nonetheless alarming because of Asia's much larger population and the fact that several years ago in places such as India the "virus barely had a toehold," in the words of one of the conference documents.

"You go through a long incubation phase, and then you have an outbreak," Mr. Piot said.

Mechai Viravaidya, who has worked with the government of Thailand in a high-profile and so far successful campaign against AIDS in that country, said one of the biggest problems in Asia was that some governments were ignoring the existence of the disease.

"Many countries in Asia are in 'denial mode,"' Mr. Mechai said. "Some countries don't talk much about it, fearing it will hurt their reputation or tourism or whatever." Miss Nishimizu of the World Bank added: "In every country with a serious AIDS epidemic today, people once said: 'It can't happen here. We don't have the behaviors that spread AIDS.' They were wrong."

Many of the projected effects of the rising HIV infection rate are not yet apparent. But in countries where the disease struck earlier in the decade, death rates have already climbed considerably.

Fatalities as a result of AIDS have pushed up the death rate by 16 percent in Thailand, 12 percent in Burma and 10 percent in Cambodia, according to Unaids.

And for those living with HIV in Asia, obtaining the expensive drugs commonly used in the West to help inhibit the deadly effects of the disease is sometimes impossible.

"Some politicians and government officials in Asia say, 'Look, to put money into drug treatment — they won't get better, they'll just die more slowly, using more of our money,"' Mr. Mechai said. "Economically you can justify that, but in terms of decency and humanity, that's just not acceptable."

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