> The East-West Wire is a news service provided by the East-West Center in

> Honolulu. Any or all of this report may be used with attribution to the

> East-West Center or to the person quoted. For information, contact Susan

> Kreifels at (808) 944-7176 or eastwestwire@eastwestcenter.org.

>

> For a directory of all East-West Wire reports, see

> http://www.eastwestcenter.org/events-en.asp

> For daily news on the Pacific Islands, see www.pireport.org

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> www.eastwestcenter.org/journalists

>

> *** International Seminar on HIV/AIDS: Social Behavior, Stigma and

> Discrimination, Beijing, July 6-9, supported by the Ford Foundation and

> hosted by the National Population and Family Planning Commission and the

> Network for HIV/AIDS Prevention in China, with help from the East-West

> Center in Honolulu.

>

> *** XV International AIDS Conference, Bangkok, July 11-16.

>

> *** Recent East-West Center publications on HIV/AIDS in the Asia Pacific:

> 1. "HIV/AIDS Awareness Is Improving in China," by Chen Shengli, Zhang

> Shikun, and Sidney B. Westley. Asia-Pacific Population & Policy, April

> 2004, No. 69, 4 pp. Free PDF file:

> http://www.eastwestcenter.org/res-rp-publicationdetails.asp?pub_ID=1474&Se

> archString=

>

> 2. "Tackling the HIV/AIDS Epidemic in Asia," by Tim Brown. Asia-Pacific

> Population & Policy, January 2004, No. 68, 4 pp. Free PDF file:

> http://www.eastwestcenter.org/res-rp-publicationdetails.asp?pub_ID=1447&Se

> archString=

>

>

> COMPLACENCY IN FIGHTING HIV/AIDS IN ASIA SPELLS 'HUGE TROUBLE' FOR THE

> REGION

>

> HONOLULU (July 5) -- Asian countries are underestimating the HIV/AIDS

> epidemic and missing essential data on populations at risk, leading Asian

> policymakers to become complacent in fighting the epidemic, an East-West

> Center health specialist said.

>

> While experts predict Asia's HIV epidemic will not reach sub-Saharan

> levels of 15 percent or more of the adult population, reaching 2-3 percent

> levels still means "huge trouble" for Asian countries, said Tim Brown, a

> senior research fellow who focuses on HIV/AIDS in Asia and the Pacific.

>

> "The countries of this region have to wake up to reality," Brown said.

> "Two and three percent levels are possible in much of Asia. Those levels

> are sufficiently bad that leaders must take an active role.

>

> "The most dangerous thing is that the numbers stay below the threshold of

> political attention while the epidemics continue to grow steadily," said

> Brown, whose work on developing the Asian Epidemic Model was featured in

> the June 25 issue of Science magazine. The model includes the populations

> driving HIV/AIDS in Asia, including sex workers and their clients,

> injecting drug users and men who have sex with other men.

>

> Brown said there are major gaps in Asian data systems. Most countries

> don't know how many sex workers they have or what percent of males visit

> them, nor do they have counts on drug users. "These are what drive the

> epidemic, yet these key pieces of information are still not known 20 years

> into the epidemic."

>

> This lack of data and the slower growth of HIV/AIDS epidemics in Asia have

> led policymakers, media and international aid programs to underplay and

> ignore the problem, leading to anemic responses. Brown conducted a seminar

> this summer at the East-West Center on integrated analysis for 30

> researchers from Vietnam, Bangladesh, China, Thailand and India to help

> them get a "clearer picture" of the epidemic.

>

> Brown said that while there have been some successes in Asia, most

> countries are not seriously addressing HIV/AIDS. In most of the region,

> small but well-funded "boutique" prevention programs remain far too

> limited in scale and reach. The coverage of the key populations driving

> the epidemic remains quite low and the programs to reach them are

> underfunded. In the last year, leaders in China and Vietnam have promised

> expanded and appropriate responses, but it remains to be seen if they will

> follow through on a scale that can turn their epidemics around.

>

> Thailand and Cambodia have seen success in their prevention programs, but

> Brown questions if Thailand can sustain this success as antiretroviral

> costs climb. In half a decade providing antiretroviral drugs for the 1

> percent of its population living with HIV will cost $100 million or more

> annually. The government now budgets $40 million for its HIV/AIDS

> programs. It will be a challenge for the country to sustain prevention

> efforts as care needs grow, but maintaining the balance is essential.

>

> Other indicators of growing problems:

> -- Increasing levels of HIV infection among sex workers, injecting drug

> users, and men who have sex with other men are being seen in countries

> around the region, including some of the world's largest countries: China,

> India, and Indonesia.

> -- In many countries less than 10 percent of the at-risk population is

> being reached by programs.

> -- In many parts of Asia people get arrested for carrying condoms or

> needles. "How can you engage in prevention if carrying these gets you

> arrested?" Brown asked.

> -- The sex industry is a part of much of Asian business culture.

>

> Brown said conservative attitudes in Asian countries often prevent data

> collection and limit work among the vulnerable populations. "Public

> service announcements don't have a big impact, but we do know that

> programs for sex work and drug use are effective in an Asian context. The

> problem is that we just aren't doing them on a scale that will make a

> difference."

>

> Tim Brown can be reached at (808) 944-7476 or tim@hawaii.edu

>

>

>

>