amfAR, The Foundation for AIDS Research

ICAAP Confronts Widening Asian AIDS Epidemic


October 2005—Against the backdrop of a newly released UNAIDS report showing 8.2 million Asians living with HIV/AIDS and the danger posed by the epidemic to be greater than ever, the 7th International Congress on AIDS in Asia and the Pacific (ICAAP) drew more than 2,000 people to Kobe, Japan, 1–5 July, for a wide-ranging exploration of HIV/AIDS prevention, education, treatment, and care issues facing the region. The Congress presented a number of new studies of HIV/AIDS in Asia, along with several reports showing a disturbing uptick in reported cases.

UNAIDS: Asia Faces Increasing Threat From HIV/AIDS
East Asia faces the fastest growing epidemic of HIV/AIDS in the world, according to a new UNAIDS report, and the Asia-Pacific region stands on the brink of a broad public health disaster if significant new efforts are not made to “stop the epidemic in its tracks.” The report predicted 12 million additional infections over the next five years without concerted prevention and treatment campaigns.

Underlining the extreme urgency of the situation, the UNAIDS report predicted funding shortfalls in the region of almost US$3.1 billion by 2007. (An estimated US$5 billion will be needed at that point, with only US$1.6 billion expected.) “As long as prevention programmes remain under funded, we will not get ahead of the epidemic,” said J.V.R Prasada Rao, director of the UNAIDS Regional Support Team for Asia and the Pacific.

The epidemic remains concentrated largely among vulnerable groups, including sex workers and their clients, injection drug users, men who have sex with men, young people, and mobile populations, but current prevention efforts are inadequate to keep it from advancing into the broader population, according to UNAIDS. The report strongly urges Asian governments to develop aggressive national plans to combat the epidemic.

China: HIV Spreading Through Drug Routes
HIV appears to be spreading into China primarily along drug trafficking routes from the region of the Golden Triangle, according to a report issued by Japan’s National Institute of Infectious Diseases. The Japanese research team studied two strains of HIV seen in patients in Yunnan province, where the virus first appeared around 1989, and discovered that one was found in Thailand in 1988 and the other was a hybrid of strains found in India and Thailand. The scientists assert that the strains of HIV now found in China originally arrived in the country from the heroin-producing areas of the Golden Triangle, which include parts of Thailand, Laos, and Myanmar.

MAP: Asian Governments Must Address
Major Causes of Epidemic

Even as Asian nations emphasize scaling up ARV treatment, they cannot lose sight of the major forces driving HIV in the region—commercial sex, unsafe injecting drug use, and male-male sex—according to several reports released at ICAAP by the Monitoring the AIDS Pandemic (MAP) Network. In order to slow the spread of the epidemic, the MAP reports urge Asian governments to recognize the behaviors that contribute to the epidemic’s spread and address them with programs and policies aimed at supporting and helping severely affected communities. Without increased attention to these particularly vulnerable groups, the reports note, HIV can spread quickly into the general population through sexual transmission.

According to MAP, in most Asian countries AIDS was first identified among men who have sex with men (MSM), but the virus has since moved strongly into other communities and many governments now ignore the MSM community. “Recent high levels of HIV prevalence among men who have sex with men—17 percent—should serve as a wake-up call,” said the network’s report on male-male sex. Increasing rates of infection among injection drug users were singled out in another report as another possible route into the general population. “Mixing sex and drugs is a lethal combination that can trigger a rapidly escalating epidemic,” Dr. Consorcia Lim Quizon told HDNet.

Indonesia: HIV Rates Soaring
HIV/AIDS numbers in Indonesia continue to rise, according to a country report submitted at ICAAP. Injection drug use is the primary means of transmission, although unprotected heterosexual sex tops the list in Papua, which has now surpassed Jakarta as the province with the highest AIDS rate. The total number of people living with HIV/AIDS in Indonesia is estimated to be between 90,000 and 130,000.

Japan: Apathy Poses Serious Threat
Despite its low HIV/AIDS prevalence, ICAAP host country Japan is facing a serious potential threat both from the virus and from complacency about HIV/AIDS. According to experts at the Kobe meeting, the country’s apathy about the epidemic ignores recent statistics that show the number of infections creeping upward. In April, that number surpassed 10,000, even as Tokyo cut its AIDS budget by two-thirds in 2005.