Health

International Aid Crisis Continues to Mount in Africa, India, and China

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Anti-retrovirals, which extend victim’s lives, not widely used in such areas

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Statistics on Heterosexual Transmission Rise Dramatically

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UN Reports 37.7 Million Living with AIDS

By Michele Leight

NEW DELHI, Oct. 14, 2000 – Progress with drugs known as anti-retrovirals has prolonged the lives of many victims of the AIDS epidemic in the United States, but it is raging in developing regions such as Africa and countries such as India and China where the situation festers like a time-bomb, with extreme poverty, ignorance and gigantic populations thrown into the already complex socio-economic mix.

According to various reports, there are about 35 million people living with AIDS worldwide, of which less than 750,000 are Americans.

Although there is no cure yet for AIDS, the anti-retrovirals have prolonged life for its victims for up to 10 or 15 years, offering a decent quality of life and preventing unnecessary suffering. Without these drugs, which cut back the full impact of the Human Immunodeficiency Virus (HIV) victims often die within two or three years.

HIV/AIDS victims in America and the Western nations are ahead of their counterparts in the rest of the world, especially Africa, India and China, where many HIV/AIDS victims do not even understand that they have a deadly, infectious disease.

There has often been no commitment from government or media in some developing areas to inform citizens of the hazards of HIV infection, and no infrastructure to deal with those infected. Unlike chicken pox, and other viruses which very soon manifests itself on the victim’s body, the HIV virus lurks over a period of years without outward symptoms before/if it becomes AIDS. In Africa, governments have let things sit a little too long, and denial in the face of hard evidence has lead to the tragic situation now confronting Sub-Saharan Africa, where 24.5 million adults and children are living with HIV.

The insidious nature of HIV/AIDS has lead to the unbelievable prospect ahead for Kenya, South Africa, Zimbabwe and Botswana, where at least one out of two boys now aged 15 will eventually die of AIDS, according to a report available at http://www.unaids.org/epidemic.html. Given the proper medications, which the Western countries have offered, this situation could have been avoided. It is a warning to other countries, especially India and China, not to walk the same path.

Thailand was one of the first South East Asian countries to succumb to AIDS, mainly because of the sex industry, and has been addressing the problem ever since, but other countries in South East Asia are experiencing record rises in AIDS cases.

Without regular HIV testing or a health-care infrastructure to take care of those already infected, this creates the perfect breeding ground for the elusive and tenacious HIV virus, which can lurk undetected for years before it strikes – like the "plague"- cutting away the immune systems defense mechanisms, and exposing the victim to any number of infections and diseases which the body cannot fight, mainly tuberculosis. After prolonged suffering, it is the body’s lack of immunity which kills.

In London on September 4, 2000, at a symposium organized by the Royal Institute of International Affairs entitled "We The Peoples: The UN in the 21st Century," Dr. Peter Piot, Executive Director of the Joint United Nations Program on HIV/AIDS (UNAIDS) (http:www.unaids.org) said: "Aids is one of the key issues shaping the world today and should rank as high on the list of human concerns as globalization, peace and the environment."

Dr. Piot highlighted the deadly inequalities of health that continue to divide the world, pointing to the growing AIDS epidemic in developing countries and calling for political will and commitment from government. To date 18.8 million around the world have died of AIDS, 3.8 million of them children. Nearly twice as many, 34.3 million, are now living with HIV, the virus that causes AIDS.

In 1999 alone, 5.4 million people were newly infected with HIV. AIDS, according to a report available at http://www.avert.org/worldwidestats.html. Subtracting the U.S. total of 733,374 from the above statistics gives some idea of how fast this disease is encroaching on the developing nations.

Building on the agreement reached by the UN General Assembly, Secretary General Kofi Anan, calls for a strategy that focuses on young people aged 15-24, and on providing care to those living with HIV. He explicitly recommends action to reduce HIV infection rates by 25% in the most affected countries before 2005, and globally by 2010. There will be a symposium and panel discussion at the United Nations on the emerging HIV/AIDS epidemic in South and Southeast Asia and Thailand Nov. 30, 2000 from 9:30AM to Noon.

HIV is the virus not the disease, and although there is no cure at present for full-blown AIDS, regular testing, proper medications (anti-retrovirals) and responsible life-styles can dramatically lengthen and improve the quality of life for millions of infected people around the world, as they have done in the U.S, till a cure is found. Amongst other organizations, the American Foundation for Aids Research (http://www.amfar.org) has been tireless in raising funds for the research teams they fund worldwide, in the hope that they will find a cure for HIV/AIDS.

While the big picture in America shows the AIDS problem improving, grass roots observers, like Chris Camp, a gay man living in Baltimore who tested positive for HIV since the 1980s, has a different perspective. In a report at http://www.discoveryhealth.com he writes: "The people who are on the higher socio-economic level are the ones who seem to thrive and survive longer. I think HIV is really coming down to an issue of class. Your class dictates who will manage, who will survive and who won’t…you are seeing the emergence of two almost different diseases and, for those who are not part of the privileged crowd and don’t have the connections that can lead them to the medications and the care, HIV is the same deadly disease it always was."

The U.S. is fortunate; the crisis is being dealt with at present and is under control, but HIV is a tenacious and sneaky virus which needs constant monitoring, especially with the young, who are predicted to be the long term victims of HIV/AIDS worldwide. Statistics on new infections in the U.S. indicate an alarming increase of HIV through heterosexual transmission - and the present situation worldwide clearly shows the disease swinging over to the heterosexual population at epidemic levels.

Mr. Camp’s "socio-economic" case is supported by the Center for Disease Control’s report on U.S HIV/AIDS Statistics, ending December 1999. According to the report, the epidemic has shifted toward growing proportions of AIDS cases in blacks (7%) and Hispanics (18%) and in women (18%) and a decreasing proportion of MSM (Homosexuals). This last group remains the single largest exposed group in the U.S. however (43%). Blacks have outnumbered whites in new AIDS diagnosed deaths since 1996 and in the number of people living with AIDS since 1998, and there is a disturbing statistic for female deaths – up to 23% in 1999.

The Center for Disease Control list 6.2 million women and 3.6 million children (under 15 years of age) of the estimated 16.3 million lost to AIDS since the epidemic began. Women are becoming increasingly affected by HIV – 46% or 14.8 million of the 32.4 million adults living with HIV and AIDS are women, according to a CDC report at http://www.cdc.gov/hiv/stats/internat.htm. During 1999, HIV-associated illnesses caused the deaths of an estimated 2.6 million adults – nearly half of which (1.1 million) were women and 470,000 and 470,000 children under 15. (The number of people living with HIV and AIDS is put at somewhat higher totals in other reports.)

A 17-year survivor of HIV and AIDS, Mr. Camp is currently chairman of the Baltimore/Washington D.C. community advisory boards MACS study (Multicenter AIDS Cohort Study), based at the Johns Hopkins School of Public Health.

Mieko Nishimizu, Vice President of the World Bank South Asia Region, speaking recently at the Fifth International Conference on AIDS in Asia, said that a quarterof the people infected worldwide live in Asia. "India is now the country with the largest number of people living with HIV/AIDS in the world," he said, in a report available as news release No. 99/2250/SAS at http://www.worldbank.org/aids.html, adding that "for leaders both in government and in civil society to choose not to act, knowing the consequences, would be unethical and a betrayal of their people."

By early next century, India is expected by some experts to have the highest number of AIDS cases in the world – an estimated 37 million will be HIV infected. With a population of a billion at present, only a small percentage are able to distinguish the seriousness of their disease and educated enough to do something about it. The remaining victims are too poor and too ignorant to understand that they have AIDS – and are continuing to spread it.

Nafisa Ali

Nafisa Ali, a film star who is president and founder of ACTION INDIA, an organization for raising awareness of AIDS and creating a holistic AIDS care center in New Delhi

A few weeks ago in New Delhi, India, Nafisa Ali, shown above, AIDS advocate and President and founder of ACTION INDIA (http://www.actionindia.org), (an NGO, or "non government organization"), whose aim is to raise AIDS awareness and establish a "Holistic Aids Care Centre" in her home city, New Delhi, spoke to this reporter of the frustrations and sadness in confronting the problem in her country.

"We only need to look at Africa, where villagers are being wiped out, with only the old and the young remaining – orphaned because their parents have died of AIDS…and for years their government did nothing except deny they had a problem," Ms. Ali said.

A former Miss India, model and well-known actress in her country, (the land of Bollywood and as many movie-goers as the rest of the world put together), Nafisa Ali starred in "Junoon," with the legendary Shashi Kapoor in 1979 and more recently in "Major Saab," with Amitabh Bachan, a beloved actor nationwide who hosts the Indian equivalent of "Do You Want To Be a Millionaire?" Ms. Ali admits to using her "star status" to draw attention to the plight of AIDS victims in India, a country where most of the population cannot afford computers, the Internet and TV, but do go to a movie and get information through the newspapers and radio.

In her own efforts to raise funds for her Aids Shelter, Ms. Ali has been made acutely aware of the "unpopular" nature of this cause in a country that believes that punishment comes with risky sexual behavior, prostitution and drug abuse. The facts, she said, show clearly, however, that the transmission of AIDS in India is almost entirely through heterosexual contact – a staggering 80%. Raising funds for other causes has never been a problem, but Ms. Ali’s solicitations on behalf of AIDS victims are met with polite side-stepping and avoidance, while the statistics for HIV in India continue to predict disaster. "The youth of our country must be made aware of this threat and practice safer lifestyles," she stressed, adding that "India is a patriarchal society, and people must be told that HIV infections are heterosexually transmitted."

Statistics for South and Southeast Asia from http://www.avert.org support Ms. Ali’s concerns and indicate that of the newly HIV infected adults in those regions, 30% are women, exclusively through heterosexual transmission.

Of great concern to Ms. Ali, a mother of two daughters and a son, is the effect that passivity will have on the young:

"How many parents can openly and honestly speak to their children about sex education? Statistics in our country are proving that over 80% of all HIV positive cases are through the sexual route and the most vulnerable age group are those between the ages of 15 and 39. This to me is a human rights violation. If we are putting our young at risk, then I do feel that by not talking about adolescent hormones and the dangers in mainstream life, we are exposing them to harm and violating their right to a safe, long life"

The similarities in Ms. Ali’s comments to the situation in Africa, or to cultures which cannot afford or do not want to use condoms is alarming. With women not empowered to require a condom of a husband, they are at high risk themselves, a fear echoed by Dr. Piot, who raised the same subject at a UNAIDS Conference in New Delhi on March 6th, 2000, titled "Men Make a Difference." Piot stressed that more men get AIDS than women, but they risk their wives in the process, and it is men who can change the course of the AIDS epidemic, by changing commonly held attitudes and behaviors, including the way adult men look on risk and sexuality, and how boys are socialized to become men.

Boys who are brought up to believe that "real men don’t get sick" often see themselves as invulnerable to illness or risk. Of the newly infected 5.6 million worldwide, 3.8 million are in Sub-Saharan Africa and 1.3 million in South and South East Asia. Apart from the conditioning that condoms are not considered "manly," they are also expensive and not as readily available as they are in the West.

So how did a beauty queen and film star become an AIDS advocate and the founding President of "ACTION INDIA"? Nafisa Ali flashed a dazzling movie-star smile but immediately became serious again:" I have used my stardom – to blast the politicians!" she said, sweetly.

"In 1992, I took my daughter for a routine check-up to the Government children’s hospital in Madras. My husband, "Pickles" Sodhi, who is also a well-known Polo player, was still serving in the Army. I saw a 4-year-old boy who was pale and pot-bellied…his limbs were wasted but he had sparkling eyes. To my horror I learned that this child had tested positive for HIV, during investigations for his anemia. His mother had been transfused with a few bottles of unscreened blood after delivery due to profuse bleeding. The mother had also tested positive for HIV infection and transmitted the virus to her baby most probably through her breast milk. I kept track of the child who died two years later. I have always been interested in medicine."

In his Pulitzer Prize-Winning book, "Guns, Germs and Steel: The Fates of Human Societies," author Jared Diamond discusses the scenario of the "passive" microbe, or virus – syphilis, rubella and most specifically AIDS – which passes from the mother to her fetus, thereby infecting it. He concludes that for those individuals who believe in a just universe, the "ethical dilemma" embodied in this tragedy produces a desperate inner struggle. ("Guns, Germs and Steel: The Fates of Human Societies," by Jared Diamond, W. W. Norton and Company, Inc., 1999). Condoms and anti-retrovirals are too often not reaching the infected poor because of money, and babies of infected mothers continue to be born to a life of suffering and AIDS.

In the 20th Century, smallpox claimed 300 million lives until the vaccine for prevention began to be implemented worldwide. It was the "plague" of societies and civilizations throughout history, so the world is no stranger to viral epidemics. However, unlike AIDS, within a few weeks of contracting smallpox, without the vaccine, the victim was/is dead, according to Michael B. A. Goldstone in his book, "Viruses, Plagues and History," Oxford University Press, 1998. Smallpox is no longer an issue in developing countries; breakouts still occur but smallpox vaccines are relatively easy to administer and implement compared with HIV medications. With HIV/AIDS the ethical factor remains because the medications exist, but not for everyone.

To call this disease a scourge or a plague does not do it justice. It is not difficult to understand the fear that those who are not infected feel when confronted with caring for anyone, even the closest loved one; this meanest of all viruses attacks on all fronts and renders the victim helpless, taking the body into a physical degradation which even the most loving friend or family member often fears. AIDS is a highly infectious disease only when certain "body fluid connections" are made, but with responsible and educated behaviors and attitudes, the sufferer can be treated and cared for without risk to the care-giver. This makes information and education on all aspects of dealing with AIDS so vital. Without removing the fear, progress cannot be made. The American Foundation for Aids Research (amFAR)(http://www.amfar.org) also funds educational programs to raise awareness and dilute the fear surrounding this disease.

Six years ago, Ms. Ali’s husband retired from the Army, and the family moved to Delhi. She resolved to explore the AIDS issue in India, and got an appointment with the Health Minister. "A senior bureaucrat was called in and he handed me a file on what was being done about creating awareness of this dreadful disease, which was ‘a Western disease!’ I was quite dumfounded when the officer brushed off the aids problem with ‘These western organizations came to India and worked in areas where HIV/AIDS is prevalent, for example Maharashtra, Manipur, etc, and generate statistics from this limited exposure…We are culturally not like the West…AIDS will not be a problem in India."

"It is this blinkered view which is largely responsible for the mess we are in today," says Ms.Ali. She also stresses there are many NGO’s now doing good work in the field of HIV awareness, as well as some who are misappropriating funds. She feels strongly that NACO (the National Aids Control Organization, a governmental agency, should be expanded with the NGOs who have done credible work and together they should be responsible for implementing HIV/AIDS guidelines - within a broad framework of communication in terms of HIV and human rights.

The "human right" is an important point in countries where population control is an issue and where many believe that a human being does not really deserve to live if they contract a deadly disease like AIDS because of sexual misconduct. This reporter has encountered numerous comments like "Well, homosexuals get this," or "It’s the third world" from highly educated people of all countries, who do not grasp that this disease is communicable through heterosexual contact – an "It can never happen to me" attitude which is dangerous in today’s AIDS climate. What people worldwide need to understand is that AIDS is no longer the preserve of homosexuals, needle-injecting drug users or prostitutes, but may well be present in their own heterosexual husbands or teenage children – or, without ever being promiscuous, in themselves.

The World Bank has given India $50 million, which Ms. Ali feels strongly should be made available to NGO’s to set up care homes to supply vital medicines to those with HIV, so they can live longer, productive like their American and Western counterparts, instead of dying in the first few years of infection – as outcasts spurned by a society too ignorant and moralistic to help them die with dignity.

The cost of treating AIDS patients with anti-retroviral drugs, which prolong life and prevent the ravages of full-blown AIDS, costs approximately 15 to 22,000 rupees a month (between $400 and $550), a huge amount of money to the average sufferer in India, where there is no infrastructure to begin to deal with regular care of this disease, not much discussion of the subject in the media, and computers and the Internet’s "information highway" beyond the dreams of most citizens.

While Nafisa Ali waits in hope for the funding necessary for her Holistic Aids Shelter for "NAZ" Foundation for HIV/AIDS patients, which she estimates will cost $4.5- million, she has not been idle. The aim is to help all HIV and full-blown AIDS cases, and sensitize families to care for their loved ones, instead of casting them out. Moved by attending many "World Aids Awareness Day" marches, held every December 1, she resolved to make strong documentaries on AIDS in India. At a function in 1995, she sat down at a candle-lit dinner, where she was joined by Mike Pandey, a film-maker, and his wife and another couple. By the end of the evening she had been promised two documentary fundings.

As it turned out, in addition to funding the documentaries, Mike Pandey accepted her request to make her films on AIDS, for which he has been nominated for his second Green Oscar. Sadly, not a single person in the Government at that time congratulated him. Undaunted, Nafisa Ali and Mike Pandey battled on, releasing the video "Know Aids for No Aids," on December 1, 1999, which is available in several languages including Hindi and English. There are approximately 200 languages and dialects in India, which shows how vital it is to be able to reach different segments of society, with a language barrier to overcome.

It was during the making of this documentary that Nafisa Ali encountered the prostitute whose photograph was taken by Ms. Ali. I am no stranger to images of human poverty or degradation, but the photograph of this woman showed she was in a state of physical disintegration beyond description. Most of her body had been eaten away, but she was smiling at Ms. Ali as she clicked her camera. Ms. Ali put it best: "This gentle lady had developed bedsores beyond human imagination…her eyes still haunt me and I don’t want her death to go in vain. It is vital to remove the stigmatization of HIV patients in India."

With the exception of the prostitute’s sister, no one would come near her to treat her – and without anti-retroviral medication to combat the virus, it turned the smallest of bedsores into craters, exposing bones, organs, veins – all with the human being still alive. The woman in the photograph is now dead.

A one-minute awareness message for T.V., also by Nafisa Ali and Mike Panday, featuring high-profile cricketing stars (who are akin to gods in India!) like Kapil Dev, Mohammed Azrauddin and Rahul Dravid, who gave their time unselfishlessly, has aired free of charge for the past year on Star TV (owned by Rupert Murdoch), ESPN, Discovery Channel and Doordashan. Only ZEE TV refused as they do not do social causes free.

Richard Gere, the Hollywood movie star famous for his role in "American Gigolo" and other romantic blockbuster hits, is equally well-known for his following of the Dalai Lama. In 1998, on one of his frequent visits to India, he lent his name to the cause of AIDS awareness as well. In an article in the "Hindustan Times," April 11, 1998, Ms. Ali wrote that Mr. Gere appealed to the government, the media and the public not to condemn, segregate or refuse treatment to those infected with HIV. He said that people were not caring enough, and shared with the audience the great frustration and sadness - and helplessness – he felt, when close friends die.

AIDS came out of America’s closet and went "public" in Hollywood, with Rock Hudson’s announcement to the media that he had AIDS. Shocked that the handsome "ladies’ man" was a homosexual, the world watched and waited, many assuming it was a "Western" disease. Elizabeth Taylor - now Dame Elizabeth Taylor, courtesy of Queen Elizabeth! - a close friend and co-star of Rock Hudson in "Giant," took up the AIDS cause and helped raise funds for amFAR for Aids research and for AIDS awareness through educational programs.

Dr. Mathilde Krim, Founding Co-Chair and Chairman of the Board of the American Foundation for AIDS Research (amFAR), received the Presidential Medal of Freedom on August 9, 2000 from President Clinton at a White House ceremony. Dr. Krim focused on the scientists: "This Medal of Freedom must also recognize the advances achieved by the outstanding scientists, health care givers and defenders of human rights that amFAR has funded, as well as the many people with HIV/AIDS who, as volunteers in treatment and vaccine trials, have crucially sustained the pace of medical progress…their work is far from over in a world where 15,000 new HIV infections occur each day, and curative treatments and protective immunization against HIV have not as yet been achieved."

Dr. Krim concluded with a reminder that 500,000 have been lost to the epidemic in America alone. Although she is still very active, Dame Elizabeth Taylor has passed the baton to Sharon Stone, who is currently President of amFAR, who will be chairing ‘Seasons of Hope," amFAR’s third annual awards dinner Nov. 29, 2000 in New York commemorating world AIDS day. (For tickets, call Sheila Charton at 212-806-1657 or for more information about special events and benefits surf the amFAR website at http://www.amfar.org.)

Moving and still images are forceful aids in understanding suffering, which Ms. Ali knows well, but her photographs also convey a deep concern for the plight of India’s millions of women and children, who are not free to make choices taken for granted by women in the West – like who they will marry or being able to insist upon the precaution of condoms during sexual activity or being able to freely discuss with their children the adverse effects of unprotected sex – with deadly consequences.

In Western countries, "sex education" in schools begins at a young age, and it is generally considered an ethical and moral obligation to let the young know what might happen if they do not protect themselves against HIV.

India is a land of a billion people, where prostitutes are visited by truckers who criss-cross the country; migrant workers and domestic staff and industrial workers are away from families for long periods of time because their jobs demand it. Women are vulnerable to prostitution through poverty or sold into the sex trade, where a condom is not part of the deal if the man does not want to use it. Smaller developing countries face exactly the same problems, and in Thailand the AIDS epidemic, particularly amongst sex workers, is now monitored and on the decline – because it was not ignored. The Center for Disease Control reports that the overwhelming majority of people with HIV, approximately 95% of the global total – now live in the developing world.

Ms. Ali has obviously done her research: "Women should be given the right to safer sex to avoid the HIV related consequences of their husband’s or partner’s sexual behavior, but due to economic consequences and cultural attitudes, they can’t, as has been proved by the World Bank’s survey carried out in Calcutta’s well known red light area at Sonargachi, where sex workers did make a conscious difference. These women, who are despised outcasts of Indian society, understood the importance of their partners wearing condoms, the most effective shield against HIV infection; they agreed to demand that every client wear a condom, but it is shocking to read how some clients tear off the condom during actual intercourse to derive maximum pleasure...do these men value their wives at home

Where to now, I asked Ms. Ali. Her beautiful face lit up: "Well, I hope for funding for my shelter and I would like a reply to the material I sent to our Prime Minister Mr. Vajpayee on what needs to be done about our attitude to AIDS," she said optimistically. "No reply to date!" Two years ago Ms. Ali had great hope when her Prime Minister did issue a statement: "When HIV appeared in India in 1986, everyone thought it was a Western disease contracted only by sex workers in red light areas, gay men and injecting drug users. The consequences of that myopic view are now upon us."

This year, during his Independence Day address to the Nation, the Prime Minister acknowledged the menace of HIV/AIDS in India. Perhaps Mr. Vajpayee will sanction Ms. Ali’s Aids Shelter, and many more around his country of a billion people. If Mahatma Gandhi were around today, AIDS victims would be highest on the list of "outcasts" he did so much to reinstate in India.

Moving to India’s neighbor, China, AIDS is taking its toll in rural areas, where blood selling has been big business for some time, until it became a criminal offense two years ago. The damage it seems, has been done, according to a front-page story in The New York Times, Saturday, October 28, 2000, by Elizabeth Rosenthal, entitled "In Rural China, a Steep Price of Poverty: Dying of AIDS." The article maintained that "covert studies" suggest that some of the towns in Central China have the highest localized rates of HIV in the world – as high as 20 percent. The article said that in rural China "Blood Heads" buy illegal blood from poor donors, and use unsterile collection methods and re-use contaminated needles and return to donors the remaining blood once the often "pooled" blood has been removed of the desired elements.

The article reported that local Chinese officials have forbidden media coverage of the problem and made it clear they do not want "outside" researchers studying the problem.

The Chinese Government has acknowledged the AIDS problem with needle-injecting drug users in its Western Provinces, but not the issue of infected blood sellers cashing in on the only commodity they have to sell – their own blood – often to build houses they could not otherwise afford, according to the story in The Times.

The illegal blood trade continues in China because of blood shortages at hospitals, the article stated, adding that most donors are women, because local thinking puts a lower value on women – men’s blood is too precious to waste.

In the same article in The Times, Dr. Gui Xien, a researcher from Hubei Province was quoted as stating that in Shangcai County "the medical examinations that are required for all Chinese citizens before marriage still do not include AIDS testing or counseling" and "more than half of hospitalized patients who test positive for H.I.V. are not informed of the test results."

The world AIDS situation has proved that stigmatization, ostracism, neglect and downright denial of this problem will not make it go away. There is no magic-wand treatment for the sufferers, no cure at present, but there are anti-retrovirals to prevent suffering. In a recent e-mail, Ms. Ali remarked sadly: "In India people want me to take up other causes which they will give me funding for, and let AIDS victims die as they deserve."

At the forthcoming symposium at the United Nations, Dr. Y. Shao, M.D., Phd., Deputy Director, National Center for Prevention and Control, Chinese Academy of Preventive Medicine, will be amongst the panelists (http://www.unaids.org/whatsnew/others/un).

Two weeks after the article on AIDS in China, The New York Times ran another front page article about AIDS in Southeast Asia, this time focused on Burma. The Nov. 14, 2000 article, entitled "For Burmese, Repression, AIDS and Denial," was written by Blaine Harden, who visited Burma under the guise of a tourist, because Burma’s military junta does not take kindly to foreign reporters, especially Americans, and for five years authorities have refused to grant journalist visas. Burmese citizens, who have lived under the iron rule of SLORC (State Law and Order Restoration Council) for 38 years, caught talking to foreign reporters can go to prison., so the report is a valuable first-hand account of the plight of the country’s beleaguered citizens.

According to the article, the World Health Organization ranked Burma, which has been named Myanmar by the generals, second to last of 191 nations in health-care services. In 1952, British travel writer Norman Lewis described Burma in "Golden Earth," as the place where "There is no misery that manifests itself in rags and sores." Despite World War II, Burma emerged from the war with the best civil rights, the best health-care system and the highest literacy rate in South East Asia.

The article noted that among other catastrophes which have emerged since the generals of SLORC have taken control of the country is the onset of AIDS, with three times the infection rate in Thailand amongst prostitutes – 47% last year – according to Dr. Chris Beyrer, a specialist in AIDS in South-East Asia, and an epidemiologist and director of international AIDS training at Johns Hopkins School of Hygiene and Public Health. Sadly, prostitutes are only the beginning of the problem.

Heroin addiction jumped dramatically in 1988, the year that democracy was crushed and the junta gained power, and needle-sharing in tea stalls fired an addiction rate that Dr. Beyrer said is amongst the highest in the world with 57 percent of needle-injecting drug users infected with HIV, the article noted.

Shunned by their families, many young men infected with AIDS have moved into monasteries to die, the article continued, adding that one doctor reported treating several monks with AIDS who told him before they died that they had contracted the disease by shaving their heads with razors shared inside the monastery.

The Center for Disease Control’s report on its most recent statistics concludes: "By the end of 1999, the epidemic (HIV/AIDS) left behind a cumulative total of 11.2 million AIDS orphans, defined as those having lost their mother before reaching the age of 15. Many of these maternal orphans have also lost their fathers…"

It will be interesting what the historians of the next century will have to say about that.

For more information on AMFAR, visit its website at http://www.amfar.org

For more information from the Center for Disease Control, visit its website at http://www.cdc.gov

For ACTION INDIA, contact Nafisa Ali by email at NAFISAALI@HOTMAIL.COM

"Harvest of Innocence," a book on coping with risky behavior by Michele Leight, is at www.amazon.com and at www.ashraya-ny.org

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