HIV/AIDS & Asia and the Pacific

Uganda has reportedly taken the lead in AIDS prevention efforts in Africa, by establishing a National AIDS Control Program in 1987 and hosting the first Phase I HIV vaccine trial in 1999. Through extensive education efforts, approximately 90% of the population has awareness about HIV and AIDS, and many people have adopted safe sex practices. Unfortunately, other African countries are not following Uganda's lead.

The epidemic is made grimmer by the fact that most Africans cannot afford the antiretroviral drugs that are the cornerstone of AIDS care in the United States and other Western nations. The drugs can cost up to $20,000 per year. Although efforts are being made in the United States and elsewhere to lower the cost, some African leaders say that even an 80% cut in price would not be enough to make the drugs affordable.

Further, the strict regimen that the drugs demand requires a drastic change in lifestyle that may be difficult for many people. Perhaps even more basic than medicine, many HIV-infected Africans are undernourished and hungry. Getting food to the people may be even more important than providing drugs.

Various factors have contributed to the current AIDS crisis in Africa, including the following:

• The likelihood that the HIV virus originated in Africa and spread and evolved before preventative actions could be taken
• A fierce denial on the part of many Africans, including presidents of nations, that HIV causes AIDS, that sex education is necessary to stop its spread, and that Western medicine or science can be trusted
• The inability to pay for the expensive antiretroviral drugs
• The malnourishment and poor health of many Africans

Because education, prevention, and AIDS therapy present insurmountable challenges, some people think that Africa's best hope for stopping the epidemic is a vaccine. Though more than two dozen experimental vaccines have been tested worldwide, only one—AIDSVAX—has reached a Phase III clinical trial.

HIV/AIDS & Asia and the Pacific

In 1999, 20% of the 5.6 million new HIV infections worldwide were in southern Asia. HIV began its spread in Asia in the early to mid-1980s. With a population of nearly 3.5 billion—60% of the world's population—this region has the potential to greatly affect the course of the AIDS epidemic.

Nearly one-half million of China's more than 1 billion inhabitants are infected with HIV; most new cases are among injectable drug users who share needles.

India has more people infected with HIV than any other country in the world; 3.7 million Indians have HIV or AIDS.

HIV was first reported in Thailand in the mid-1980s and increased dramatically to 800,000 in 1999; prevention programs have stabilized its prevalence.

In Malaysia, HIV transmission appears to have stabilized since it reached its peak in the 1990s; 15% to 20% of all injectable drug users are infected with HIV.

In Vietnam, transmission is increasing, especially among injectable drug users and sex workers; the prevalence of HIV among injectable drug users has risen from less than 1% in 1995 to nearly 70% in 1998.

In Bangladesh, transmission is increasing among injectable drug users and sex workers.

The highest rate of HIV infection in Asia is in Cambodia, where the primary mode of transmission is heterosexual contact.