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AIDS: Asia's Hidden Menace
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BANGKOK, THAILAND
Across Asia and the Pacific, policymakers generally have not recognized the growing devastation—both human and economic— being wreaked by HIV/AIDS in their countries. Assuming the disease to be an epidemic with serious impact only when it occurs on a large scale nationwide, they have drawn false comfort from relatively low national HIV prevalence figures.
But a series of studies undertaken by the Asian Development Bank (ADB) jointly with the United Nations Programme on HIV/AIDS (UNAIDS) has shown this assumption to be false. Aggregate losses are found to be severe in certain provinces/ states with higher than the national average prevalence figures, even in countries where the epidemic has not yet infected more than 1% of adults.
The studies also show that low HIV/ AIDS prevalence in countries, such as India and Viet Nam, still translates into numbers of sick and dying people that are on a scale comparable to those seen in sub-Saharan Africa, one of the world’s worst affected regions.
KOFI ANNAN addresses the conference opening ceremony
“For the Asia and Pacific region, the populations and numbers are large,” ADB Vice-President Geert van der Linden told a special ADB-UNAIDS Meet the Leaders session to discuss the studies, during the International AIDS Conference held in Bangkok in July.
Among those who took part in the ADBUNAIDS event were Kathleen Cravero, UNAIDS Deputy Executive Director; Ponmek Dalaloy, Minister of Health for the Lao People’s Democratic Republic; J.V.R. Prasada Rao, Secretary of Health for India; and Mechai Viravaidya, Thai Senator and outspoken AIDS campaigner, who moderated.
The AIDS conference, held 11–16 July, attracted at least 17,000 participants, including a vibrant mix of media; scientists; drug company representatives; policymakers; nongovernment organizations; activists; highly vocal protestors; celebrities, such as actor Richard Gere; and world figures, including UN Secretary General Kofi Annan, Sonia Gandhi, and Nelson Mandela.
Amid the sometimes carnival-like atmosphere, which included free elephant rides, cultural and art shows, fashion displays, photographic exhibitions, and even international plaza with go-go dancers, there were serious messages to be delivered about the human and economic threat posed by HIV/AIDS.
“An increase of only 1% in the rate of infection among the adult population means an additional 7.3 million people infected in China, in India more than 5 million, in Bangladesh 780,000 people, and in Viet Nam close to half a million people,” Mr. van der Linden told the ADB-UNAIDS session.
"Governments in Asia and the Pacific can still avert a massive increase in infections and deaths, limit economic losses, and save millions of people from poverty of they are willing to finance comprehensive AIDS programs"
- Peter Piot, UNAIDS Executive Director
India’s prevalence is one twentieth that of South Africa, the studies say. Yet India now has nearly as many people living with HIV/AIDS and could soon exceed South Africa as the world’s worst affected country. Similarly, Viet Nam has an adult prevalence of 0.4%, which translates into more than 220,000 people living with HIV/AIDS, significantly more than Swaziland, where adult prevalence exceeds 38%.
The studies, which have been summarized into a concise report, Asia-Pacific’s Opportunity: Investing to Avert an HIV/AIDS Crisis, cover four countries—Cambodia, India, Thailand, and Viet Nam.
Mr. van der Linden said one of the key messages of the studies is that failure to quickly establish effective care and prevention programs in the region will result in about 10 million more people becoming newly infected by 2010.
RICHARD GERE lends his name to a good cause
More than 7 million people are already living with HIV in Asia and the Pacific, with hundreds of thousands of people dying each year. Economic losses totaled $7.3 billion in 2001.
The report suggests that if prompt action is not taken, by the end of the decade the economic costs of the virus could rise to $17.5 billion annually, resulting in millions more people thrown into poverty.
Resources needed to fight the disease are expected to reach at least $5.1 billion per year between 2007 and 2010, the report says. However, in 2003, when the region’s countries required $1.5 billion to finance a comprehensive response, only $200 million was available from all public sector sources, governments, and funding agencies combined.
The report stresses that regional leaders must give top priority to ending the enormous—and increasing—shortfall in finances required to build comprehensive prevention and care responses. In all but a few countries in Asia, private households have to bear some of the highest proportion of out-ofpocket spending on health in the world.
“Governments in Asia and the Pacific can still avert a massive increase in infections and deaths, limit economic losses, and save millions of people from poverty if they are willing to finance comprehensive AIDS programs,” said Peter Piot, UNAIDS Executive Director, who jointly launched the report at a news conference in Bangkok with Mr. van der Linden. “The role of political leadership is more critical at this point than ever before.”
A carnival atmosphere
The ADB-UNAIDS studies indicate that public sector investments should increase tenfold from 2003 levels to, at least, $2 billion in 2007 to satisfy unfulfilled needs. International assistance must also increase, although this cannot substitute for government financing in a region where massive resources are needed.
Acknowledging the gravity of the AIDS situation facing Asia and its relation to poverty reduction, ADB is allocating 2% of its soft lending window, the Asian Development Fund, to fight HIV/AIDS and other communicable diseases in the region. From 2005, this will equate to about $140 million in grants to the region’s neediest countries for AIDS and health-related work.
“The Asia and Pacific region is at a crossroads regarding the future of the epidemic,” Mr. van der Linden concluded.
“Our report states clearly that this is the Asia-Pacific Region’s ‘make or break opportunity’… the future of the global HIV/ AIDS epidemic will be shaped by the Asian response.”
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