AIDS haunts low-prevalence countries in Asia-Pacific (Feature)

By John Grafilo Sep 2, 2008, 4:52 GMT

Manila - Bhutan Health Minister Lyonpo Zangley Dukpa did not hide his grave concern over an increasing number of HIV cases in his tiny kingdom in the bosom of the Himalayan Mountains.

Dukpa said the geographical isolation of his country and its close-knit communities have been breached by the disease, which has killed more than 2 million people around the world since it first surfaced in the late 1970s.

While Bhutan has confirmed 144 HIV infections, a low number compared with other Asian countries like China or Indonesia, Dukpa said his government was nonetheless alarmed.

'I come from a very small country,' he said, noting that Bhutan's population is just over 600,000. 'We thought we would be spared by this deadly disease that afflicts countries around the world, but we were not spared.'

'For the past three years, the number of HIV/AIDS cases is increasing despite our greater advocacy campaign, and, therefore, we are now working on measures on how to counter the spread,' Dukpa said in Manila at the end of a three-day meeting of 11 Asia-Pacific countries with a low prevalence of HIV.

According to the UN's World Health Organization, about 33 million people around the world are HIV-positive, 22 million of whom live in sub-Saharan Africa.

In Asia, China is one of the countries with the highest number of cases, estimated at 700,000. Other countries in the region with large numbers of HIV cases are Thailand with 610,000 and Indonesia with 270,000.

Dukpa conceded that extended families, monogamous marriages and other traditional cultural and religious practices, which have traditionally shielded his people and other Asian peoples from the dreaded virus, are no longer enough to contain the disease.

Nirmal Siripala De Silva, Sri Lanka's health minister, noted that industrialization and globalization have led people to open up to more liberal lifestyles that make them more susceptible to the disease.

While 706 cases have been confirmed in Sri Lanka, a country with more than 20 million people, De Silva said he was expecting more infections amid rising numbers of Sri Lankans working abroad.

'We have 1.5 million people working abroad, so that is one of our challenges,' he said.

Sri Lanka's situation is magnified in the Philippines, where more than 8 million Filipinos are working abroad and the influential Catholic Church objects to promoting condom use

Philippine Health Undersecretary Mario Villaverde said more Filipinos contracted HIV in the past two years.

'There is also a shift in terms of the pattern of transmission,' he said. 'In the previous decade, up to two or three years ago, predominantly it was through heterosexual contact, but there is now a shift in transmission to men having sex with men.'

The Philippines' Health Department said it had recorded 3,305 HIV infections in the country since 1984. Thirty-five percent of them were overseas Filipino workers.

Health Secretary Francisco Duque lamented that condom use in the Philippines was below international standards.

He noted that according to a 2007 survey, 48 per cent of female sex workers, 27 per cent of drug users and 49 per cent of men having sex with men used condoms.

Duque warned that while in previous years there was an average of 20 HIV cases reported every month, that number had risen to 29 since last year.

'Although the Philippines remains to be a low-prevalence country, it should not be the reason to be complacent as statistics and trends show that the number of those infected are on the rise,' he said.

Fiji Deputy Foreign Affairs Minister Ratu Epeli Nailatikau lamented that being labeled a low-prevalence country has made political leaders and people complacent.

'Low prevalence is not a crowning glory,' he said. 'I don't want my country to be classified as low prevalence. I want it to be no prevalence. That's the thing we have to aim for. There is no time for relaxation.'