Voices from the front of the other exploding epidemic.
Asia is home to half of the human race -- more than 3.7 billion
people -- and the most crowded part of our planet. From country to
country, as Marina Mahathir, one of the continent's leading
activists, explains in the next article, it is almost
incomprehensibly diverse in culture and politics, economy and
ethnicity. And it is teetering on the brink of the AIDS abyss. As
the world's activists, researchers and media descend this month on
Durban's International AIDS Conference and the globe's gaze rightly
falls on the HIV apocalypse in Africa, POZ also wants to look
beyond Africa to the next theater of the world war on the virus:
The epidemic spread to Asia in the early '90s, a decade after it
erupted in the United States and sub-Saharan Africa. But because the
continent is so densely populated, people are transmitting the virus
to one another there at a rate faster than anywhere else in the
world. Currently, there are more than 7 million HIV-positive people
in Asia, only 10 percent of whom know their status. In India alone,
with a sixth of the world's people, there are already more than 4
million HIVers -- a number that rivals South Africa's. But unlike
the hardest-hit African nations, where as many as 25 percent of the
people have the virus, the immensity of Asia's population translates
relatively low infection rates into staggering absolute numbers of
people with HIV. By 2010, the Asian epidemic will likely outstrip
that of Africa.
AIDS did not creep into Asia by stealth. Although its projected
devastation has long been foretold, attempts to stop it have been so
inadequate that I.S. Gilada, Ph.D., the honorary secretary of the
People's Health Organization in India, calls the epidemic a
"man-made, socially neglected and government-sponsored calamity." A
number of factors have conspired to paralyze Asia's response to AIDS
over the past decade: National governments that are reeling from the
1997 economic crisis and unable to mount or maintain HIV prevention
programs. Predominantly private health care systems vulnerable to
market fluctuations. Unaffordable or otherwise unobtainable anti-HIV
meds. Minimal needle-exchange programs. Cultural taboos clinging to
discussion and distribution of condoms, not to mention their use. A
weak network of NGOs whose agendas emphasize prevention over
treatment, care and other PWA needs. Bureaucracies that divert money
from AIDS. International funding agencies that cripple or censor
targeted, grass-roots prevention efforts.
Above all, rampant anti-PWA discrimination makes coming out with
HIV in itself a life-threatening act. Compounding this is what our
cover girl, Indonesia's openly positive Suzana Murni, calls "our
Eastern, or Asian, values" -- politeness, respect, saving face.
"When you get HIV, these good qualities boomerang back at you," she
says. "Having HIV in Asia is all about shame." The importance of
saving face -- avoiding disgrace at any price -- has not only kept
nearly all Asians with HIV in the closet but hindered the
development of PWA activism. In a few languages in the region, there
are no words for discrimination, let alone
But as the reports, testimonies and images in the following pages
reveal, a burgeoning advocacy movement is shaking things up at home
and abroad. Thailand, celebrated for turning around its exploding
infection rate, is taking on multinational drug companies and U.S.
trade sanctions to manufacture generic AIDS drugs. The Philippines
has passed a landmark nondiscrimination law that protects HIVers.
And while India is already producing four generic antiretrovirals,
researchers there are now also investigating the potential of
ayurveda in AIDS treatment. Most important, Asia's HIVers --
led by APN+, the Asia Pacific Network of People Living with HIV/AIDS
-- are coming together, coming out and creating an activism of their
dollar spent on AIDS in Asia goes to treatment or care
of new infections in Asia
are among women, ages 15-49.
Asians has HIV.
1 in 5
of the world's HIVers
lives in Asia. By 2010, more than 1 in 2
with HIV have access to Western meds.
1 in 12
Asians who have HIV
know their status.