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: Asia.
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 activism.
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 own.