The AIDS nursery of the world
South Asia plagued with epidemic

By Ahmar Mustikhan
© 1999 (see for all your news.)

KARACHI, Pakistan -- The entire South Asian landscape is under severe jolts -- from the brothels in Bombay, to the holy Buddhist sites in Dharamsala in north India, to the railway stations and bus stands in Pakistan, where illicit child sex flourishes, and up to even landlocked insulated, mountainous Bhutan.

The South Asians are being awakened from a centuries old slumber to face a new reality of mass deaths, unprecedented in history. At the turn of the century South Asia has earned itself the dubious distinction of becoming the AIDS epicenter of the world. With governments looking the other way, the traditional religious and eastern values are melting under the pressures of globalization, while the armies of female sex workers, passive male gays specializing in anal sex and street child prostitutes are sprouting. At least 300 women and girls go into prostitution each day in South Asia.

In this backdrop where sex is the name of the game, the United Nations has predicted that by the year 2000, about half of the world's HIV-infected population will live in Asia -- most of them in South Asia. During the opening years of the coming century, it is expected AIDS will rapidly spread into South Asian countries, while having little impact on the region's population level.

The UN estimates that 7,500 people around the world are infected with HIV every day, and that heterosexual transmission has been the cause of more than 75 percent of all HIV infections worldwide. Nearly 50 percent of the 7,500 daily infections are in women. The agency estimated that by the end of 1995, more than 4 million people in Asia had HIV or AIDS. The majority of the cases are in India and Thailand, but the virus is spreading to other Asian countries.

The UN agencies have estimated that over 1.5 million South Asians might have AIDS as of today, with as many as 15 million infected with HIV. Officials have estimated that as many as 50 million South Asians will be infected by HIV one year from now, and that there will be more AIDS patients than hospital beds. The government medicare systems cannot possibly cope with the pandemic. AIDS is on the rise in South Asia, where 50 percent of the prostitutes and 10 percent of the approximately eight million truck drivers in the region are HIV-infected. Truckers are especially important because experts believe they are the vital link between the general population and the high-risk groups.

By 2005, the number of HIV cases in South Asia expected to exceed the number of cases in all of Africa. AIDS began spreading in Asia in the late 1980s. As the incubation period for many people ends, however, the deaths increase. Experts estimate that about 10 million Asians, the majority of them South Asians, will die of AIDS before 2015. Infection continues to spread here, mostly through heterosexual intercourse. In the West, AIDS is transmitted mostly through homosexual contact and intravenous drug use, and is spread by the strain HIV1-B. But in Africa and Asia, other strains of AIDS are more prevalent, and the disease is transmitted mostly by heterosexual contact. Sex education in developing countries is lacking compared to AIDS awareness efforts aimed at youths in the West. Most Western therapies developed for AIDS are for HIV1-B alone and it is now known that other strains could cause a heterosexual epidemic. International experts accuse South Asian governments of drifting toward indifference at this critical juncture.

Ignorance, apathy, corruption, and lack of commitment still prevail. Officials from the United Nations deplore that governments' responses to prevention programs, if any, are still mixed despite the obvious threat. The national AIDS programs suffer from a lack of political backing, hampering the agencies' work. Many of the countries are preoccupied grappling with their political and economical problems, and are not focusing enough attention on countering the spread of HIV. A large number of cases are going unreported with governments not knowing how to use the scarce resources on sex education and management of sexually transmitted diseases. Most South Asian government forbid the distribution of condoms in prisons, needles to injection-drug users, or free drugs to AIDS patients. While the advanced countries of Asia should be able to avoid the scope of disaster that was seen in Africa, the South Asian countries would be sitting ducks. Just one short year from now in India alone, for instance, experts say AIDS may kill more people than in any other country.

Moreover, a significant homosexual community does exist in South Asia. Increasingly gays are slowly coming out of the closet, though they fear that public health officials have not awakend to the danger presented by AIDS. Many consider themselves more susceptible to the disease because of what they say are the relatively higher levels of promiscuity in the gay community. The countries are in need of a nationwide support system for gay men, with setting up of anonymous AIDS testing centers high on their list of priorities. The rate of attrition within the homosexual community is yet to be known. The United Nations Development Program has cited poverty as one of the major issues in the spread of the disease. More than 90 percent of people with HIV are today living in a developing country.

Worldwide, the hardest hit age group is those aged 15 to 24. According to some reports, the number of AIDS cases in South Asia is doubling every two years, with India being the worst hit, having numbers doubling every 14 months. This is largely due to the gradual permissiveness of South Asian societies. For the health care workers the situation is mind-boggling: at times the matter of life and death hinges on a simple matter--condom supplies. At times, condoms for prostitutes are absent for an entire season leaving nearly leaving tens of thousands of sex workers and their clients vulnerable to HIV and other sexually transmitted diseases.

Africa cradled AIDS yesterday, and today South Asia is the world's largest nursery for the dreaded disease, mainly because of the lust of sex. According to experts, more people should have to wait to have sex, decreasing their number of partners, and use condoms, if the region wished to cut down on its AIDS populace.