14 SUB-SAHARAN AFRICA

clock service where experts would be on call to give
specialized advise on problems regarding AIDS. [end
recording]

Minister Says 300 Infected Wth HIV Virus Daily

MB1010115991 Johannesburg THE STAR in English
10 Oct 91 p6

[Report by Peter Fabricius: “300 Infected With HIV a
Day in SA [South Africa]”]

[Text] Strand—About 300 people are being infected
every day in South Africa with the HIV virus, which
almost invariably leads to death by AIDS, National
Health Minister Dr. Rina Venter disclosed at the Cape
National Party congress yesterday.

“The seriousness of the AIDS pandemic is best illus-
trated by the fact that, by comparison, 24 people die
every day from tuberculosis, 31 in motor accidents, 35
through smoking-related diseases and 10 in political
violence,” Dr. Venter said.

She was replying to a resolution from the congress asking
the Government to establish a more comprehensive
programme to combat AIDS.

She detailed several measures, including a recent Cab-
inet decision that AIDS education would become com-
pulsory in schools from next year.

Dr. Venter said that of the 300 people being infected by
HIV every day, between 120 and 140 were women,
110-130 men and 20-40 children.

Group Votes AIDS Not To Be Notifiable Disease

MB1810142691 Johannesburg SAPA in English
1400 GMT 18 Oct 91

[Text] Pretoria Oct 18 SAPA—AIDS will not be made a
notifiable disease in South Africa, it was announced in
Pretoria on Friday.

The minister of national health, Dr. Rina Venter,
announced this decision on the advice of the AIDS
Advisory Group [AAG]. “There are no sound scientific
resons for making AIDS or HIV infection a notifiable
condition,” she said in a statement.

AAG chairman, Prof. Anton du P. Heyns, said at a ‘news
conference there was no justification to make such a
move at this time despite the fact that the HIV infection
could be one of the “greatest threats to health” in South
Africa.

The executive of the AAG, an independent body of
authorities on AIDS which advises the minister on
various aspects of the disease, had voted unanimously
against making it a notifiable disease.

The executive argued in a statement that AIDS should be
made a notifiable disease only if by so doing it would

JPRS-TEP-91-023
12 November 1991

contribute towards the control and prevention of further
spread of the HIV infection.

This would not be the case with AIDS as it was untreat-
able and there was no vaccine available for its preven-
tion, said Prof Heyns.

“There is really nothing that can be physically done to
combat the disease or its spread.”

It would only be logical to make HIV-seropositivity
notifiable if it were linked to mass screening of the
population. This was not viable in South Africa.

Prof. Heyns said another argument against notifiabilty
was the possibility of stigmatisation of individuals with
the infection due to discrimination.

“This could drive the disease underground and make
preventative measures even more difficult to imple-
ment.”

Prof. Heyns emphasised that the decision would be
reviewed if circumstances warranted it.

Such circumstances would include the development of a
cure for the disease or a vaccine for its prevention.

He said AIDS WAS a notifiable disease in some states in
America and there was a system of voluntary notifica-
tion in the United Kingdom.

“But there is no evidence in the world that notification
has aided the preventative measures to combat the
disease.”

Doctor Discusses Trends in AIDS, Medical Care

MB2210203391 Johannesburg SAPA in English
1630 GMT 22 Oct 91

[Article by Ada Stuijt]

[Text] Johannesburg Oct 22 SAPA—AIDS-related
deaths could number 700,000 a year by the year 2005—
when about 27 percent of all South Africans could test
Positive for the HIV virus, according to a “possibly
optimistic” projection by Dr. Ivan Lockyer. Releasing
his report on Tuesday [22 October], the chief medical
officer of one of the country’s largest life assurance
companies also warned the AIDS epidemic would fur-
ther aggravate the possibility that many South Africans
could have only limited access to basic medical care by
the turn of the century.

He warned that by then, only a select group might enjoy
the high standards of medical care available through the
private sector. However, he hoped for a “high-road”
scenario—where a growing economy with increased per
capita income gave people access to an appropriate level
of medical care. With or without medical aid, medical
costs were rising far faster than the consumer could
accommodate. “What price advanced medicine if the
average man is unable to afford it?” Dr. Lockyer asked.


SJPRS-TEP-91-023
12 November 1991

BANGLADESH

Writer Discusses AIDS Surveillance in
Bangladesh

92WE0040 Dhaka THE BANGLADESH OBSERVER
in English 13 Sep 91 p 5

[Article by Geetha Hasan: “AIDS—Emerging Pattern
and Issues”]

[Text] The emerging AIDS situation in the country
necessitates analysis of current AIDS surveillance in
Bangladesh.

So far, seven HIV infected persons have been reported.
Of them, the first reported infected person was of
Spanish nationality and was sent back to Spain.

Of the remaining six, one died of AIDS related com-
plexes (ARC) and currently there are five HIV infected
persons, including one female, in Bangladesh and all
these five infected persons live outside Dhaka.

One of the puzzling discoveries of emerging HIV infec-
tion patterns in the country is that so far Dhaka has been
spared of HIV infected persons.

According to common belief, population in the capital is
more vulnerable for infectious diseases like AIDS than
population at large in the countryside.

The rationale behind this belief is based on the following:

1) The “risk groups” such as prostitutes, professional
blood donors, foreign travellers and STD patients who
are vulnerable to AIDS infection are mostly concen-
trated in the city areas of the country.

2) The city life or behaviour of sections of the people of
the cities tends to provide conductive breeding ground
for AIDS infection.

3) Cities by their sheer size of population concentration
and unmatched health resources fail to trace the infected
and thus contribute to further spread of diseases like
AIDS.

Viewed from the above rationale, the present pattern of
emergence of HIV infected persons i.e. only from outside
Dhaka display a false sense of security of Dhaka from
AIDS epidemic.

The expert opinion based on the above rationale dictated
that AIDS prevention programme activities need to be
concentrated more in Dhaka and less in peripheries.

Ironically, the rapidly evolving AIDS situation outside
Dhaka although may seem against such expert opin-
ions—does indicate the extent to which AIDS has
already made inroads into the community.

Despite the existence of a moderate (in terms of size of
the surveillance target) AIDS surveillance network which

NEAR EAST & SOUTH ASIA 35

is mostly concentrated in and around Dhaka and selec-
tively in Chittagong and Sylhet: the HIV infected per-
sons continue to emerge outside Dhaka and outside the
national AIDS surveillance network.

So far all the HIV infected persons have emerged by
accident than through the established surveillance net-
work, All except the first reported HIV infected persons
had been diagnosed outside the country—particularly in
Middle Eastern Countries—as HIV positive and was
sent back to Bangladesh. This should crystalise at least
two points concerning AIDS detection in Bangladesh.

One, that the actual HIV infected persons are greater in
number than what we have taken for granted or formally
declared as infected. According to expert opinion, if 7
HIV infected persons are detected and reported, at least
70 are out there in the community undetected and
spreading the infection.

Two, that the current surveillance network needs to be
expanded (i) in terms of size of the target population for
surveillance and; (ii) to include more surveillance sites
outside Dhaka (iii) a meaningful collaboration between
countries on exchange of information regarding HIV/
AIDS detection: among expatriates and travellers
without violating concerned infected individual’s human

rights.

How do we expand the current AIDS surveillance among
the target population is a question that needs to be
addressed sooner than later in order to widen the current
AIDS surveillance network.

Apart from the cost involved for an expanded AIDS
surveillance, there are other factors which partially
explain the difficulties the AIDS surveillance [is] cur-
rently facing and will continue to face for some time to
come.

i) Institutional/Procedural Barriers within Ministry of
Health and Family Welfare (MH&FW): At present, with ~
limited success the MH&FW has installed AIDS surveil-
lance network within its system. There is a long way to go
before the installed AIDS surveillance network begins to
operate throughout MH&FW’s entire system.

ii) Administrative Barriers: Numerous administrative
barriers need to be overcome to establish a comprehen-
sive national AIDS surveillance in Bangladesh. Not all
target groups identified for AIDS surveillance are regu-
larly in touch with the health care system to complete the
tax of surveillance. In fact many of them are discreet,
mobile and outside the administrative arm of the health
care system.

For example, the professional blood donors who fre-
quent private blood collection establishments, emigrants
and frequent travellers, garment industry workers, hotel
and tourist industry workers are still outside the AIDS
surveillance network. Also still outside are the STD
patients who frequent private clinics.



JPRS-TEP-91-023
12 November 1991

REGIONAL AFFAIRS

Regional AIDS Conference Opens in Trinidad

FL0710222391 Bridgetown CANA in English
2039 GMT 7 Oct 91

[Text] Port of Spain, Trinidad, Oct 7, CANA—A three-
day conference, aimed at combatting the spread of AIDS
in the Caribbean through education, began here on
Monday.

“The Caribbean Community, Sharing the Challenge of
AIDS,” is the theme of first sub-regional conference of
Caribbean AIDS service organizations, which has
brought together participants from 20 countries to share
experiences in the fight against the deadly disease.

Trinidad and Tobago’s health minister, Selwyn Richard-
son, in a speech to open the conference, stressed the role
of education in preventing the spread of AIDS, acronym
for Acquired Immune Deficiency Syndrome.

“The key to prevention is education, and the promotion
of healthy and responsible sexual lifestyles is of partic-
ular importance in the Caribbean where the spread of
HIV infection occurs mainly through sexual transmis-
sion, and in which heterosexual activity has been rapidly
outstripping other modes of spread,” he said.

The conference is sponsored by the National AIDS
Hotline of Trinidad and Tobago, the Pan American
Health Organisation/World Health Organistion (PAHO/
WHO), the Caribbean Epidemiology Centre (Carec), the
International Council of AIDS Services Organisation
(ICASO), the U.S. Agency for International Develop-
ment, and AIDScom.

BARBADOS

Of 231 AIDS Cases Reported Since 1984, 162
Have Died

FL1010233891 Bridgetown CANA in English
2025 GMT 10 Oct 91

[Text] Bridgetown, Barbados, Oct 10, CANA—A 19-
year-old girl is among 23 new cases of full-blown AIDS
detected in Barbados between July and September, med-
ical officials have said.

Chairman of the National Advisory Committee on
AIDS, Professor E.R. “Mickey” Walrond, said the teen-
ager was known to be HIV positive for the past two
years.

He said there were 19 deaths during the same period,
and the total number of AIDS cases diagnosed, since
testing for the Acquired Immune Deficiency Syndrome
started here in November 1984, now stands at 231. Of
these, 162 have died.

LATIN AMERICA 31

BERMUDA

AIDS Deaths Reach 149 of Total 184 Cases

FL0410235991 Bridgetown CANA in English
2103 GMT 4 Oct 91

[Text] Hamilton, Bermuda, Oct 4, CANA—Two more
Bermudians have died from Acquired Immune Defi-
ciency Syndrome (AIDS), the island’s health department
said Friday.

Their deaths brought the AIDS toll in the British West
Atlantic colony up to August to 149. A total of 184 cases
have been reported to-date.

BRAZIL

AIDS Incidence Rising Among Women

91WE0515B Brasilia CORREIO BRAZILIENSE
in Portuguese 31 Jul 91 p 5

[Article by Eliane Sobral: “More Women Are Being
Infected With AIDS”]

[Text] Sao Paulo (Special to CORREIO BRAZIL-
IENSE)}—The proportion of women infected with the
AIDS virus has increased rapidly in Brazil and
throughout the world. In 1984 one out of 122 persons
infected with the virus was female; in 1991 this propor-
tion has already dropped to one female per seven males.
“If this trend continues, the ratio will soon be one to
one,” says Naila Santos, supervisor of Epidemiologic
Vigilance of the Sao Paulo State Secretariat of Health.
She took part in the seminar on “Women and AIDS”
that was held yesterday by the Municipal Secretariat.

According to Naila, of the 18,118 AIDS cases recorded
in Brazil as of last March, 1,993 are women. The highest
incidence among women is found in the 15- to 40-
year-old age group. “That is to say, the period when
fertility is highest among women, and this fact ultimately
results in increasing the number of newborn infants who
carry the virus,” said Professor Joao Yunes, Brazilian
representative in the Pan-American Health Organization
(PAHO), who also took part in the seminar.

The trend toward an increasing number of women with
AIDS is being recorded throughout the world, and not
just in Brazil. “In Africa and in the Caribbean,” Yunes
disclosed, “the proportion has already reached one to
one, male to female.” He added that although there are
not yet any official statistics, it is already possible to
establish that the number of pregnant women infected
with the AIDS virus is also increasing.

“Few studies have been made concerning this aspect,”
Yunes said, but it can be stated that the number of
pregnant women infected with the virus has increased in
recent years. This means,“ he emphasized, “that the
number of newborn infants who carry the virus has also



40 NEAR EAST & SOUTH ASIA

Experts point out that the enormity of the problem has
not yet hit us hard because of the long gestation period
before a positive case develops into full blown AIDS.
This accounts for the small number of full blown AIDS
cases in the country. But with more than 4,500 persons
having tested positive already, one could expect a large
majority of them to develop full blown AIDS in the next
few years.

In 1985-86 only 71 persons of a total sample of just over
27,000 tested positive. By the next year the sample was
less than double, and the number of positive cases also
went up proportionately to 120. In 1988 this number
more than doubled to 467 and then went on to 1,183 in
1989 and 2,674 in 1990. One can easily see that if this
trend continues the number of affected persons could be
in tens of thousands within a few years.

The very nature of disease and the long period during
which it remains dormant ensures that it has a multiplier
effect. In Thailand the number of HIV positive cases
increased dramatically from about 50,000 in 1989 to
200,000 in 1990. And India, which already has reported
the cumulative figure of over 4,500 HIV positive cases, is
the second most affected country of the South East Asian
region.

Controversy

About a year ago the then Director-General of the Indian
Council of Medical Research had stirred up a contro-
versy by stating that by the year 2000 every third
housewife in Bombay will run the risk of being infected
by the dreaded disease. He had apparently arrived at this
alarming conclusion by projecting the available figures
and by looking at other relevant factors like poor nutri-
tional levels of the people and poor sanitation.

In the South Asia Region countries while HIV-1 is the
dominant type of infection, some cases of HIV-2 have
been reported from Maharashtra and one case from Sri
Lanka. It has also been established that in India the
disease has been transmitted heterosexually.

Amore recent cause of worry is the pattern of the disease
in Manipur, where it seems to be widespread among
intravenous drug users. Of the 2,455 such cases tested,
1,073 (43.7 percent) tested positive. And it has quickly
spread to other sections of society. In the small state of
Manipur alone as of January 31 this year there were as
many as 1,135 positive cases.

The WHO has stated in this update that in three coun-
tries of this region—Thailand, India and Myanmar—the
disease is in epidemic form. The financial, manpower
and logistic constraints in the countries of this region,
combined with poverty and lack of adequate nutrition
and sanitation could lead to a very rapid advance of
AIDS.

SJPRS-TEP-91-023
12 November 1991

Serious Consequences

India is to implement a medium term plan to control the
scourge of this century. All the countries of this region
have been advised to intensify education and informa-
tion activities related to AIDS. In some countries such
information is included in the school curriculum. The
WHO has also been emphasizing that AIDS must be seen
as an ‘emerging’ health problem in this region with
unimaginably serious consequences. It has suggested that
medical and public health professionals be trained to
manage and control AIDS and workshops be organized
for practicing physicians.

Four international training courses for clinicians and
nurses were supported by the WHO and organized at
Sydney in Australia but the total number of people
trained at these courses is very small—six clinicians and
nurses each from India, three each from Thailand, two
each from Indonesia and one each from Myanmar,
Bangladesh and Nepal. Although Sri Lanka as yet has
reported only a total of 31 HIV positive cases, it sent four
clinicians and three nurses for training.

The management committee of the WHO’s Global Pro-
gramme on AIDS has appointed an external review
committee to make a worldwide appraisal of AIDS
control programmes. The review team visited India in
June and its report will be placed before the next Global
Management Committee.

Increase in Uttar Pradesh

92WE0032B New Delhi PATRIOT in English
2 Sep 91 p5

[Text] Kanpur, Sep 1 (UNI)}—The number of AIDS-
victims is increasing in Uttar Pradesh. In the State so far
109 AIDS positive patients have been identified com-
pared to only two AIDS-patients about two and half
years ago.

This was stated by Uttar Pradesh Health Minister Dr.
Dinesh Jauhari at a press conference here yesterday.

The State Government had sought the World Health
Organization (WHO) assistance to combat the AIDS
menace. Mass awakenings against the disease would be
created by seminars and symposia on “AIDS” in dif-
ferent medical institutions, the minister said.

The WHO has sent its technical experts and finances for
the AIDS awareness programmes, Dr. Jauhari said and
added that the vulnerable spots, known for spreading the
disease, were being identified.

More on Manipur

92WE0032C Calcutta THE STATESMAN in English
29 Aug 91 p7

[Text] The outbreak of Manipur AIDS is gradually
taking a virulent form with nine deaths reported in
which succession during the past few months. The State
Government fears that this toll among drug-addicts


8 SUB-SAHARAN AFRICA

case of South Africa’s neighbour, Zimbabwe. In 1987 the
number of reported AIDS cases in Zimbabwe was
reduced on the order of the Minister of Health, Herbert
Ushewokunze.

Both hospitals and the blood transfusion service were
told they could only tell doctors and not donors of their
HIV status, while doctors were told they could report
AIDS cases only to the AIDS Control Programme. AIDS
sufferers were officially discouraged from telling anyone
of their ailment and doctors were actually accused of
misdiagnosis and hence over-reporting of the disease.

This disgraceful and counterproductive policy ended
only with the appointment of a new Minister of Health
in 1990. The veil of secrecy and confusion thus created,
together with the accompanying demoralisation of the
medical and nursing professions, delayed energetic
action against the spread of the virus in its most critical
phase.

While South Africa shows no sign of replicating this
disastrous Zimbabwean example, public propaganda
and education about the AIDS threat is extraordinarily
muted when one considers the size of the approaching
epidemic and the fact that the country is now only
months away from the critical point when the proportion
of the adult population who are HIV positive reaches
two percent.

Exponential Growth

From what is known from studies elsewhere in Africa, it
is as the epidemic reaches the two percent line that its
growth rate becomes exponential: the curve of the graph
then becomes almost vertical and only begins to level out
when around a third of the population is HIV positive.

The Durban conference, a landmark event in the wide
Participation it attracted from the academic, govern-
ment and business worlds, produced both hard data and
some notably tough-minded thinking about the unthink-
able. The conference’s key survey data came from a
study of 14,376 women of all racial groups attending
ante-natal clinics in October-November 1990.

This reliably large sample showed a HIV positive rate of
0.76 percent. Assuming a doubling time of 12-14
months, this means that an overall HIV positive rate of
about 1.5 percent will be reached by the end of 1991,
with the two percent line being reached in May-June
1992. The implication is that in the months remaining
before that date South Africa really ought to be the
subject of a saturation TV, radio, poster and leaflet
campaign: of this there is currently no sign.

The Government has allotted the princely sum of R1.5
million for AIDS education and neither the ANC nor
Inkatha give the subject much time or energy. No
politician of any hue—black, white or brown—has been
willing to involve himself in the issue. There is no active
conspiracy of silence, merely embarrassment and com-
placency on a huge scale.

JPRS-TEP-91-023
12 November 1991

But what can really be done? The answer is threefold: an
education campaign aimed at increasing condom-use
and generally encouraging safer sexual practices; the
careful (and non-oppressive) monitoring of prostitutes;
and a major drive against other sexually transmitted
diseases, for everything suggests that the prevalence of
such diseases elsewhere in Africa has been a major factor
in accelerating the spread of AIDS.

Such measures could not hope to prevent a major
epidemic, but they could slow its progress and perhaps
cause the HIV positive graph to level off at a lower point
than seen in countries to the north.

Some would, of course, favour a far tougher line. The
Cubans are the chief exemplar here, insisting on com-
pulsory blood sampling and enforced quarantine for all
those who emerge as HIV positive. Many Cuban troops
repatriated from Angola have in effect returned home
into permanent quarantine, the unfortunate sufferer
only being allowed out into society on a strictly chaper-
oned basis.

It would appear that this tough regime has been highly
successful in preventing the spread of the virus but even
the South African Communist Party, which has strong
ties with Cuba—it held its last congress in Havana in
1989—does not advocate similar measures here. Indeed,
both the SACP and ANC are vociferous in resisting the
notion of AIDS-testing their Umkhonto guerillas on
their return home, although these guerillas include many
men who were stationed in Angola and fought alongside
the same Cubans now subjected to compulsory testing.

Heat Generated

A great deal of heat has been generated by discussions of
the HIV status of Umkhonto returnees, but in the end
the issue may almost be a red herring, for the progress of
the epidemic hardly depends upon them.

A regional breakdown of the 1990 ante-natal sample
cited above shows that the overall 0.76 percent rate was
actually constituted by a rate of only 0.16 percent in the
Cape (logically enough: the virus is advancing from the
north and the Cape lies furthest to the south); 0.53
percent in the Transvaal; 0.58 percent in the Free State
and 1.61 percent in Natal and Chief Buthelezi’s domain
of kwaZulu.

It is tempting to believe that the reason for Natal/
kwaZulu’s unhappy prominence is that Durban, the
region’s centre, is Africa’s largest port—but impression-
istic evidence suggests that the HIV positive rate is
actually worst in small towns and rural areas, pointing to
landborne infection from neighbouring Mozambique as
the more likely source. More important, Natal/
kwaZulu’s 1.61 percent level was reached nine months
ago, which means it must have breached the fateful two
percent level by April 1991.

One cannot but decry a fearful symmetry in this latter
figure. Of all South Africa’s blacks, it is the Zulu people


n

wis
@TTH PROCESS 10%

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48 WEST EUROPE

heterosexuals and six babies born to intravenous drug
abusers. A total of 1,101 cases of HIV infection have also
been diagnosed.

Rise in Heterosexual AIDS

91WE0551 Dublin IRISH INDEPENDENT in English
14 Aug 91 p2

[Text] The number of heterosexuals in Ireland who have
become infected with the AIDS virus has increased by 44
percent in the 12 months since June of last year—the
biggest rise in any group, the organisation Aidswise
claimed last night.

Aidswise director Ger Philpott said 101 heterosexuals
were now HIV positive but this sector of the population
was still failing to fully realise the extent of the infection
tisk.

The organisation is to conduct a poster campaign aimed

at various risk groups, starting with the gay population
who, along with drug users, have the highest incidence of
infection.

The blunt poster message will aim to bring home to
homosexuals the need to use a good quality condom.
Phone numbers of organisations to contact will also be
included.

Mr. Philpott said he hoped the posters, which will be
distributed to restaurants, pubs, galleries and other
public venues, would prompt debate on the subject.

“It is important to give people all of the information
necessary to enable them to make their own responsible
and informed decisions,” he said.

NORWAY

Law Proposed on Testing, Isolation of HIV
Patients

91WE0482A Oslo AFTENPOSTEN in Norwegian
5 Aug p5

{Article by Liv Hegna: “More Compulsion in New Law
on Infection Prevention”—first paragraph is AFTEN-
POSTEN introduction]

{Text] HIV patients can be compulsorily examined and
isolated up to seven days in the hospital. That will be the
upshot should the Storting follow the recommendations
of a hearing held on a new law concerning prevention of
infection. HIV-positive individuals are protesting.

The Storting will also take a stance on whether doctors
should be made responsible for tracking down infectious
sources, whether the right of confidentiality could be
suspended in given circumstances, and whether the
HIV-infected can be denied a passport for six months.

SJPRS-TEP-91-023
12 November 1991

The Norwegian Physicians’ Association, in its hearing
statement, announced a proposal for a law on compul-
sory treatment. The conclusions of the round of discus-
sions are now in department hands. A draft of the law is
expected to be laid before the Storting next spring.

The new law ‘Teplaces eight earlier health laws and paves
the way for giving HIV-positive individuals a legal status
comparable to others with infectious diseases. The infec-
tion prevention provisions in the law represent a distinct
tightening up in comparison with earlier laws.

Compulsion

The interest organization for HIV-positive individuals
in Norway, PLUSS, in its statement rejected the pro-
posed law on mandatory isolation in the hospital, and
called it “hospital prison,” referring to the penal code’s
potential reaction with regard to individuals who know-
ingly spread the disease.

The Physicians’ Association states that mandatory hos-
pitalization in isolation for up to seven days should only
be used with the greatest reservation. The Physicians’
Association meanwhile contests the Social Services
Department’s reservations concerning compulsory treat-
ment. The Physicians’ Association feels that it is unrea-
sonable to hold this back, “since in future situations it
could be very important.”

A number of voluntary organizations expressed skepti-
cism over the provisions which open the way for a breach
of the right of confidentiality for health personnel in the
case of serious infectious diseases. PLUSS maintains
that the legislation threatens the confidentiality between
health personnel and the public. PLUSS asserts that the
active pursuit of infectious sources permitted by the new
law would result in a danger of persecution of selected
population groups.

The professional organizations think just the opposite:
Where there is danger of transmission of a dangerous
infectious disease, it is too weak and legally vague for
doctors, nurses, and midwives, if it merely states a
concerned party ‘may’ give information, say the Physi-
cians Association. It is insisting that the legislation read
‘must’.

PLUSS reacted also to the six month denial of a passport
and the prohibition on travelling out of the country.
Some of the participants in the hearing feel that a six
months denial of a passport is extreme, and that three
months is sufficient.

Methods of Infection

The Physicians’ Association is holding a discussion
about blood banks, donor selection, and bone marrow
transplants in connection with the risk for serious con-
tagion. Various hospitals also pointed this out in their
hearing statements:

“Hospital contagion is a large and serious problem.
Many infections can be prevented with the aid of various


46 SOVIET UNION

AIDS Figures Said To Increase

LD1909150591 Moscow TASS in English 1342 GMT
19 Sep 91

[Article by TASS correspondent Lubov Dunayeva]

[Text] Moscow September 19 TASS— Central control
over the spread of AIDS in the USSR has been lost
because the republics have stopped providing informa-
tion to the all-union anti-AIDS center, chairman of the
anti-AIDS association, Doctor Vadim Pokrovskiy told
TASS. He said the AIDS situation cannot be monitored
by the Moscow center either as it has limited possibili-
ties. Many AIDS-infected people are travelling all over
the country without any control. This must cause serious
concern, he said.

It would be foolish to expect the spread of the disease to
slow down, says Pokrovskiy, who also heads a specialised

IJPRS-TEP-91-023
12 November 1991

anti-AIDS laboratory of the Central Epidemiological
Research Institute of the Soviet Health Ministry.
Without a central body, even those small anti-AIDS
allocations will be spent irrationally. Moreover, bank
accounts for importing medicines have been frozen, he
said.

This can result in an uncontrolled AIDS spread, mostly
in hospitals. The United States is allocating a thousand
times more than the Soviet Union to the fight against
AIDS, and still there were a hundred thousand AIDS
deaths in the last ten years there. One can hardly imagine
what’s in store for this country, Pokrovskij warned.

Officially there are 665 AIDS-infected people in the
country today, among them 290 children. But specialists
believe the real number is ten times higher. Most AIDS-
sufferers became infected in hospitals between 1988-89.



18 SUB-SAHARAN AFRICA

Turning to AIDS, President Museveni particularly cau-
tioned the youth to discard the habit of boy and girl-
friend relationship, which phenomenon he termed as a
very dangerous health hazard which must be seriously
addressed. He said that AIDS is spread by undisciplined
sex. He also cautioned the adults who misuse children
that there is a law which punishes those who defile
children below the age of fourteen and those who are
below eighteen years.

He therefore urged the masses to know and understand
the implications of this fact on their conduct. President
Museveni again urged the people to use the infrastruc-
ture laid down by the government and try to banish the
phenomenon of poverty from their own families and the
country as a whole.

Earlier, the president addressed teachers and students of
23 post-primary institutions who gathered at Kamuli
boarding primary school. He told them that Africa is the
most backward continent in the world because its pro-
ductive forces, that is science, technology and manage-
ment skills, are not developed. He told them that other
factors which characterized Africa’s backwardness,
Uganda inclusive, are lack of integrated economy,
narrow markets, and lack of conceptual independence.
{passage omitted]

ZAMBIA

UNDP To Assist in HIV/AIDS Program

91WE0534A Lusaka TIMES OF ZAMBIA in English
19 Aug 91 p 3

[Article: “Most Zambians Still Ignorant....”]

[Text] An AIDS expert has called for more work in
educating the masses on the disease in the country.

Dr. Katele Kalumba, a senior fellow in community
health at University of Zambia (UNZA) said at a Society
for Women and AIDS in Zambia (SWAAZ) annual
general meeting in Lusaka yesterday that a considerable
number of Zambians were not educated on the disease.

He urged higher institutions to incorporate lectures on
AIDS in the students’ programmes.

Patron of the society, UNIP Member of Central Com-
mittee Cde. Mary Fulano said AIDS was not a medical
problem but a social, economic and political one which
required the involvement of each and every individual in
Zambia.

She urged SWAAZ to create projects to control the ‘high
risk’ problem existing because of ‘call girls’ who lined up
the streets at night.

The most important step to make was to initiate behav-
ioural change in society by disseminating information in
local languages, holding seminars and making full use of
the mass media.

IPRS-TEP-91-023
12 November 1991

She said orphans, often called “children in distress”
should be treated as a priority because they were left
helpless as most relatives had large families to look after
and could not take on extra burdens.

And the United Nations Development Programme
(UNDP) has approved K30.6m to aid the prevention of
AIDS in Zambia.

The latest edition of the United Nations ZAMBIA
NEWS says a total of K30,625,000 will be used on the
HIV-AIDS pilot project which started in July.

UNDP residents representative in Zambia, Mr. Alieu
Sallah was quoted as saying that the two year HIV/AIDS
project which would be implemented by the Zambia
National AIDS Prevention and Control programme
(ZNAPCP) and executed by the United Nations Volun-
teer Service was aimed at helping Zambia on HIV/AIDS
prevention education, care and counselling.

The UNDP would provide United Nations volunteers
technical support using a multi-sectoral team approach
to develop community-oriented approaches to preven-
tion, care and support of people living with and affected
by HIV/AIDS.

Mr. Sallah said during the two year project’s life, atten-
tion would be on the promotion of poverty alleviation
and income generating programmes for affected house-
holds and communities.

He said the HIV/AIDS pilot project was designed to
support ongoing HIV/AIDS related activities by putting
emphasis on a pilot demonstration model of placing a
multi-disciplinary team of three to work at district level.

The project would start with three teams which will be in
Lusaka Urban district, Mansa, in Luapula Province and
Livingstone in Southern Province.

“UNDP’s involvement in the process of increasing its
support to AIDS prevention and control activities is in
response to the UNDP, governing council decision of
February last year which called upon UNDP field
officers to respond effectively to the problems of HIV/
AIDS within the framework of national HIV/AIDS pro-
grammes.”

ZIMBABWE

AIDS Claims 125 in Bulawayo Apr-Jun 1991

MB24 10083291 Harare THE HERALD in English
15 Oct 91 pI

[Unattributed report: “AIDS Claims 125 Bulawayo Vic-
tims”]
[Text] At least 125 people died of AIDS in Bulawayo

between April and June this year, according to City
Health authorities.


36 NEAR EAST & SOUTH ASIA

Also, the port authorities and prisons need to be brought
in a systematic manner into the AIDS surveillance
network.

So, unless there is a way found—sooner than later—to
bring these groups through administrative procedures,
into the national AIDS surveillance fold, the AIDS
surveillance in Bangladesh will be of marginal signifi-
cance and use for assessing and monitoring the HIV/
AIDS prevalence in Bangladesh.

iii) Personal/Psychological Barriers: Some of the staff of
MH&FW at different levels are yet to give their fullest
support to AIDS surveillance activities. While certain
amount of resistance can be partially understood from
increase in workload for which a system of incentives
may be introduced, much of the resistance is of personal
and psychological nature.

Misinformation and misconceptions about AIDS among
health professionals is also quite high which may provide
explanation for the noncooperation of some sections of
the staff with AIDS surveillance at various levels.

iv) Surveillance System: It is rather easier in the short
run to pluck into an existing system of national surveil-
lance network (if one exists) than to build up a vertical
surveillance network for AIDS alone or to integrate
AIDS surveillance into an emerging national surveil-
lance system.

In Bangladesh we do not have an existing national
surveillance network into which AIDS can be conve-
niently plucked into. For example there is no national
STD prevalence date available due to absence of a
national surveillance system and network. A national
and comprehensive surveillance network is yet to be
developed for all infections and causes of death.

Nor do we have extensive resources to build a vertical
AIDS surveillance network. Even if resources are found
initially from donors, the nature of target population of
AIDS and long term sustainability of a vertical AIDS
surveillance will render the entire operation a flop.

The emerging national surveillance network and system
under the Institute of Epidemiology and Disease Control
(IEDCR)’s direct guidance and technical competence
will take a few more years to take shape and to come into
full operation. AIDS surveillance cannot wait until then.
Time is one thing AIDS prevention does not have.

v) Motivational Barriers: Lastly, no amount of surveil-
lance efforts are likely to succeed unless the target
population vulnerable to AIDS infection are motivated
to freely participate in the surveillance activities.

Greater community effort must be mobilised to remove
fear, social stigma, discrimination and taboos that are
attached to STD/AIDS infections, so that people volun-
teer to have their blood screened for not only AIDS but
also for other infections including Hep. B. virus.

IJPRS-TEP-91-023
12 November 1991

The elite, educated, enlightened, idealists and the prag-
matists all should mobilise and set examples to others in
removing the social and behavioural veil attached to
AIDS so that individuals seek health care for themselves,
for their family and for their community.

Of course, the motivational barrier is the hardest of them
all to overcome and needs to be overcome and it takes
time too. While we work towards motivating individuals
to volunteer and for screening the other barriers should
be tackled thorough political and administrative initia-
tives so that AIDS surveillance in Bangladesh soon
becomes comprehensive and national.

INDIA

More Reportage on Fight Against AIDS

Discussion in Lok Sabha

91WE0519A Secunderabad DECCAN CHRONICLE
in English 6 Aug 91 p7

Excerpt] New Delhi, August (PTI & UNI)—AIDS is
slowly spreading in several parts of the country and as on
30 June this year more than 5,000 persons out of 9.50
lakh persons practising high risk behaviour were found
HIV positive during screening, the Lok Sabha was
informed on Monday.

Of the 5,588 HIV positive cases, 68 have been reported
to be full blown AIDS cases, the Minister of State for
Health and Family Welfare, Mrs. D.K. Thara Devi
Siddhartha told Mr. C. Srinivasan in a written reply.

The Minister said a medium term plan for AIDS control
is being implemented by the government with emphasis
on increased facilities for early diagnosis and manage-
ment of HIV infection including establishment of AIDS
treatment centres and health education to contain spread
of the infection among high risk and vulnerable groups.

In reply to another question from Mr. Amal Datta, the
minister said following the ICMR [Indian Council for
Medical Research] recommendations, the government
has identified and strengthened 13 hospitals for clinical
management of HIV infected/AIDS cases in the country.

World Bank Team To Visit

A World Bank team will visit India in October or
November this year to finalise a project to control the
incidence of Acquired Immune Deficiency Syndrome
(AIDS) in the country.

In a written reply to a question by former Lok Sabha
Speaker Rabi Ray, Minister of State for Health and
Family Welfare D.K. Thara Devi Siddhartha said the
World Bank has shown interest in collaborative projects
in the field of health, especially in areas such as AIDS
control. It has assured the government that it would
process such proposals expeditiously.


SJPRS-TEP-91-023
12 November 1991 4 AIDS
LATIN AMERICA
REGIONAL AFFAIRS
Regional AIDS Conference Opens in Trinidad [Bridgetown CANA, 7 Oct 91] ....
BARBADOS
Of 231 AIDS Cases Reported Since 1984, 162 Have Died [Bridgetown CANA, 10 Oct DT] ssvescsseees 31
BERMUDA

. 31

AIDS Deaths Reach 149 of Total 184 Cases (Bridgetown CANA, 4 Oct 91] ....
BRAZIL

AIDS Incidence Rising Among Women
[Eliane Sobral; Brasilia CORREIO BRAZILIENSE, 31 Jul 91] ...
HIV Infected Estimated at 500,000 in Sao Paulo
[Sao Paulo O ESTADO DE SAO PAULO, 17 Aug 91] .
AIDS Cases In Greater Sao Paulo Increase {Sao Paulo Ft

COSTA RICA

Official Statistics on AIDS Cases Released [Hamburg DPA, 22 Sept 91]
CUBA

AIDS Sanatorium Opens in Matanzas Province [Havana Tele Rebelde Network, 12 Sep 91]
HONDURAS

33

Health Ministry Reports Increase In AIDS Cases [Mexico City NOTIMEX, 20 Sep 91] .....
MEXICO

AIDS Seen Infecting at Least 250,000 by 1994
[Eduardo Chimely; Mexico City EXCELSIOR, 25 Aug 91] ....

NICARAGUA

Health Ministry Issues Statistics on AIDS [Managua Radio Sandino, 27 Sep 91) .... 34
PERU
Cases of AIDS Through June at 454 /Lima EXPRESO, 30 Sep 91] ... 34

ST. LUCIA

Of 31 Known AIDS Victims, 28 Dead [Bridgetown CANA, 10 Oct 91]
URUGUAY

Over 800 AIDS Cases Registered Since 1983 [Madrid EFE, 16 Oct 91) ..... 34
NEAR EAST & SOUTH ASIA
BANGLADESH
Writer Discusses AIDS Surveillance in Bangladesh
[Geetha Hasan; Dhaka THE BANGLADESH OBSERVER, 13 Sep 91] ..... . 35



SIPRS-TEP-91-023
12 November 1991

At 1100, Michai Wirawaithaya, minister attached to the
Prime Minister’s Office, and Michael Merson, director
of the Global Program Against AIDS of the WHO,
delivered speeches on the economic impact of AIDS.

Michai told reporters that he was raising the problem of
AIDS before the meeting because he felt that it was a
serious problem. As long as the problem prevailed in any
country, it would have a serious impact on economic
development. Therefore, those working in the financial
field in every country should be aware of the problem of
the deadly disease. Countries faced with a serious AIDS
problem would find difficulties in loan repayments.

As for Thailand, Michai said that the country had
realized the serious repurcussion of the AIDS problem
and was implementing radical measures to prevent and
tackle the problem. If successful, Thailand would be able
to save as many as 35 million Thai people.

Currently, Thailand had become a model country for
AIDS prevention, while many countries that had been
suffering from AIDS had not yet accepted the fact of the
problem. Therefore, countries facing the problem should
quickly try to find ways to prevent and eradicate the
disease before it was too late, Michai stressed. [Passage
omitted]

Country To Become Testing Ground for AIDS
Vaccine

BK1510125691 Hong Kong AFP in English 0832 GMT
15 Oct 91

[Article by Anchali Worrachate]

[Text] Bangkok, Oct 15 (AFP)—Thailand, gripped by fear of
an AIDS epidemic, is likely to accept a United nations
proposal to become a testing ground for vaccines against the
killer disease, a senior U.N. official said Tuesday.

But Michael Merson, of the World Health Organisation
(WHO), told AFP that testing would be performed on a
stricly voluntary basis, dismissing suggestions that Thais
would be turned into “guinea pigs.”

Merson, the director of WHO’s global programme
against AIDS, said Thailand was one of four countries
that had been selected by his organisation for the tests.
The others are Rwanda, Uganda and Brazil.

The Thai authorities have not yet approved the testing
programme, he said. A team from the WHO is to visit here
before the end of the month to make a formal approach.

Merson, who has had talks over the past few days with
top Thai officials, including Prime Minister Anand Pan-
yarachun, added: “I’m very sure that Thailand will
accept our proposal.”

He pointed out that the WHO project was entirely
separate from one which has been proposed by U.S.
researchers to test AIDS vaccines in Thailand, especially
among Thai military recruits.

EAST ASIA 29

Once it has been accepted, detailed arrangements will be
worked out on test procedures including selecting partici-
pants, WHO's assistance on the project, and determining
which vaccines are to be put on trial, Merson said.

According to the WHO official, visiting the Thai capital
to attend annual meetings of the World Bank and the
International Monetary Fund (IMF), it will take at least
two to three years before actual field work can begin.

“By the year 2000, 90 percent of AIDS cases in the world
will be in developing world,” he said. “So the vaccines
will have to be put to use primarily in the developing
world. It will be important to test whether they work in
the developing world.”

The government estimates that 300,000 Thais are car-
riers of the HIV virus which in most cases leads to AIDS.
Officials say up to 7.5 million could be infected by the
end of the century.

Merson said that the WHO test would be voluntary and
in accordance with the organisation’s strict technical and
ethical standards.

“Those who think we are going to turn them into guinea
pigs have got it all wrong,” he stressed.

“We gave countries the best assurances in the world”
against this, Merson added.

He said AIDS had reached such proportions that many
government leaders thoughout the world “would want to
see vaccines tested in their countries.”

“It would be crazy for the Thais to think that they
shouldn’t do it,” Merson said.

The U.S. proposal to test vaccines primarily on Thai
soldiers provoked outcry when it was made public
recently. Some top military officials said the testing
should not be allowed and a military spokesman said: “If
the Americans want to carry out the tests, why not carry
them out on their own troops.”

VIETNAM

AIDS Consulting Centers Set Up Nationwide

BK1909072791 Hanoi VNA in English 0643 GMT
19 Sep 91

[Text] Hanoi VNA Sept. 19—The national Anti-AIDS Com-
mittee of Vietnam has set up 18 AIDS-consulting centers
throughout the country and trained out consultants.

Initially, some centres in Hanoi, Ho Chi Minh City and
Haiphong have helped people with information and
knowledge on the prevention of the disease.

By July, 1991 the committee had conducted blood tests
‘on 65,018 persons of high-risk groups and so far in
Vietnam, only one young woman was tested to be
HIV-seropositive.



IJPRS-TEP-91-023
12 November 1991

“Tronically, a major reason for rising costs is the large
number of sophisticated procedures being made avail-
able on a wider basis to treat common ailments like
coronary heart disease, vascular disorders, kidney dis-
ease and diabetes, to name a few.

“These procedures have been refined to the point where
they are almost risk free and their greater availability has
created burgeoning demand.

“This technological explosion in medicine on the trans-
plant, investigative and therapeutic fronts will continue,
but it is costly in terms of time and resources. The costs
of medical care are, therefore, not going to come down.”

To illustrate his point, he said a coronary heart bypass,
which now cost around R{rand]30,000, would cost
R200,000 by the year 2000, given the increase in medical
costs over the past five years.

South Africa’s experience in rising medical costs was
likely to follow the American pattern. In the USA,
medical costs, which once comprised six percent of the
gross national product, has risen to the present level of
12 percent. “In South Africa, medical costs currently
make up six percent of the GNP, but as the demand for
exclusive medical care increases, so will the percentage
of the GNP taken by the nation for medical care costs.
Someone will have to pay and it won’t be the govern-
ment.”

Addressing the AIDS issue, he warned that the impact on
medical services would be dramatic. “There will be a
significant increase in demand. Treatment of symptom-
atic AIDS patients will have to alter, becoming largely
family- and home-based.

“AIDS, the 10 percent increase across the board for
value-added tax and the huge effect rapid urbanisation is
having on health care services, make the high-road
scenario—a real increase in GNP—even more impera-
tive,” Dr. Lockyer said. “Against this background, the
average man is going to have to consider his options if he
is not prepared to compromise on the standard of his
medical care.”

Fifty-one AIDS Deaths Reported; Decrease Noted
in Fatality Rate

MB2210175491 Johannesburg South African
Broadcasting Corporation Network in Afrikaans
1400 GMT 22 Oct 91

{Text] AIDS has claimed 51 lives in South Africa this
year so far, but the Department of National Education
and Population Development says that the fatality rate
has decreased from 24 to 22 percent over the same
period last year. According to the department, 235 AIDS
cases have been reported this year so far. Last year 305
cases were reported, with 74 deaths.

SUB-SAHARAN AFRICA 15

Study Says About 100,000 Already Infected With
AIDS Virus

MB2610053091 Johannesburg SAPA in English

0059 GMT 26 Oct 91

[Text] Cape Town Oct 25 SAPA—About 100,000 people
in South Africa were already infected with the AIDS
virus and about half of these are likely to die as a result
of the infection within the next 10 years because they
have limited access to health services, including preven-
tative education.

SWAZILAND

Minister Says ‘Host’ of AIDS Related Problems
Expected

MB2609201491 Mbabane Radio Swaziland Network
in English 1600 GMT 26 Sep 91

[Text] The minister for health, Dr. Fanny Friedman,
says Swaziland can now begin to expect a host of
AIDS-related disruptions since the clinical manifesta-
tion is already due. Officially opening a [words indis-
tinct] mobilization meeting for AIDS prevention at the
Yen Saan Hotel today, Dr. Friedman said it is already
five years since the first case of HIV infection in the
country was diagnosed, and the manifestations begin to
appear between five and 10 years. She observed that the
country can now expect an increase in hospitalized cases,
an increasing numbers of orphans and disruption in the
nation’s labor force. She noted that the working group
whose age ranges between 20 and 49 is, unfortunately,
the one that has the highest prevalence rate in Africa.

Calling for quality AIDS prevention programs, Dr.
Friedman said the only group that still appears to be
spared and saved is that between five and 15 years-old.
She appealed for aggressiveness among all AIDS preven-
tion agencies so that all barriers can be overcome.

Health Official Estimates 4,500 AIDS Sufferers

MB3009083791 Mbabane THE TIMES OF
SWAZILAND in English 30 Sep 91 p 1

[Report by Gordon Mbuli: “AIDS Shock, 4,500 Are
Sufferers”]

[Text] An estimated 4,500 people here might be sufferers
of the dreaded Acquired Immune Deficiency Syndrome
(AIDS).

This was disclosed by the deputy director of health
services, Dr. Qhing Qhing Dlamini at the second
resource mobilisation meeting in support of the national
AIDS prevention and control programme.

The meeting was held at the Yen Saan Hotel at Ezulwini
on Friday [27 September] and was organised jointly by
the government and the World Health Organization
(WHO).



IJPRS-TEP-91-023
12 November 1991

Strategies for AIDS Control

91WE0419B Beijing YIYAO XINXI LUNTAN [CHINA
MEDICAL TRIBUNE] in Chinese 30 May 91 p 1

[Text] Not long ago, an international cooperation con-
ference on preventing and controlling AIDS in China
was sponsored by the Ministry of Health, WHO,
UNICEF, and UNDP. The meeting not only discussed
preventing and controlling AIDS in the world and in
China, but also the mid-term (1990-1992) plan for
controlling AIDS in China.

In order to effectively prevent and control the happening
and spreading of AIDS in China, the Ministry of Health
has proposed long-term goals and basic strategies for
preventing and controlling AIDS in China.

The long-term goals
1) prevent the spreading of AIDS,
2) reduce the disease and death caused by HIV

3) reduce the impact of AIDS on the individual, family,
population and society

The mid-term goals

1) step up education and widely promote preventive
knowledge

2) establish AIDS monitor system

3) prevent medical infection and insure blood safety
4) provide treatment and counseling for the patients
The strategies

1) prevent sexual spreading of AIDS

2) prevent blood spreading of AIDS

3) prevent the spreading of AIDS via pregnancy

4) reduce the impact of AIDS on the individual, group,
and society

5) improve reporting of disease and monitoring of the
epidemic

6) develop scientific research

The Ministry of Health has recently issued mid-term
planning notices for preventing and controlling AIDS

and requested the regions to implement the plans rigor-
ously.

‘Dwarf’ Mouse Produced

91P60273A Shanghai WEN HUI BAO in Chinese
9 Jun 91 pl

[Article by Zhang Ziqiang [1728 5261 1730] and Wang
Weixi [3769 4850 1585]

[Summary] A ‘dwarf mouse research animal for AIDS
and hepatitis B viral experiments, has been produced by

CHINA a

the Shanghai Second Medical University, a break-
through in Chinese biological research. The researchers
have adopted a new system, crossbreed-reciprocal cross-
reciprocal cross-back cross, to produce the hybrid. The
cross of two defective parents, the cell immune function-
deficiency male and the natural killer cell-deficiency
female, produces this super-immunodeficiency ‘dwarf’
mouse. Because of its serious immune system deficiency,
the ‘dwarf or ‘human’ mouse is able to accept the
virus-infected human cells and maintain their prolifera-
tion indefinitely. Instead of conducting AIDS and hepa-
titis B research in human bodies and chimpanzees, the
‘dwarf mouse makes a better and a cheaper test animal
for such purpose. To date, ten generations of this species
have been obtained for studying the AIDS mechanism
and human cell biology.

China Spares No Effort in Fighting Spread of
AIDS

54004802B Beijing CHINA DAILY (NATIONAL)
in English 24 Jul 91 p 3

[Text] Kunming (Xinhua)—China has stepped up mea-
sures to prevent and control AIDS since the first case of
the disease was reported in the country in 1985.

A recent national seminar in Kunming, sponsored by the
Ministry of Public Health, was attended by over 50
experts who discussed effective steps to take in the fight
against the disease.

Although China is among the countries with the lowest
number of reported AIDS cases in the world, its govern-
ment and the medical community have remained on
constant alert since the first patient was diagnosed at the
Peking Union Medical College Hospital, in June 1985.

Along with increasing international contacts and the
development of tourism, China is faced with a growing
threat of AIDS, which has worsened in recent years with
the spread of drug trafficking.

According to the ministry’s statistics, 493 people have
tested HIV positive, five of whom were identified as
suffering from AIDS, from 1985 to 1990, as the result of
blood tests administered to 480,000 people throughout
the country.

Eighty-three of the 493 were foreign, including three
AIDS patients.

Further studies have shown that blood transfusions or
sexual activities are major channels of spreading AIDS
in China, but no-one was found to have inherited the
disease from their parents. A ministry official warned,
however, that “the possibility of AIDS inheritance
cannot be ignored.”

In 1989, China passed “the law to prevent and control
infectious diseases,” which classified AIDS and two



SJPRS-TEP-91-023

12 November 1991 SUB-SAH.

He told the House that AIDS was spreading alarmingly.
There were only about four cases in 1986 in the Main-
land.

Ndugu Chomeka also called for deliberate national
efforts to promote family planning to check population
explosion.

[Passage omitted]

National AIDS Program Issues Report on
Infections

EA3009193591 Dar es Salaam Radio Tanzania
External Service in English 0400 GMT 30 Sep 91

{Text] Dar es Salaam—The National AIDS Control
Program announced that 100,000 Tanzanians have
already developed symptoms of the dreadful AIDS and
many others have died since the scourge was first
reported in the country in 1983. The program’s review
report said the numbers revealed are scientific estimates
and that another 700,000 people are believed to be
infected with the viruas—of them, 140,000 are teenagers.

The report stated that unless the National AIDS Control
Program and other bodies involved in the war against
AIDS are successful, it is estimated that by the end of
this decade there would be 800,000 cases and over 2
million infected people. It stated that more than 50,000
children have been orphaned because of AIDS and by
1997 the number might rise to 500,000.

According to the report, information campaigns have
succeeded in making a large proportion of Tanzanians
aware of the dangers of AIDS and in transmission
through sex. However, the report said, people are not
fully aware that AIDS is also spread by people who feel
and appear healthy.

AIDS Figures for Zanzibar, Pemba Released

EA1510135091 Dar es Salaam Radio Tanzania
Network in Swahili 0330 GMT 15 Oct 91

{From the press review]

{Text] Sixty-six people, including two children, have
died of AIDS since the scourge surfaced in the isles
[Zanzibar and Pemba] in May 1986. These figures were
reported yesterday in UHURU on page six.

UGANDA

Sixty Percent of TB Cases HIV Positive

91WE0537A Kampala THE STAR in English
12 Aug 91 pp 1,7

[Article by Alfredo Amodoi: “60 Percent TB Cases Have
AIDS”}

{Text[ The Director of AIDS Control Programme (ACP)
in the Ministry of Health Dr. Warren Namara has called

RAN AFRICA 17

for discipline in a fight against AIDS epidemic. He
reported that 60 percent of TV cases had HIV; the virus
that caused AIDS killer disease.

He was addressing a seminar for NRC [National Resis-
tance Council] members last Friday, organised by
Uganda AIDS Commission at the Uganda International
Conference Centre Kampala. The seminar was called to
share with the members the responsibility in the fight
against AIDS. The theme was “The multisectoral
strategy for AIDS control: the role of political leaders.”

Dr. Namara appealed to Ugandans to love to be alive.
He said that out of the national population of about 16
million people 10 out of 100 had HIV. He said there
were 40,000 TB cases each year in the districts of Jinja
and Mbarara. And 20 out of 100 got TB because they had
AIDS, said Namara. The Director noted that social
health infrastructure had been overstrayed by the TB
cases,

On the risk of acquiring the ‘no repent’ disease, Namara
said “If you do sex, you have got a 24 percent chance of
acquiring AIDS. He said one risk factor was through the
sexually transmitted diseases (STDs). He gave advice
that once a person developed one of the STDs, he must
treat it immediately. AIDS is crucial.”

He said there were three HIV disaster stages namely,
HIV infection, patient and death. [Sentence as received]
He noted the death of the productive sector of society
had high social economic loss and effects to Uganda. Dr.
Namara challenged the leaders and everybody for him-
self and for others to spread the awareness and keep off
AIDS risks. Twenty-four percent of mothers in Uganda,
he said, “were exposed to HIV.” He said the impact of
AIDS caused orphans was sorrowful.

Namara told the seminar that 18 out of 100 people
donating blood in Western Uganda had HIV.

The ACP Director called for total change in sexual
behaviour, human interaction on AIDS and target group
education.

Museveni Addresses Group on Development,
AIDS

AB2909214791 Kampala Radio Uganda Network
in English 0400 GMT 29 Sep 91

[Excerpts] President Yoweri Museveni, who is now ona
visit to Busoga region, has started a tour of Kamuli
district. Addressing a public rally at Nabanyango pri-
mary school, in Buzaya county, last evening under a
heavy downpour, Mr. Museveni assured the people that
the NRM [National Resistance Movement] government
is ready to face all development problems which Uganda
has. He said that the movement has always and will
always point out to the people of Uganda the develop-
ment problems their nation is facing so that everybody
understands them fully and tries to brace up together
with other citizens to solve them. [Passage omitted]



30 EAST EUROPE

REGIONAL AFFAIRS

European AIDS Conference Opens in Prague

LD2310080391 Prague CSTK in English 1939 GMT
22 Oct 91

[Text] Prague Oct 22 (CSTK)—Thirty European organ-
isations and representatives of the World Health Organ-
isation (WHO) met here today to discuss how best to
help AIDS victims and people infected with the HIV
virus, which causes AIDS.

The conference, which continues through October 26, is
organised jointly by the European Council of AIDS
Service Organisations (EUROCASO) and the Czecho-
slovak “Society AIDS-Help” (SAP).

The aim of the conference is to incorporate humani-
tarian organisations from Central and Eastern Europe
into EUROCASO, SAP Chairman Radomir Ruzicka
said.

There are 25 registered cases of AIDS in Czechoslovakia,
and 155 people have tested HIV-positive. Thirteen
people in Czechoslovakia have died of the immune-
deficiency disease to date.

HUNGARY

Mandatory AIDS Testing Required for
‘High-Risk Groups’

LD1710063091 Budapest MTI in English 1756 GMT
16 Oct 91

[Text] Budapest, October 16 (MTI)—Mandatory AIDS
testing faces certain high-risk groups in Hungary.

JPRS-TEP-91-023
12 November 1991

The requirement is to remain restricted to this one
group, says Social Welfare Ministry senior offical Adam
Vass, “we have no intention of introducing the compul-
sory AIDS screening into the population, or foreign
visitors, considering the test only reflects a momentary
condition.”

The test is also available free of charge to the public.

By early October, 28 new AIDS cases had been registered
in Hungary (pop. 10.3 million), bringing the overall
number since 1986 to 76. Thirty-nine patients have died
from the disease already. There are 282 HIV-positives on
record, of which 249 are male.

Current figures list Hungary as one of the lesser-infected
countries.

YUGOSLAVIA

Over 200 AIDS Cases Since 1985

LD1110083991 Belgrade TANJUG Domestic Service
in Serbo-Croatian 1606 GMT 10 Oct 91

[Summary] Belgrade, 10 Oct (TANJUG)—The Federal
Institute for Health Protection has told TANJUG that
233 AIDS cases were reported in Yugoslavia from 1985
to October this year. Out of that number, 125 have died.
The largest number of AIDS cases were in Serbia. There
were 137 cases in Serbia, 15 in Vojvodina, four in
Kosovo, 37 in Croatia, 14 in Slovenia, 11 in Bosnia-
Hercegovina, three in Macedonia, and two in Montene-
gro.

Another 1,200 people in Yugoslavia have been diag-
nosed HIV positive.


12 SUB-SAHARAN AFRICA

factors—moral, physical and ethical—will be taken into
account in handling the issue.”

AIDS Causes Renewed Outbreak of Tuberculosis

92WE0027 Johannesburg THE STAR in English
12 Sep 91 p 5

[Article by Shirley Woodgate]

[Text] A renewed wave of tuberculosis has surfaced in
South Africa since the link between TB and AIDS was
revealed, says SA National Tuberculosis Association
(Santa) Director of Community Tuberculosis Education
Dr. Theo Collins.

New cases of TB increased from 55,000 in 1986 to
80,000 in August 1990.

“Tuberculosis and AIDS go hand in hand. There are
probably about 15 million people in South Africa who
have dormant TB infection.

“In normal circumstances, the disease would never have
erupted in most cases, but where the HIV virus has
appeared, the resistance of these people is so low that the
TB infection becomes active.”

TB, which had virtually been wiped out in the U.S., had
resurfaced since the advent of AIDS, and in Uganda the
World Health Organisation claimed the disease had
doubled since the appearance of the virus.

Dr. Collins claimed that some 36 people were dying daily
of TB in South Africa and at any one time about 250,000
were being treated.

Warning that the cost of treatment was likely to soar, he
said about R5,400 was spent on each patient admitted to
hospital for about six months.

It is claimed that the degree of success of State anti-TB
measures depends on the extent of voluntary support.

Santarama Miniland at Wemmer Pan, south of Johan-
nesburg, not only provides a valuable education and
entertainment venue, but supports Santa. But the min-
iature town needs R150,000 to revamp the models and
replace the income-producing pleasure boat.

THE STAR has launched the Santarama Fund with its
own donation of R5,000, and invites businesses, schools
and individuals to add their contributions.

Please send your ideas or donations to the Santarama
Fund, Box 1014, Johannesburg 2000 (Sauer St. Charities
No 011 001 22 000 5).

Financial Burden of AIDS on Country Noted

92WE0023 Cape Town THE ARGUS in English
12 Sep 91 p 5

[Article by Blaise Hopkinson]

[Text] AIDS will cost the country billions in the next
decade and up to 10 million people could test HIV

JPRS-TEP-91-023
12 November 1991

positive by the turn of the century, an Institute of
Personnel Management seminar in Bellville has been
told.

As many as 220,000 people could die from AIDS each
year, Mr. Andre Spier, the director of the AIDS Policy
Research Group, told the seminar.

Mr. Spier said the direct costs in terms of medical care
would run into hundreds of millions of rands, but this
would account for only 30 percent of the costs. Absen-
teeism, retraining and general economic damage would
account for the rest.

He warned that business would have to take a major
proactive role in combating the spread of the disease and
that every single company would be affected by it.

In a wide range of presentations, representatives from
industry, government, the ANC and organised labour all
pointed to the singular lack of progress in the fight
against AIDS in this country.

Dr. Neil Cameron of the Department of National Health
and Population said R50 million was being spent by the
government on AIDS in this financial year.

Mr. Francois Marais of life-giant Sanlam said the group
had allocated R200 million to an AIDS contingency
fund.

Industry-wide statistics showed R8.5 million had been
paid so far in AIDS claim settlements.

He predicted the cost of death benefits would double and
said there was no “right price” for life insurance that
included AIDS cover, given that the relative mortality of
an HIV-positive person was 2,600 percent higher than a
standard non-smoker.

Eskom’s corporate medical consultant, Dr. Charles
Roos, spoke on the contentious issue of pre-employment
screening for HIV-positive candidates, a policy the com-
pany had pursued since 1988. So far 15 cases had been
identified.

He denied the policy was discriminatory and said:
“Everybody from the chairman down is tested.”

The ANC’s Dr. Kamy Chetty said the party rejected
pre-employment screening outright because it was “dis-
criminatory.”

Labour lawyer Mr. Michael Bagraim said the law had yet
to contend with AIDS.


4 SUB-SAHARAN AFRICA

Last week a team from the AIDS Coordination Center
visited the province, not only to observe the activities in
progress but to assist in taking a survey of the needs,
considering the current rate at which AIDS cases are
being diagnosed.

First AIDS Counseling Course Under Way

91WE0513C Maputo NOTICIAS in Portuguese
10 Aug 91 p 4

[Text]Since last Monday and for a 15-day period, 34
civilian and military health technicians and Social
Action technicians are receiving training in counseling
AIDS patients interned in the Central and Military
hospitals of Maputo. This is the first training course for
personnel who will be acting as counselors in their area
of nursing care, to ensure the training of other profes-
sionals so as to initiate a vitally needed service, a means
to provide psychological and social support to all AIDS
patients and all individuals who are infected with the
HIV virus or who test serum-positive.

In effect, counseling AIDS patients and HIV-infected
individuals is seen as urgent; in addition to the fact that
many individuals have not yet received any information
about the danger of the disease and that others have not
taken to heart the implications of being infected by the
AIDS virus, the number of cases that are showing up
every month dictates the initiation of a counseling
program, to provide all the moral and social support that
the patient needs.

Such counseling is much needed, since it is well known
that, in their families and in the communities where they
live, many of these AIDS patients and HIV-infected
individuals are still not receiving the support and care
that they need, as much as any other patient with
tuberculosis, malaria, or any other of the ordinary ail-
ments that we commonly suffer from.

It is in light of this reasoning that the course is being
conducted, to be followed by many others until the
health technicians, or more precisely, the nurses are able
to give the AIDS patients and HIV- positive individuals
all the care and psychological and social support that is
as vital to the patient as medicine and food.

According to the officials sponsoring the training, there
will be a first phase for nurse-chiefs of department and
services of the Central and Military hospitals of Maputo,
because all the wards are already beginning to receive
patients. At this time, at least five wards in the Central
Hospital of Maputo have been admitting AIDS patients
with great regularity.

Within this year, the plan for nurses’ training in coun-
seling should take in all the general hospitals and health
centers in Maputo City, so that, within the year, the
counseling of patients and HIV-positive individuals will
be a routine activity for these professionals, because, as
we said before, we are beginning to see many AIDS
patients interned in the hospitals.

JPRS-TEP-91-023
12 November 1991

As the reader will recall, Maputo City has the largest
number of AIDS cases diagnosed in the country: more
than 100. These cases have not only been diagnosed in
the Maputo Central Hospital but in other hospital units,
such as the Chamanculo General Hospital and the Alto
Mae Health Center, to cite some examples.

Once the training of health technicians in Maputo is
completed, the training will be extended to technicians
in Manica Province, which will be the pilot for the other
provinces in counseling AIDS and HIV- infected
patients; Manica Province has the second largest number
of reported cases in the country, partly because its
clinical system is functioning properly with regard to
suspecting and diagnosing the disease.

Course Contents

The course is divided into eight parts, the first of which
is devoted to the dissemination of basic information
about HIV, its nature and form of transmission, incuba-
tion period, the course of the infection, and opportu-
nistic diseases.

In the area of counseling, strictly speaking, the course
takes up the psychological and social aspects of coun-
seling patients and their families, infected women, eth-
ical aspects, and the confidentiality that professionals in
the sector should maintain, among other topics.

The training of these health workers is preceded by small
surveys to give some idea of what each of them knows
about HIV infection and the disease itself. The contents
of the training course have been organized on the basis of
these surveys.

Our Advice to the Reader

As long as we do not have an AIDS patient in our home,
we go on denying the existence of the disease and we
thank our stars or fate that we have been lucky.

Ideally, the disease would never strike our home. How-
ever, if for any reason we were to have an AIDS or HIV
victim in our midst, we should know how to care for him
and give him all the support he would need.

The reader may ask why there are appeals to give support
and care to AIDS victims and not to victims of other
diseases.

The question is legitimate. We suggest that you send us
your views on the matter.

Meanwhile, and for our part, we would add that AIDS is
a new disease and, as such, is not yet much accepted;
many people refuse to believe it exists, precisely because
they do not wish to abstain from the intimacy of sexual
activity or because having sex with more than one
partner is a habit that is difficult to break from one day
to the next.


SJPRS-TEP-91-023
12 November 1991

AIDS. These discussions arose in the context of Thai
concerns about the rapid rise of HIV-positive testing
among Thai military recruits,” said embassy spokesman
James Williams.

However, Supreme Command Spokesman Gen.
Narudol Detpradiyut sought to downplay the possibility
of the Thai military joining the testing programme.

“Why must the Americans travel all the way here to test
the vaccine? I don’t think it will be possible because Thai
troops are not guinea pigs,” he said.

Minister Says U.S. AIDS Vaccine Test Needs
Study

BK2809025191 Bangkok THE NATION in English
28 Sep 91 pp Al, A3

{Text] The government or any other responsible Thai
agency must carefully consider the US Army’s proposal
to test an AIDS vaccine on Royal Thai Army personnel
before making a commitment, PM Office Minister
Michai Wirawaithaya said yesterday.

Commenting on a report on the project, he said: “This
project involves the use of human beings to test a new
drug so it would have to be carefully considered by the
government to ensure it is safe.” He said a special
committee should be set up to study the proposal.

The Royal Thai Army was approached earlier this year
by the US Army for a possible joint project to test a new
AIDS vaccine using Thai Army volunteers. The vaccine,
GP 160, was reported to have produced promising results
in boosting the immunity system of HIV positive
patients. It is also expected that the vaccine, which has
been tested on several hundred US Army personnel,
might possess some preventive quality against the deadly
virus for normal persons.

According to the sources, the project would involve
about 30 Thai military personnel and civilians. Those
people must be volunters and the project would not start
until it received the go-ahead from the Army Com-
mander-in-Chief and the Supreme Commander.

Meanwhile, Dr. Col. Thawisak Nopkaison, a member of
the Thai Army team handling the project, yesterday
down played the implications, saying it was aimed at
only studying the rate of infection in the Army and was
intended to find measures to make soldiers change their
activities that lead to AIDS infection. He also said that
no vaccine had yet been used on Thai Army personnel.

“The project began about six months ago after we
received a grant from the US Army. The aim is to study
the rate of increase in AIDS in new recruits six months
after they join the army and then two years later. The
study would also include teenage civilians. We expect the
results would better help us understand what type of
activities led them to contract the disease and how we
can persuade the soldiers to substitute them with
healtheir past times,” he said.

EAST ASIA 21

He added that project is expected to be expanded to
cover all army units and tests would be conducted every
two years.

Thawisak admitted that there was a very high percentage
of new recruits carrying the virus, especially from the
upper provinces.

“We found that 15 percent of the new recruits from the
upper north provinces now have the virus. It has caused
us concern because the figure is higher than would
normally be acceptable. So we are trying to find a way to
stop it,” he said.

But he added that the high rate is only prevalent in the
uppor north, while about 2 to 3 percent of the recruits
from other areas in the country have the disease in line
with the HIV-infection rate found in the general popu-
lation.

Doctor on ‘Alarming’ AIDS Infection Rate in
Songkhla

BKO0310032791 Bangkok THE NATION in English
3 Oct 91 p A3

[Text] The spread of AIDS here has reached “alarming”
proportions with 1,329 people reported having con-
tracted the virus and the number of AIDS carriers
estimated to be five times higher, a local public health
official said yesterday.

Dr. Chetsada Chongphaibun, chief of Hat Yai Hospital's
technical division, said so far 623 men and 706 women
in this southern province, well known for the bustling
town of Hat Yai, had contracted AIDS.

The doctor said pregnant housewives were among those
infected. He did not give the exact number of house-
wives who tested positive to human immunodeficiency
virus (HIV) after having their pregnancies registered
with government hospitals and clinics.

Three of the infected persons were suffering from the
AIDS- related complex syndrome and most of the others
were just carriers, Chetsada said.

The doctor said he belived the real number of HIV-
infected people in Songkhla was five times higher than
the figure detected by authorities.

Chetsada based his assumption on the fact that most of
those belonging to high-risk groups—prostitutes, intra-
venous drug users and men frequenting brothels—had
not yet taken the AIDS test.

The doctor said it was believed that between 7,00 to
8,000 women were working as prostitutes in the province
with the number growing to about 10,000 during holi-
days, but only around 3,000 to 3,500 of them have their
health checked regularly.



“4 EAST ASIA

which causes the disease. Health Minister Datuk Lee
Kim Sai says 90 percent of the victims and HIV carriers
were drug dependents. Of the number, 485 people or 35
percent of the carriers were detected in Johor.

Although Malaysia counted for only 0.8 percent of the
AIDS cases in the Asia-Pacific region, the government
still views the situation seriously. He told reporters this
after presenting certificates to 322 nurses at the Sultana
Aminah General Hospital’s Nursing School in Johor
Baharu. Datuk Lee said the authorities were taking
appropriate measures to check the spread of the deadly
disease. They include conducting a campaign on the
need for a healthy lifestyle. In addition, the government
was studying whether to set up separate centers for AIDS
patients seeking medical treatment.

NEW ZEALAND

Health Secretary Says Country Free of AIDS,

BKO0510105091 Hong Kong AFP in English 0123 GMT
5 Oct 91

[Text] Avarua, Oct 4 (AFP)—The Cook Islands are free
of both Aquired Immune Deficency Sydrome (AIDS)
and the Human Immuno Virus (HIV) that causes the
disease, according to the South Pacific nation’s secretary
of health, George Koteka.

Tests on some 2,000 of the island’s total population of
18,000 people since 1987 have detected neither HIV nor
AIDS.

Koteka said that although the islands remained free of
the virus, the ongoing awareness campaign should con-
tinue.

Workshops for secondary school teachers will be held
later this year to prepare them to introduce AIDS edu-
cation in 1992.

Education Secretary Lionel Brown said the plan to teach
high schools pupils about AIDS was a sensitive one, but
stressed that the programme would focus on general
awareness, not explicit details. “The emphasis would be
on prevention and precautions,” he said.

Koteka, a medical doctor, said he was concerned that
neither Tahiti nor American Samoa had initiated AIDS
programmes, given the Cook Island’s close relationship
with them. “Through working together we would be
better able to control the virus in the region,” he said in
an interview.

PHILIPPINES

Government Conducts AIDS Education Campaign
HK2609061191 Manila PHILIPPINES NEWSDAY

in English 26 Sep 91 p 1

[Article by Danilo P. Lucas]

[Text] The Acquired Immune Deficiency Syndrome
(AIDS), which health Secretary Alfredo R.A. Bengzon

SJPRS-TEP-91-023
12 November 1991

described as a “terrible disease,” claimed its 32nd vic-
tim—a male homosexual balikbayan [returning filipino]
from Spain—last Saturday.

Expressing alarm over the significant increase of AIDS
cases in the country, the Department of Health admitted
that the surveillance data showed that the human immu-
nodeficiency virus (HIV)—the AIDS- causing virus—
had been significantly affecting certain groups of Fili-
pinos earlier regarded by Department of Health (DOH)
officials as unlikely recipients of the infection.

The present infection rates indicated that HIV was no
longer confined to commercial sex workers or their
foreign clients, but already included seamen, students,
professionals, and housewives.

The AIDS registry under the National AIDS Prevention
and Control Program (NAPCP) of Dr. Ricky Hernandez
indicated that a growing number of Filipinos who have
worked and traveled abroad and other men were signif-
icantly contributing to the HIV reservoir.

The warning is definite: Science has yet to discover a
formula that can cure AIDS. But likewise the message is
clear: Only the individual himself can present the entry
of this virus into his body. Inasmuch as there is no
known cure or vaccine against AIDS, the only means of
protection is the correct information.

The stigma caused by AIDS prompted concerted action
from foreign institutions, governments, non-government
organizations, and the private sector aimed at pre-
venting the proliferation of this scourge.

Spearheaded by the DOH, the government, with the
active participation of various NGOs [non-government
organizations] has been conducting a massive education
campaign to apprise the public about the “myths and
misconceptions” of AIDS.

The thrust of this nationwide information drive is to
educate the general public to enable them to protect
themselves from the disease as well as alleviate the
stigma on and trauma of the AIDS patients.

The DOH and various NGOs have been working hand in
hand to inform the Filipino people that AIDS could be
definitely prevented.

The private sector, on the other hand, has expressed
willingness to support the programs and services of the
government and NGOs.

In fact, a physician said the hospitalization and burial
expenses of the latest AIDS fatality were shouldered by
Mrs. Zobel de Ayala.

the doctor, who refused to be identified, said the AIDS
victim met Mrs. Zobel on his way back to the Philip-
pines. He narrated to Mrs. Zobel his plight. Mrs. Zobel,



IJPRS-TEP-91-023
12 November 1991

CAMEROON

Progress of Anti-AIDS Campaign Assessed

91WE0532A Yaounde CAMEROON TRIBUNE
in English 17 Jul 91 p &

{Article by Peter M. Ndumbe, Deputy Director of the
Institute of Medical Research and the Study of Medic-
inal Plants. He is also a Senior immunology in CUSS:
“AIDS Activities in Cameroon”]

[Excerpts] [Passage omitted] Cameroon was one of the
first countries in Africa to develop a national AIDS
programme. Our efforts started in 1986 with the elabo-
ration of a short term plan of action which lasted one
year. The object of the plan of action was to assess the
HIV/AIDS situation in Cameroon. In 1987, a National
AIDS Committee was formed. With the help of the
World Health Organization (WHO), a five year medium
term plan for the control of AIDS was started in 1988/89.
An AIDS Control Service went into operation in 1989.
This service was supported by five ad-hoc sub-
committees of the National AIDS Committee. They
were the Epidemiology sub-committee, the Health Edu-
cation sub-committee, the Clinical Services sub-
committee, the Laboratory Services sub-committee and
the Research sub-Committee. We will discuss the activ-
ities of the National AIDS Committee with reference to
its sub-committees.

The first studies on infection with the human immuno-
deficiency virus in Cameroon were conducted in 1986/
87. At that time, the overall seroprevalence (i.e. persons
who had been exposed to the virus), was less than 0.1
percent. Certain categories of persons such as prostitutes
had higher prevalence than the rest of the population
(between 4 to 7 percent). These findings confirmed the
assumption that the main method of spread of the
disease was by the sexual route. As in other parts of
Africa, HIV infection was higher in the urban areas. An
unexplained high seroprevalence in the South of
Cameroon was noted.

As of April 1991, the overall seroprevalence is about 1
percent (i.e. one out of every 100 Cameroonians has
been in contact with the HIV virus). This figure is about
10 percent in prostitutes, 4 percent in people who attend
venereal disease clinics, and about 3 percent in patients
with tuberculosis. The rate in pregnant women appears
to be about the same as in the general population, if not
higher.

About 429 cases of AIDS have been seen since 1985 of
which 211 are men, and 218 women—177 of these
patients have died.

These estimates are probably lower than the true situa-
tion, which may be two to three times higher.

Information, education and communication have been
very well developed. Posters, radio messages and pam-
phlets have been made to inform people about the means

SUB-SAHARAN AFRICA 1

of spread of the virus and how to prevent this. Safe
sexual practices (use of condoms, reduction of partners)
have been encouraged. Programmes to reduce spread by
sex have been made for prostitutes and adolescents.

Although, there are indications that many people have
heard and acted on these messages, there are a lot more
who have not changed their risk behaviours. Some
people still believe that infection is associated with
poverty and lack of hygiene. This is not true.

We have attempted to document the common com-
plaints and findings among our AIDS patients. Although
zidovudine (AZT) is marketed in Cameroon it is very
expensive. Very few people can afford it.

The laboratory service have been expanded in the
country. At least one technician per division has been
trained in testing for HIV infection. Most hospitals that
carry out blood transfusion have their blood tested
before use. Confirmation of infection is done only in
about four of five centers nationwide.

A condom testing laboratory has been set-up to control
the quality of condoms sold in Cameroon.

[Passage omitted]

Sixteen AIDS Cases Confirmed in South

91WE0539A Yaounde CAMEROON TRIBUNE
in French 17 Jul 91 p 15

[Article by Matip Timohee: “Intensification of the
Struggle Against AIDS”]

[Text] CAMNEWS, Ocean—It is no longer a secret to
anyone: Cameroon has now declared several hundred
cases of AIDS to the WHO (World Health Organization).
In South Province 24 persons suspected of having the
disease have been tested, and 16 cases have been posi-
tively confirmed. These revelations were made by Dr.
Banemeg during a departmental seminar on AIDS
recently held in the meeting hall of the City of Kribi.
Organized by the Ministry of Health, this seminar
brought together delegates from the five districts of the
department. Doctor Banemeg, the provincial delegate
for health in South Province, presided over the seminar,
whose meetings covered such subjects as: the epidemi-
ology and statistics of AIDS, clinical aspects of AIDS,
and a summary of the activities carried out by the
departmental committee for the fight against AIDS.

Right now prevention is the only means of halting the
spread of AIDS. Therefore, it is important that the
leaders involved in the fight against AIDS should them-
selves be informed, be aware of the situation, and be
convinced of the correctness of this approach. In view of
the decentralization of the fight against AIDS, which we
can see at present, each person at his or her own level
must make his or her own contribution to the mobiliza-
tion of the people and convince them to adopt a pattern
of behavior which favors maintaining good health, the



JPRS-TEP-91-023

12 November 1991 5 AIDS
INDIA

More Reportage on Fight Against AIDS _.. 36
Discussion in Lok Sabha Secunderabad DECCAN CHRONICLE, 6 Aug 91] 36

Situation in Calcutta /Barun Ghosh; Calcutta THE TELEGRAPH, 2 Aug 91] 37

Cases in Tirupati [Secunderabad DECCAN CHRONICLE, 3 Aug 91] 37

Education on AIDS Urged [New Delhi PATRIOT, 2 Aug 91] .. 38
Continuing Fight Against AIDS . . 38
Bombay Workshop Discussion _ /Bombay THE TIMES OF INDIA, 27 Aug 91] 38

Most Cases in Maharashtra [Madras THE HINDU, 28 Aug 91] .... . 39

AIDS Deaths, Prevention Measures in Kerala {Calcutta THE STATESMAN, 12 Sep 91] 39
Papers Give Details in Fight Against AIDS ...... 39
Epidemic Proportions {Madras THE HINDU, 21 Sep 91] 39

Increase in Uttar Pradesh [New Delhi PATRIOT, 2 Sep 91] . 40

More on Manipur [Calcutta THE STATESMAN, 29 Aug 91] . 40

Campaign in Tamil Nadu [Madras INDIAN EXPRESS, 4 Sep . 4

Study on HIV-2 [Conrad Prabhu; Bombay THE TIMES OF INDIA, . 4

Rao Calls for Action {Bombay THE TIMES OF INDIA, 11 Sep 91] ..... . 43

IRAN

Status of AIDS Detailed (Tehran JAHAN-E ESLAM, 3 Aug 91] . 43
Health Minister Notes 400 People Carry AIDS Virus [Tehran IRNA, 22 Sep 91] 44

ISRAEL
AIDS Virus Growing Among Heterosexuals /’Ezra Hen; Tel Aviv DAVAR, 24 Oct 91] ....
MOROCCO
Extent of AIDS Epidemic in Country Assessed /Rabat L’OPINION, 2 Sep 91] ....
PAKISTAN
AIDS Spreading Rapidly /Lahore NAWA-I-WAQT, 10 Jul 91] ....
SOVIET UNION
AIDS Figures Said To Increase /Lubov Dunayeva; Moscow TASS, 19 Sep 91] ....
WEST EUROPE
BELGIUM
Quaterly AIDS Statistics Published /Brussels LE SOIR, 23 Aug 91]
DENMARK

AIDS Epidemic Feared in Greenland; Nine New Cases
[Copenhagen BERLINGSKE TIDENDE, 10 Sep 91] ....

IRELAND

Health Department Gives Statistics on AIDS _/Dublin IRISH INDEPENDENT, 26 Jul 91]
Rise in Heterosexual AIDS /Dublin IRISH INDEPENDENT, 14 Aug 91] .....

NORWAY

Law Proposed on Testing, Isolation of HIV Patients
[Liv Hegna; Oslo AFTENPOSTEN, 5 Aug 91] ....

UNITED KINGDOM
Heterosexual AIDS Epidemic in Shires [THE DAILY TELEGRAPH, 20 Sep 91] ....



JPRS-TEP-91-023
12 November 1991

Experts Predict 12 Million AIDS Victims

92WE0054C Cape Town THE ARGUS in English
25 Sep 91 p 1

[Text] Johannesburg—The AIDS virus threatens to hit
as many as 12 million adults and children in South
Africa in the next eight years, according to new esti-
mates.

The sombre warning—one of the worst scenarios yet
drawn—comes from the authoritative Development
Bank of South Africa.

It disclosed yesterday that research showed that the lives
of almost one in every three of the entire population
could be endangered by the disease between now and the
year 2000.

The death toll could rocket above 5.2 million—about 4.5
million aged between 15 and 64 and more than 700,000
infants.

The AIDS crisis would tend to proliferate most among
urban dwellers especially educated people and members
of the uniformed services.

Studies commissioned from the economic research unit
at the University of Natal projected that should efforts to
curb the disease through education fail, the cumulative
number of minors and adults who would test HIV
positive could be as many as 12 million by the end of the
decade.

The grave warning was carried in a special report entitled
“South Africa: An inter-regional profile.”

Researchers estimated the direct cost of treating a single
patient to be about R15,000. That would entail overall
total costs between R10,000 million and R16,000 mil-
lion.

“Should patients be treated intensively with prohibi-
tively expensive drugs such as AZT,” the bank added,
“the cost per patient could escalate to between R60,000
and R100,000—a burden the economy can definitely not
afford.

“Even if direct costs could be kept to about R15,000, this
is likely to be only 20 percent of total (direct and
indirect) costs, especially if the African pattern of AIDS
among educated people is repeated.

“With education already in short supply, it would be a
double disaster to lose to the disease people who have
been educated at great cost.

“The AIDS problem highlights the need for a preventive
as opposed to a curative health system.”

SUB-SAHARAN AFRICA 13

Number of HIV Infected in Cape Reaches 1,000

92WE0054B Cape Town THE ARGUS in English
25 Sep 91 pI

{Article by Vivien Horler: “1,000 in the Cape Have
AIDS Virus”]

[Text] The number of people who have tested positive
for HIV infection in the Cape has passed the 1,000 mark
for the first time, the Department of Health said.

It said 60 new cases of infection were diagnosed in
August, compared with 34 in July.

“There has been a worrying jump,” said Dr. P.T. Vur-
garellis. “At this stage we're not sure if it is purely
coincidental—perhaps because of a new survey some-
where in the area on blood samples—or whether the
increase will be sustained.

“We think it is coincidental, but we won’t know until the
next monthly report. We have to keep tabs on this.”

Of the 1,000 cases, almost 500 are in the Greater Cape
Town area.

Professor Cited on AIDS Figures for Natal

MB0810183491 Johannesburg SABC TV 1 Network
in Afrikaans 1600 GMT 8 Oct 91

[Text] At least 2.5 percent of Natal’s population is
possibly infected with the AIDS virus. This shocking.
revelation was made by the University of Natal medical
school after tests on blood donated to the Natal blood
Transfusion Service and on mothers who visited the
post-natal section of King Edward VIII Hospital in
Durban.

Professor Dennis Padafin of the university says the
group on which the tests were conducted is regarded as a
low- or middle-risk group and he shudders to think how
high the figure would be among so-called high-risk
groups. He said the 2.5 percent means that the 2 percent
threshold at which the virus gains momentum has
already been passed. [Begin Padafin video recording in
English]

Padafin: The implication of that is that if this trend were
to continue, the figure in one year’s time would be 5
percent and in two years’ time would be 10 percent.

Minister Discusses Anti-AIDS Phone Program

MB0910191091 Johannesburg SABC TV 1 Network
in English 1600 GMT 9 Oct 91

[Text] [Begin recording] Reporter Conrad Burke: On the
AIDS problem, Health Minister Dr. Rina Venter gave
details of a comprehensive plan to beat the killer virus
which latest studies show is infecting 300 victims a day.

The plan centers on getting information to the public
effectively. An AIDS phone in service on a toll-free
number was being considered. Also planned, around the


SJPRS-TEP-91-023
12 November 1991

The DMS refuted the figure and said that Kenya was the
leading [country] in Africa in the programme of control-
ling AIDS and the government as in many ways collected
accurate data about AIDS situation in the country.
[sentence as received] Prof. Oliech was addressing a
press conference in his office today to give an as up-
to-date figures and statistics of the dreaded disease,
AIDS. [sentence as received]

He noted that AIDS figures were a sensitive issue and if
mishandled or inaccurately made public would have
adverse negative effects on the economy of the country.
Prof. Oliech advised public officers to consult his office
for accurate figures on AIDS cases before they announce
them to members of the press or public. Estimates, said
Prof. Oliech, are dangerous and more so if they are an
over estimation of cases of AIDS.

The professor admitted that the present official figure
could not be very accurate because some AIDS cases go
unnoticed because death certificates do not indicate
those who have died of AIDS.

He said that despite a very vigorous campaign by the
National AIDS Control Committee, AIDS cases con-
tinued to rise year after year. He said that from 26
reported cases in 1985, the figure has risen to 6,851
reported cases in 1990 giving a cumulative figure of
19,000 cases to date. The medical boss said that Kenya
has very modern and effective blood screening machines
which have given a 100 percent efficiency to AIDS
screening in donated blood before being used in transfu-
sions.

Prof. Oliech said that Kenya has given up-to-date figures
to the World Health Organisation unlike some countries
which have given very low figures whereas it was known
they have very high level of AIDS cases.

Report of 700,000 With AIDS Virus

EA1710134091 Nairobi KTN Television in English
0500 GMT 17 Oct 91

[From the press review]

[Text] The attention of MPs was drawn to the staggering
figure of 700,000 Kenyans carrying the AIDS virus by an
assistant minister for information and broadcasting,
Shariff Nassir, in the house yesterday. The DAILY
NATION has the story on its front page. It is also carried
by the KENYA TIMES and the STANDARD.

MOZAMBIQUE

Data Show AIDS Increasing Among Women

91WE0513B Maputo NOTICIAS in Portuguese
3 Aug 91 p4

[Excerpt] [Passage omitted] The most recent epidemio-
logical data, released this week, indicate that HIV infec-
tion is increasing alarmingly among women. According
to the data, the ratio of infection among men and women
is currently three to one.

SUB-SAHARAN AFRICA 3

Although both sexes are exposed to infection in the same
way, the phenomenon which is being observed now may
be explained by the fact that there are more females than
males in the Mozambican population. However, because
the phenomenon is new, it merits research to determine
the reasons for it; it is understood that only some of them
are socio- biological [or demographic] in nature, because
the ratio of men to women [in the general population] is
approximately 1:1.2.

Studies conducted in sub-Saharan Africa indicate that
many women of child-bearing age are HIV-positive. For
this reason, perinatal transmission or transmission from
the mother to the child during pregnancy or immediately
after birth is becoming an alarming problem because of
the growing number of cases.

Manica AIDS Program: ‘Satisfactory’ Results

91WE0513A Maputo NOTICIAS in Portuguese
3 Aug 91 p 4

[Text] Manica Province, which is second only to Maputo
City in the number of AIDS cases it has diagnosed, is
considered a model for the other provinces.

With 52 cases of AIDS, Manica is sending an average of
five blood samples a month to the National Referral
Laboratory. Most of these samples are positive in the
EISSA [as received] tests. Ten AIDS cases a month are
diagnosed in the country, most of which are in Maputo
and Manica cities.

The other provinces where the epidemiological surveil-
lance is functioning satisfactorily are Maputo and Tete,
which have 31 and 18 cases, respectively.

To carry out its information and community education
activities, Manica Province has two theatrical groups,
consisting of students at the Teacher Training Center
and members of the Red Cross. These groups are not
only performing in Chimoio City but also in such neigh-
boring districts as Gondola, Manica, and Sussundenga.

It is predicted that by December the groups will have
presented 10 plays, all dealing with the topic of health
and also about how to avoid some diseases, such as
sexually transmitted diseases and HIV infection.

For some time, the AIDS program in this region has been
financed by the Redd Barna organization, which has not
only provided financial support but also support in
aspects of the training of activists to work with specific
population groups, such as displaced people, students,
and the military, among others.

In addition to the two training courses conducted in June
and July, the province is also organizing other courses
for the next three months.

Manica Province has won the attention of the National
Program for AIDS Combat because of its proximity to
Zimbabwe, one of the African countries in the region
with a high incidence of HIV-positive inhabitants.



JPRS-TEP-91-023
12 November 1991

In addition, 79 others died of tuberculosis during the
first half of this year.

A report released by the Bulawayo City Council’s
director of health services, Dr. Barnett Nyathi, said the
figure of 125 was an underestimate because many other
AIDS-related deaths were not recorded.

Out of the 125, 71 were males while 54 were females.
The highest number of AIDS-related deaths occurred
among children under the age of four, followed by the 20
to 29 age group. Ten of the dead were over 50 years old.

The report said between January and June, 46,134
people were treated for sexually transmitted diseases,
[STD] and out of that number, 32,989 were men.

An additional 6,761 women suffered from a pelvic
inflammatory disease, which is a complication resulting
from untreated STD.

Official Says Men Seeking Virgins To Avoid
AIDS

MB2710133691 Johannesburg SUNDAY TIMES
in English 27 Oct 91 p 15

[Report by Dawn Barkhuizen: “Where a Condom Comes
With Your Pay Packet”]

[Text] The men of Zimbabwe are seeking out virgins for
their sexual encounters. In a country where AIDS is
rampant and where everyone has a relative, friend or
employee with the disease, promiscuous men are looking
for young, “clean” women for sex.

This is the finding of Dr. Sunanda Ray, an executive
member of the Women and AIDS Support Network of
Zimbabwe.

As a result, there has been an increase in the number of
girls from younger age groups who are sexually molested
and abused, a Harare-based paediatrician said. This has
pushed up the incidents of AIDS at schools.

The disease, having permeated Zimbabwe from trucking
routes of the north, is now reaching critical levels.

It has reached across the colour divide and into every
level of society—even affecting high-ranking govern-
ment officials.

For those in the medical profession, AIDS is part of daily
life. Not only do doctors and counsellors deal with AIDS
at work every day, but almost all say they have lost
relatives and friends from their own circles.

By early 1991, 7,441 people were reported to have
full-blown AIDS—up from the 4,362 of 1991 [date as
published], says Dr. Evaristo Marowa, co-ordinator of
the National AIDS Control Programme. Between
500,000 and 700,000 are thought to be HIV-infected.

The World Health Organisation [WHO] believes this
figures represents only 25 percent of the true number.

SUB-SAHARAN AFRICA 19

Mr. Richard Hore, executive director of Zimbabwe's
biggest medical aid society, Cimus, said this was borne
out by the fact that few of the people referred for blood
tests reported to the pathology laboratories to be tested.

Over the past three weeks, one practioner reported, only
eight of the 52 people referred to a laboratory had
bothered to turn up for their tests. AIDS has become the
biggest killer of children in Zimbabwe. A local paedia-
trician said 70 percent of all children dying in Zimba-
bwe’s hospitals were suffering from AIDS-related dis-
eases.

Zimbabwe’s Minister of Health, Dr. Timothy Stamps, is
on record as saying that the disease is “truly a knife at the
heart of the nation” and had killed 30 percent of Zim-
babwe’s children before they reached the age of five.

A paediatrician said: “When a mother brings in a sick
child, I frequently find the entire family is riddled with
AIDS.”

Dr. Marowa said diseases like shingles, usually occurring
in the elderly, were beginning to manifest themselves in
younger people. TB had increased by 39 percent within a
year—between 50 to 70 percent of TB patients were
found to have AIDS.

Ina bid to combat the disease, the Ministry of Health has
embarked on a massive AIDS education programme.
Officials travel the countryside giving lectures and
handing out condoms (more than 15-million last year).

While Dr. Marowa believes the general level of aware-
ness has risen to more than 85 percent, he does not
expect behaviour patterns to change overnight.

Sister Noreen, a Catholic sister working with AIDS
victims, said Zimbabwe was still in the “denial stage”.

People were not sufficiently educated, said Father Chad
Gandiya, chairman of the AIDS Counselling Trust.
Condoms were frequently found strewn across the coun-
tryside and small children used them as balloons, he
said.

A recent survey among prostitutes revealed that, while
aware of the dangers of AIDS, the women did not use
condoms because their clients resisted the idea. Desper-
ately poor, many of the street women said they had no
alternative means of supporting themselves.

More frightening, however, than the number of people
already suffering from AIDS is the number that doctors
and scientists predict will be infected within the decade.

WHO projects a rapid increase in AIDS in the early
1990s. The standard United States Impact Model esti-
mates that more than 1.7 million people—20 percent of
the population—will be HIV- positive by the year 2000.
Of this number, about half would develop full blown
AIDS within 10 years, perhaps all within 20 years, Dr.
Marowa said.



JPRS-TEP-9 1-023
12 NOVEMBER 1991

Foreign
Broadcast

Information
Service

ANNIVERSARY
1941 ~ 1991

PRS Report—

Epidemiology

AIDS

49990506 026, smccnusr sea
Eiieeemene

REPRODUCED BY
U.S. DEPARTMENT OF COMMERCE
NATIONAL TECHNICAL
INFORMATION SERVICE
SPRINGFIELD, VA 22161 .)



a NEAR EAST & SOUTH ASIA

assess the hazards posed by the AIDS-causing HIV-2
viral strain, recently discovered on the national health
scene.

The visit is part of a stocktaking mission that will take
the team to major towns with significant concentrations
of HIV-infection cases. The objective is to assist the
health authorities in devising an effective response to the
emergent HIV-2 strain.

The manifestation of the HIV-2 virus, long believed to
be confined to West Africa, has caught Indian AIDS
researcher off guard, especially as the current anti-AIDS
campaign is geared exclusively towards combating the
HIV-1 strain, hitherto the chief cause of the AIDS in
India.

Screening procedures adopted by surveillance centers
and blood banks throughout the country are not
designed to detect the HIV-2 strain in blood samples.

According to Dr. A.M. Mehta, assistance director of
health services (Bombay), between 25 and 30 blood
samples from persons with high risk behavior in the city,
showed an initial reactivity to HIV-2 tests, but con-
firmed positivity for HIV-2 was reported in just two
cases.

These figures admittedly do no reflect the true picture of
HIV-2 prevalence. There is no adequate diagnostic kit
for HIV-2 testing. Some kit has been made available to
referral centers like the national Institute of Virology,
Pune, and the Institute of Immuno-Hematology, Bom-
bay.

More than eight months have elapsed since two city
researchers made the startling revelation that HIV-2
antibodies were found in the blood samples of two
patients. Studies conducted by a German research Dr.
Helga Rubsamen-Waigmann at the University of Frank-
furt in collaboration with city experts have since helped
shed more light on the prevalence of HIV-2 in the city.

Out of the 193 blood samples drawn from suspected
carriers in the city for the purpose of the study, nine
proved positive for HIV-2, while 29 sera were positive
for both HIV-1 and HIV-2. Another 62 samples indi-
cated HIV-1 antibodies. Dr. Rubsamen-Waigmann’s
findings were presented at the recently concluded inter-
national conference on AIDS held at Florence in Italy.

One grim conclusion drawn from the study is that, unless
screening procedures are supplemented with HIV-2 spe-
cific kit, persons from high risk groups testing negative
for HIV-1 can potentially be HIV-2 carriers and yet be
unaware of this fact.

Some city researchers are critical of what they describe as
the government’s sluggish response to the menace on the
AIDS front. The Indian Health Organization (IHO) has
decried the lack of HIV-2 testing kit which, it asserts,
should have now been made available to all surveillance
centers and blood banks.

JPRS-TEP-91-023
12 November 1991

Even more disconcerting is IHO’s claim that the Union
health authorities had been alerted, in 1989, about the
outbreak of HIV-2 infection in India, but chose to do
nothing about it.

According to the IHO honorary secretary, Dr. LS.
Gilada, the prominent French researcher, Prof. Luc
Montagnier who co-discovered the AIDS virus, had
warned Indian health officials that screening for both
HIV-1 and HIV-2 was urgently needed in view of the
discovery of HIV-2 antibodies in some Indian sera. Dr.
Gilada says Prof. Montagnier reiterated this claim when
he met him in Paris on June 21.

The IHO has, for some time now, been campaigning for
HIV-2 screening of high risk groups in tandem with
HIV-1 testing. The organization had raised the issue
about the HIV-2 outbreak at the Zambia conference on
sexually transmitted diseases held in March, and also
with WHO officials.

Health officials however maintain that HIV-2 positive
cases first came to government’s attention only about a
year ago. According to Dr. Mehta, samples analyzed for
HIV-2 antibodies have not been comprehensive enough
yet to indicate a significant prevalence of this viral
strain.

The supply of test kits for HIV-2 screening, he asserts
can only be arranged once a pilot study to determine the
prevalence pattern of the deadly virus is conducted.

This view is also echoed by Dr. S.V. Apte, officer-
in-charge at the Institute of Immuno-Hematology, who
points out that large-scale screening for HIV-2 can only
be facilitated once a rational and scientific basis is
established for launching such an expensive venture.
With HIV-1 as the predominant causative factor for
AIDS in the country today, it is inevitable that emphasis
is being given to HIV-1 screening, he notes.

HIV-2 antibodies were first discovered in sera analyzed
at the institute, in April this year, according to Dr. Apte.

Meanwhile, it is learnt that WHO’s global programme on
AIDS is putting together a combined test kit for HIV-1
and HIV-2 screening, to be made eventually available to
all countries reporting a high incidence of both viral
strains. Dr. N.K. Shah of WHO’s regional office recently
informed IHO that the dual test kits would be supplied
to India next year.

According to WHO studies, HIV-2 is still largely con-
fined to sub-Saharan Africa, but HIV-2 infected persons
have been sporadically identified in other parts of the
world, mainly in people who have originated from West
Africa or have had sexual contacts with West Africans.

HIV-2 is transmitted in much the same way as HIV-1.
However, the period between infection and the onset of
AIDS is longer for HIV-2.


6 SUB-SAHARAN AFRICA

valuable work in informing and educating the inhabit-
ants concerning AIDS and STD’s in general.

Working hand in hand with Ministry of Health workers
in a cooperative effort, the Mozambique Red Cross has
unreservedly joined the battle against AIDS with the
ever-renewed hope that it will be possible to check the
spread of that disease.

The Maputo areas included in the STD/AIDS Program
are the following: Matola; Liberdade; Fomento;
Machava; the Green Belt; Zimpeto; Jorge Dimitrov and
Malhazine; Hulene; Laulane; Airport, Urbanization, and
Maxaquene A, B, C, and D; Luis Cabral; and Catembe.

Swedish Red Cross Says Manica Could Have
1,000 AIDS Cases

MB0709131291 Maputo Radio Mozambique Network
in Portuguese 1030 GMT 7 Sep 91

[Excerpt] The Swedish Red Cross, which supports the
Mozambique National Program for the Prevention and
Struggle Against AIDS, has disclosed that an average of
two people suffering from full blown AIDS turn up at the
Manica Provincial Hospital in Chimoio City every week.
The director of the Swedish Red Cross noted that the
situation is worrisome and added that Manica Province
may already have more than 1,000 positive AIDS cases.
The Mozambican health officials had only reported 60
affected people in Manica Province, including eight
cases detected between June and August of this year.
[passage omitted]

NIGERIA

President Launches Anti-AIDS Battle

92WE0019A Lagos THE GUARDIAN in English
24 Aug 91 p 24

[Article by Onajomo Orere, head, Health Desk: “Gov-
ernment Leads Anti-AIDS Battle with N20m”]

[Text] With a N20 million donation, the President
yesterday launched Nigeria’s anti-AIDS battle in Lagos.

States and local governments are, from next year, to
commit NI million and N500,000 each to fight the
monster, which has so far defied scientific solution.

Besides health, two other ministries—Information and
Education—are to join the battle.

Represented by Health Minister, Professor Olikoye Ran-
some-Kuti at the launching, the President directed the
Information Ministry to waive all air time cost in the
Propagation of educational materials on AIDS. The
Education Ministry is to ensure that AIDS is studied in
schools.

Of the 120,000 blood specimens screened so far, 728
were AIDS positive. Of the lot, 94 persons are down with
full-blown AIDS.

JPRS-TEP-91-023
12 November 1991

AIDS is transmitted principally through sexual contact
and blood transfusion, contaminated needles, circumci-
sion and from mother to fetus.

According to the President, over N4.5 million has been
spent on AIDS control. He is disturbed by the ominous
projection that by 1995, there may be as many as 69,000
AIDS patients in Nigeria.

The President said if the projection comes true, it would
exert “tremendous pressure on the existing health system
and strike terribly at our social, economic and political
life.”

President Babangida warned drug abusers and traf-
fickers to stop their trade because of the ease of spread of
the disease through those means.

Besides, he urged motorists to prevent accidents, as they
necessitate blood transfusion, promising that govern-
ment would do its best to ensure that all blood was tested
before use.

President Babangida directed all states, local govern-
ments and the Federal Capital Territory to initiate their
own chapters of the War Against AIDS by December.

The private sector and non-governmental organisations
are to support the anti-AIDS efforts.

President Babangida pleaded for care and love of AIDS
patients, assuring them of their rights and liberties.

Professor Ransome-Kuti had earlier reviewed the AIDS
programme, saying that international donors chipped in
$3.5 million (about N350 million). He broke the sad
news that AIDS had spread to the rural area. It hit urban
centres four years ago.

The popular view is that the N80 charged for AIDS
screening is high. The minister agreed, saying it had to be
borne until cheaper and effective screening kits were
produced.

A national blood bank and transfusion service, now in
the works, will be operational as soon as funds are
available.

To Professor Ransome-Kuti, it is difficult to change the
sexual behaviour of Nigerians. About 80 percent of
AIDS transmission is through sexual activities.

World Health Organisation (WHO) global programme
on AIDS director, Dr. M. H. Merson and several digni-
taries witnessed the launching.


SJPRS-TEP-91-023
12 November 1991

These are the basic reasons that many citizens do not
view the AIDS problem with the seriousness imposed by
the existence of the disease, until it appears.

When the first victim turns up in our home, in the home
ofa neighbor, a cousin or an aunt, an uncle or a brother,
then we believe in the existence of the disease.

We reiterate that it is already a fact for some families.
We have a goodly number of AIDS patients in some
hospital wards in the capital, and in another one or two
years we will have many more cases, so it is time for each
of us to ask ourselves how he is going to behave. If you
are in any doubt about your behavior, Change Your
Sexual Conduct Today. Have Only One Sex Partner And
Remain Faithful To That Partner.

We advise you to have only one sex partner because you
are risking your health if you go on having many sex
partners. We advise you to use protection in all casual
sex relations. Your health depends on it. It Is Up To You
To Make The Right Choice.

Red Cross Role in Combating AIDS Described

92WE0008A Maputo NOTICIAS in Portuguese 7 Sep
91p4

[Article by Dr. Joao Leopoldo da Costa, physician and
director of health of the City of Maputo]

[Text] Since 1986, when the first case of AIDS was
recorded in Mozambique, efforts have been made
throughout the country to prevent the spread of that
syndrome.

Preventing the spread of AIDS is a complex and delicate
task, even though the steps that individuals and the
community must take to achieve that objective are very
simple (in theory).

Because of that, participation by all organizations (gov-
ernmental and nongovernmental) is a necessary contri-
bution to the wide dissemination of information about
AIDS. The task is therefore one to be undertaken by
everyone and for everyone.

In that respect, the involvement of the Mozambique Red
Cross in educating people concerning ways to prevent
AIDS and in providing sex education has proven to be
effective because it permits greater coverage of the
provinces from the standpoint of making adequate infor-
mation available concerning the problem.

For that purpose, the Mozambique Red Cross began by
training 11 provincial coordinators who are now distrib-
uted among all of the country’s provinces, including the
City of Maputo.

Training of Fieldworkers

With the participation of those coordinators, training
seminars were held for fieldworkers in all the provinces,
the purpose being to promote education for the health of

SUB-SAHARAN AFRICA 5

the inhabitants, with special emphasis on STD's [sexu-
ally transmitted diseases] and AIDS.

Those fieldworkers were selected from among volunteers
from the main target group—that is, individuals between
the ages of 20 and 40 years.

Today, more than 200 Mozambique Red Cross field-
workers are scattered around the country.

In the City of Maputo, the Mozambique Red Cross, as
part of a joint effort with the City of Maputo Directorate
of Health and in close coordination with that agency,
participated in training fieldworkers for factories and
schools.

As a priority, the activities to be carried out by that
group of mass education workers center mainly on their
workplaces, but they have also been trained to take
advantage of every opportunity that arises—on the
street, in stores, in public transportation, in the market,
in conversations with native healers, and so on—to
spread information about AIDS and how to prevent it.

War Refugees

Because of the chronic situation of warfare which the
country has been experiencing, the city of Maputo has
become the preferred place of residence for many war
refugees from neighboring provinces.

The forced change of residence and of economic activity
to which refugees are subjected, made worse by the lack
of housing and of material and financial resources for
satisfying their minimum needs, makes that population
quite vulnerable to social conduct that increases the risk
of its catching AIDS.

As a result, special attention has been paid to the war
refugee groups. Brigades from the Mozambique Red
Cross have been assisting in the refugee camps, espe-
cially the one on Inhaca Island.

Given that a large number of the war refugees living in
the city do not live in large compact groups but are
scattered throughout the city’s various neighborhoods, it
was necessary to hold seminars to train a total of 34
fieldworkers who are now providing assistance in the
areas of Catembe, George Dimitrov, Hulene, Zimpeto,
the Green Belt, and Machava.

During the first quarter of 1991, the Mozambique Red
Cross trained 28 fieldworkers for the areas of Inhaca,
Chali, Chamissava, and Guachene. A total of 34 field-
work sessions (discussions) involving thousands of par-
ticipants took place during that period.

The most common educational method besides discus-
sion has involved the use of puppet theater or comic
strips. Plays and songs have also been a common means
of getting the message out.

By the use of simple but appropriate techniques, the
fieldworkers of the Mozambique Red Cross have done



Education on AIDS Urged
91WE0519D New Delhi PATRIOT in English 2 Aug 91
p4

[Text] A high powered team at the All India Institute of
Medical Sciences has admitted that this apex referral
centre is indeed inadequately equipped to deal with the
prevention and cure of the pestilence of Acquired
Immune Deficiency Syndrome (AIDS). This is
depressing for many who had looked upon the AIIMS
[All Indian Institute of Medical Science] as perhaps the
only centre which could promise hope to patients who
had tested positive for the human immuno deficiency
virus (HIV). Recent reports about a pregnant woman
who was denied medical assistance at the AIIMS have
come as a rude shock and have certainly lowered the
prestige of the medical community. The woman patient
was refused medical assistance by the gynaecology
department on the ground that the special isolation
facility of the AIDS unit did not have fool-proof arrange-
ments, The squabbling led to the exposure of further
unedifying details—the AIDS unit claimed that it was
one of the best in the country and the doctors of the
gynaecology department simply failed to perform their
duties, leading to immense mental and physical stress for
the ill-fated patient. An outside doctor was summoned.
for this patient, something unprecedented in the history
of this hospital. The good news was that a healthy and
normal child was born to the mother. The unfortunate
event had only reaffirmed the fright attached to this
disease to the extent that even doctors are scared to
function as doctors. Moreover, the health authorities
appear to be inadequately prepared to meet the problems
the disease may create. Caught unaware, they choose to
put their efforts on defending the indefensible, as it
happened in the case of the children who were infected
by contaminated syringes through blood transfusion at
the NDMC hospital in March this year, in Delhi. The
children were suffering from thelassemia, which requires
frequent blood transfusion. To compound their tragedy,
for several days the medical personnel and para-medical
staff refused to cooperate, due to the imaginary fears
associated with the disease. Innumerable programmes
have been formulated by health authorities. But mass
ignorance and the absence of trained staff and adequate
equipment persist. AIDS was a sporadic phenomenon
until a few years ago and there was no government
support given to private initiatives of some committed
doctors and social workers. The information and treat-
ment of the disease was restricted to the few who could
afford the expense of treatment. The resolve to tackle
AIDS on a war-footing is dying out. Over the years the
number of AIDS cases has risen sharply, many victims
are infected through blood transfusion. There are still
hundreds of such patients whose cases have not even
been documented in hospitals or surveillance centres.
For instance, among prostitutes in Bombay less than one
percent tested positive for HIV in 1987; three years later
the number of infected victims rose to 20 percent.
Hence, it becomes really necessary that the government

NEAR EAST & SOUTH ASIA

SJPRS-TEP-91-023
12 November 1991

and the medical establishment should launch an inten-
sive campaign to educate the people about the preven-
tion and control of AIDS.

Continuing Fight Against AIDS

Bombay Workshop Discussion

91WE0553 Bombay THE TIMES OF INDIA
in English 27 Aug 91 p 3

[Text] Bombay, 26 August—By the year 2000, 25 per-
cent of the HIV (Human Immunodeficiency Virus) cases
in the world will be from India, cautioned Dr. Ian
Campbell, medical advisor to the Salvation Army, at a
workshop on “Integrated Management of AIDS” here
today.

Dr. Campbell and his team are here in India to focus on
measures to be taken to combat the AIDS problem here,
which might not be evident right now.

He stressed that an element missing in AIDS prevention
programmes all over the world was its influence on
communities as a hole. “The effect of HIV is not only on
the physical, but other major aspects of life like relation-
ships, spirituality and identity,” he said.

Especially in the light of estimations that by 2000 A.D.
85 percent of HIV infections will be through hetero-
sexual transmissions. “It is going to be a part of our
normal lives, concerning ”us‘* and we must understand
that right now instead of dismissing it as ’someone else’s
problem,“ warned Dr. Campbell.

The Salvation Army has done much work at the Chi-
kankata hospital in Zambia, using team-work and home-
based care as their main tool to combat AIDS, via
counselling.

“We worked as a team with the community, who ulti-
mately have to make the vital decision to change and
stop the spread of HIV” informed Ms. Margaret
Melama, health educator at the Chikankata hospital.

Prevention of AIDS cannot be achieved merely through
technology, but needed to be linked to caring. This
would be the key fundamental approach, said Dr. Cam-
pbell.

A sense of normalcy was essential when dealing with the
subject and sharing it with communities and patients
themselves.

Hospitals could not be considered the ultimate solution
since it was the people, living outside the hospital walls
who were in need of attention.

Dr. T. Mahr, speaking on the Salvation Army and AIDS
in India, said that the first entry point of his team into
the AIDS prevention programme would be via their
counselling centre at Mizoram, where AIDS has posed a
serious problem and where the team is headed.


26 EAST ASIA

The Interior and Public Health Ministries were allotted
respectively 2.55 million and 2.32 million dollars.

The Population and Community Development Associa-
tion (PDA), an independent non-governmental organi-
zation, estimates that there could be up to 300,000
carriers of the virus that causes AIDS in Thailand.

Michai has said about six million Thais could have
full-blown AIDS by the year 2000.

Prostitutes rank first among AIDS-carriers, followed by
intravenous drug users, he said. The PDA study esti-
mates that between 45 and 55 percent of the country’s
estimated 200,000 prostitutes carry the virus.

Thai-U.S. Talks Underway on AIDS Vaccine
Tests

BK2709021591 Bangkok THE NATION in English
27 Sep 91 pp Al, A3

[Text] US and Thai army officials are discussing a
Protocol for possible testing of a “promising” anti-AIDS
vaccine with HIV- infected Thai Army regulars volun-
tarily participating, informed sources told THE
NATION yesterday.

US and Thai army sources said the vaccine being devel-
oped, GP 160, had already been tested on hundreds of
US Army personnel at the Walter Reed Army Medical
Centre and that the tests had produced “satisfactory
results”.

But the sources said the protocol had yet to be finalize
and forwarded to the Thai Army leadership for endorse-
ment before the project could get off the ground.

It is now only in the formulation stage. The project
would have to pass an evaluation by the Thai Army
Medical Department and the Human Use Committee
consisting of medical science experts, social workers and
other scientists which would consider whether this vac-
cine should be used on Thai citizens,“ one source said.

He said the project would also have to win support from
Army Commander in Chief Gen. Suchinda Khraphra-
yun, who will assume the top Supreme Command post
next month, for final approval.

The whole process would take months and, if approved,
the project might get under way in the first half of next
year, he added.

This type of medical test is called “postinfection vacci-
nation” which, according to results of initial tests pub-
lished in the July edition of THE NEW ENGLAND
JOURNAL OF MEDICINE, could lead to development
of a vaccine to boost the immunity of AIDS patients. If
proven clinically successful, the new approach could also
help define a protective immune response relevant to the
prophylactic use of vaccines, according to the article.

About 30 infected persons, including possibly some
civilians, would be recuited on a voluntary basis for the

JPRS-TEP-91-023
12 November 1991

first phase of testing if the project won endorsement
from the Thai military leadership, the sources said.

“We plan to target persons who are desperate in their
fight against the fatal disease,” one informed source
close to the on- going discussions said.

“Those to participate in the project must sign documents
showing that they indeed are doing it of their free will,
that they can pull out of the testing at any time they
want, and that they will be given extensive medical care
afterwards,” he said.

The source said the US Army offered Thailand last
December a substantial aid package, including millions
of baht worth of special medical equipment, if Thailand
agreed to join hands with the US Army.

An indirect benefit would be enhancement of Thai
medical technology on AIDS treatment and prevention
and genetic engineering.

The Thai side is negotiating for Thai volunteers to
receive the same non-monetary benefits which the US
Army granted its personnel who took part in the test.

He added that if the vaccine, now being tested at the US
Army’s Walter Reed Army Medical Center, was proven
effective and became commercially available, Thailand
would be able to buy the vaccine below the market price.

“Testing the vaccine on Thais would also held prove
whether it would work on the Thai population as a
whole, since they have a slightly different strain of AIDS
virus than that found in America. Plans are being down
up to send the AIDS virus found in Thai patients to the
United States for the production of a vaccine that would
best suit the Thai people,” he said, adding that this
process would take about two years.

According to AIDS experts, GP 160 is prepared by
breaking down the HIV virus, then through genetic
engineering transforming it into a harmless virus found
in insects. The virus would then be injected into a human
body to stimulate anti-bodies to protect against the HIV
virus while not actually causing the disease.

They added, however, that vaccinated persons would
test positive for AIDS on normal medical equipment
used at hospitals even though they did not have the HIV
virus.

A well-informed Thai sources said that if the Royal Thai
Army turned down the US proposal, the AIDS Centre at
‘Chulalongkorn Hospital would be ready to enter into an
agreement with the US side to launch the experimental
project in Thailand.

The US Embassy in Bangkok yesterday confirmed that
discussions between US and Thai officials about possible
testing of HIV vaccines in Thailand were under way.

“These discussions, which began early this year, were
motivated by Thai and US concerns about the spread of


JPRS-TEP-91-023
12 November 1991

Since the prevalence of HIV-2 infection is low in parts of
the world other than West Africa, most countries, it is
learnt, have decided not to test blood routinely for
HIV-2 antibodies.

Rao Calls for Action

92WE0032F Bombay THE TIMES OF INDIA
in English 11 Sep 91 p 12

[Text] New Delhi, Sep 10—Concerned about the spread
of the dreaded Acquired Immuno Deficiency Syndrome
(AIDS) in the country, the Prime Minister, Mr. P.V.
Narasimha Rao, has directed the health ministry to
prepare a foolproof action programme whereby a close
tab can be kept on the target groups.

Convening a meeting here of health ministry officials
and representatives of non-governmental organizations,
(NGOs), Mr. Rao underlined the need for “preparing a
plan” so that AIDS did not assume alarming proportions
in the country.

He assured that once the blue-print for a multi-pronged
action to contain the spread of AIDS was ready, the
government would make sure that the necessary
resources were made available. “I will ask the planning
commission to provide the necessary outlay for imple-
menting the action plan,” the Prime Minister added.

Mr. Rao recalled that four years ago when there was a
proposal to launch a campaign to create awareness about
AIDS, there was wide-spread criticism saying that the
effort would be wasted as AIDS was not prevalent in the
country and, on the contrary, the government should
concentrate on tackling other tropical diseases.

The Prime Minister was given a presentation on AIDS
and informed that while there were no exact figures, 95
full-blown cases had been reported. According to the
estimates of the World Health Organization, there were
anywhere between 100,000 to 250,000 HIV-positive
cases in India. What was alarming was the fact that in
south and south-east Asia alone, there could be one
million HIV-positive cases.

Mr. Rao was also told that there was a bill in this regard
which had been shelved and it was time to give serious
thought to passing it.

It was pointed out that surveillance of AIDS was first
started in the country in 1985. Prevalence of the disease
was first reported in 1966 and the first full-blown case of
AIDS was detected the next year.

Thereafter, the government activated its machinery and
now has a process of screening people suspected to be
carrying the disease. One million people have been
screened and the number of HIV-positive cases reported
so far were 5,632. The doctors admitted that these
figures by themselves need not reflect the magnitude of
the problem.

NEAR EAST & SOUTH ASIA 4B

The areas affected by AIDS were Tamil Nadu and
Pondicherry which accounted for 26 percent of the cases,
Maharashtra which topped the list with 33 percent
followed by Manipur and Nagaland with 24 percent
each. The capital had an incidence of eight percent.

The government was establishing surveillance centers
and also testing the blood before transfusions. Already
35 testing centers had been set up to screen blood.
Simultaneously, a close watch was being kept on the
target groups or carriers of AIDS, namely, blood donors,
prostitutes and drug addicts.

IRAN

Status of AIDS Detailed

91AS1388Z Tehran JAHAN-E ESLAM in Persian
3 Aug 91 p2

[Text] The world of advanced science is still incapable of
curing AIDS.

As the advanced Western nations strive for greater
scientific success in various areas, AIDS is still the most
deadly and painful disease, seriously threatening the
health of the people of America and Europe. Every day it
takes many victims, to the point that the very word
AIDS signifies a painful death to those afflicted.

One of the primary factors in the transfer of the AIDS
virus is sexual contact between a healthy person and a
person afflicted with this disease. For this reason, coun-
tries having no ethical or sexual standards are acutely
confronted with this problem.

“In any case, the spread of this disease in the Islamic

nations, who are better protected against the AIDS

~ problem because of their religious culture, is worrisome.

In Iran at first there was only one AIDS victim in 1366
[31 March 1987 - 20 March 1988], then two in 1367 [31
March 1988 - 20 March 1989], seven in 1368 [31 March
1989 - 20 March 1990], then 16 in 1369 [31 March 1990
- 20 March 1991], and in the first three months of 1370
alone [21 March - 21 June 1991] the number of AIDS
victims has reached 851, and these figures in themselves
show more than ever the necessity of taking the neces-
sary measures to prevent the spread of AIDS in Iran.

Last Tuesday at a press conference Dr. Bizhan
Sadrizadeh discussed the current status of AIDS in Iran.
He said: The Ministry of Health Care, Treatment and.
Medical Education has prepared a program for pre-
venting the spread of AIDS in Iran and presented it to
the Council of Ministers. If it is approved, foreign
citizens afflicted with AIDS will be prevented from
entering Iran.

Based on this program, foreign citizens who plan to stay
in Iran more than three months must undergo a medical
examination, and if they are certified free of the disease
they may stay in Iran, otherwise they will be prevented
from coming into the country.



JPRS-TEP-91-023
12 November 1991

who comes from a family of philantrophists, immedi-
ately pledged financial help.

DOH sources said Mrs. Zobel would initiate a fund
campaign among her friends for AIDS victims.

Aware of the important role of the NGOs in the preven-
tion of AIDS, the DOH gave to four non-government
institutions five projects aimed at “testing strategies to
educate various target audiences in Metro Manila.”

The projects, which received a grant of P [Philippine
pesos) 560,000 each focus on high-risk groups, specifi-
cally male sex workers, overseas contract workers, and
men who have sex with men.

The P2.6-million grant was donated by the United States
Agency for International Development (USAID)
through its AIDSCOM Project.

Recipient NGOs of the grants were the Health Action
International (HAIN), led by Dr. Michael Tan; Institute
for Social Studies and Action (ISSA), under Dr. Florence
Tadiar; The Library Foundation (TLF), headed by Schu-
bert Caesar Austero; and Stop Trafficking of Pilipinos
Foundation, Inc. (STPFI) led by Dr. Minerva Laudico.

UN Body Warns of AIDS ‘Explosive Epidemic’ in
Asia-Pacific

HKO0710052391 Manila Far East Broadcasting
Company in Tagalog 0100 GMT 7 Oct 91

[Text] The Acquired Immune Deficiency Syndrome
[AIDS] continues to spread in the Asia-Pacific region.
According to the United Nations Economic and Social
Commission for Asia and the Pacific [ESCAP], the
incidence of AIDS in the region is worsening and could
turn into an explosive epidemic in the mid-1990s.
ESCAP said that the growing numbers of AIDS and drug
abuse cases will be the center of a health crisis in the
region. It was said that from just a handful in 1988, there
are now 500,000 AIDS virus victims. ESCAP holds its
fourth ministerial conference in the country from today
until 11 October.

SINGAPORE

Health Ministry—10 More Infected With AIDS
Virus

BK2709125691 Singapore THE STRAITS TIMES
in English 26 Sep 91 p 1

[Article by Yap Koon Hong]

[Excerpts] Ten more Singaporeans have been infected by
the AIDS virus in July and August bringing the total
number so far this year to 30, almost twice as many as
the 17 cases reported for the whole of last year.

EAST ASIA 25

The Health Ministry, which released the latest figures
yesterday, also said that five foreigners were found to
have the virus during this period and have been repatri-
ated.

While the ministry did not give a reason for the sharp
rise, it noted that all 10 Singaporeans, nine of whom
were men, contracted the disease through casual sexual
contact. [passage omitted]

The ministry’s permanent Secretary, Dr. Kwa Soon Bee,
who chaired the first of a regular series of the ministry’s
dialogues with the media during which the AIDS update
was given, said that the rise in AIDS cases was a cause for
concern.

He stressed the need for the public to take simple
precautions, saying that prevention was still the best
safeguard even though the ministry had all the necessary
precautions for public safety in place. [passage omitted]

In reiterating the safeguards for public safety, he said
that this included strict multiple screening checks against
AIDS contamination, especially in blood donation.

All blood donated is screened thoroughly he said, adding
that unscreened blood from donors is never used and
always kept separately from blood which has been
screened. No blood is released until it is checked by the
ministry, he said.

The latest figures bring the total number of those who
contracted the HIV virus, which is linked to the disease,
to 91. Of this, 32 have succumbed to the full disease and
21 among them with full-blown AIDS have died.

THAILAND

Twelve Million Dollars Allocated To Fight AIDS

BK0809020691 Hong Kong AFP in English 0850 GMT
7 Sep 91

[Text] Bangkok, Sept 7 (AFP)—Thailand has allocated
308.9 million baht (12.36 million dollars) to fight
Acquired Immune Deficiency Syndrome (AIDS) during
the 1992 fiscal year, the state- owned THAI NEWS
AGENCY (TNA) said Saturday.

The money will go to 14 government agencies for anti-
AIDS projects during the fiscal year from October 1,
TNA quoted Phichai Watsanasong, spokesman for the
National Legislative Assembly’s budget scrutiny com-
mittee, as saying.

The Prime Minister’s Office will get 100 million baht
(four million dollars) for a media campaign aimed at
raising public awareness of the disease, which kills its
victims by destroying the body’s immune system,
Bhichai said.

AIDS activist and minister attached to the Prime Min-
ister’s Office Michai Wirawaithaya will administer the
grant, he said.



2 SUB-SAHARAN AFRICA

only way at the moment which can make it possible to
halt the development of this disease.

Latest AIDS Statistics Made Public

B2510080091 Yaounde CRTV Radio Network
in French 1900 GMT 23 Oct 91

[Text] The latest statistics on the AIDS epidemic in
Cameroon were made public this morning. Six hundred
and fifty cases have been recorded with 177 deaths. That
is an increase of 221 new cases in the last four months.
These figures, recorded on 30 September, were officially
reported to the WHO by Health Minister Joseph Mbede.

As for seropositives, they are currently 1 percent of the
Cameroonian population, that is, over 110,000 carriers
of the mortal virus. This, unfortunately, makes room for
a large number of new AIDS cases in the coming days.

KENYA

Trans Zoia Hospital Finds 89 Positive for AIDS

91WE0538B Nairobi DAILY NATION in English
15 Aug 91 p3

[Article by NATION Correspondent: “89 Test Positive
for the AIDS Virus”)

[Text] Of 252 patients tested for HIV at the Trans Nzoia
District General Hospital between January and July this
year, 89 cases were found to be positive, an AIDS
seminar has been told.

The hospital’s Dr. Joseph Ngereka told the participants
that, in the same period, 21 blood donors tested HIV-
Positive in a total of 668 cases.

He said that in 1990, 39 people were confirmed to have
the virus.

He told people who may have had sexual relations with
suspected AIDS sufferers to go to the hospital for testing
and counselling.

Dr. Ngereka urged married couples to maintain high
moral standards to avoid contracting the killer disease.

He said that to curb the spread of the disease, people
needed to be enlightened on the dangers of contracting
AIDS.

Closing the two-day seminar, which was held at a Kitale
hotel, the local District Development Officer, Mr.
Andrew Kassam, blamed men for spreading the disease,
saying they should change their sexual habits.

He told the youth to take the disease seriously as some of
them “think it is just a myth.”

The seminar, whose theme was “To curb the spread of
AIDS,” was attended by more than 50 participants who
included chiefs, councillors and journalists.

JPRS-TEP-91-023
12 November 1991

Kitale Hospital Finds 110 Positive for AIDS

91WE0538C Nairobi THE KENYA TIMES in English
15 Aug 91 p4

[Article: “Positive AIDS Tests Shoot Up at Hospital”’]

[Excerpt] Over 110 patients and blood samples have
been tested positive for AIDS at Kitale Hospital this
year, a hospital official announced.

Only 65 tested positive at the hospital last year, he said.

The officer in charge of AIDS cases at the hospital, Dr.
Joseph Ngeresa, said the positive tests were drawn from
sexually transmitted diseases (STDs) patients and from
samples of donor blood.

Dr. Ngeresa said out of 252 patients who were treated at
the hospital for STDs between January and July this
year, 89 tested positive. Twenty-one out of 668 donor
blood samples tested positive.

The doctor said this when he addressed a two-day
seminar on AIDS which was attended by leaders from
Trans Nzoia District at a Kitale hotel.

He noted that the district had registered only 65 cases of
AIDS last year, saying that the number had tremen-
dously increased.

[Passage omitted]

Physician Reveals 663 AIDS Cases in Eastern
Province

£A1509153091 Nairobi Kenya Broadcasting
Corporation Network in English 0400 GMT 15 Sep 91

[Text] There are 663 reported AIDS cases in Eastern
Province, over 200 of them in Embu District. The
provincial physician at the Embu General Hospital, Dr.
Francis Kimani disclosed this when he addressed health
workers at an AIDS seminar in Embu town. Dr. Kimani
noted that through open discussion health workers will
succeed in turning the shock of the disease among
wananchi {citizens] into an organized war against it. He
also noted that AIDS patients, like any other patients,
should be cared for with love by family members and the
general public.

Medical Services Director Refutes AIDS Figures

£A1810114591 Nairobi KNA in English 1932 GMT
17 Oct 91

[Text] Nairobi, 17 Oct (KNA)}—The Director of Medical
Services (DMS) Professor Joseph Oliech said today that
present Acquired Immune Deficiency Syndrome (AIDS)
cumulative cases in Kenya stood at 19,000 while the
number of people with HIV infection was 200,000. Prof.
Oliech was reacting in a wake of an alarmist figure
published in one of the local dailies to the effect that
there were 700,000 cases of people infected with HIV.


16 SUB-SAHARAN AFRICA

Dr. Dlamini said projections of HIV/AIDS in Swaziland
using the assumption that only 10 percent cases are being
diagnosed, suggest that the current estimate of AIDS
patients could be in the region of 4,500 people.

“Assuming further that this constitutes only one third of
infected persons, there may be as many as 13,500 HIV
cases in the population.”

Dr. Dlamini told the meeting that according to available
data, the male/female ratio among adult AIDS cases is
one to one.

“Therefore, out of the 13,500 HIV-positives, half will be
women of child-bearing age. It is estimated that 30
percent of new borns to HIV-positive mothers eventually
also test positive.

“Considering the high fertility rate in the Kingdom,
morbidity and mortality due to HIV/AIDS will rapidly
increase amongst infants.

Dr. Dlamini said given the above picture for AIDS as
well as the rapid spread of sexually transmitted diseases
in a relatively small population of Swaziland, preventa-
tive efforts against AIDS must receive priority attention
and appropriate support both locally and internation-
ally.

Donor communities and other international and local
interested parties agreed to make funds available, some
making pledges for the medium-term plan for prevention
and control of AIDS in the country, which start in
January next year.

The two-day meeting was officially closed by the Min-
ister for Health, Dr. Fanny Friedman who expressed
government’s praises for those donor agencies which
have promised to donate money and those who made
pledges towards the start of the project.

Three Die of AIDS During Jul-Sep 1991

MB2310071391 Mbabane THE TIMES OF
SWAZILAND in English 23 Oct 91 pp 1, 24

[Report by Vusie Ginindza: “AIDS Kills Three More”]

[Text] Three more people have died from AIDS,
bringing to 20 the number of victims struck dead by the
disease since it broke out here.

Twenty three others are presently infected by the killer
scourge and await to die.

This is according to the latest report of the Swaziland
National AIDS prevention and control programme of
the Central Public Health Laboratory.

The report covers the period between July and Sep-
tember this year.

SJPRS-TEP-91-023
12 November 1991

It states that the total number of AIDS cases since the
beginning of the AIDS Prevention and Control Pro-
gramme as of September 30, 1991, is 71 of which 20 have
since died.

Within the period covered by the report a total of 236
people have tested HIV positive, from 2,074 samples.

Of the 2,074 samples tested, 1,220 were of blood donors,
32 of whom tested positive.

Health Ministry Alarmed at AIDS Rate Among
Young People

MB2510175491 Johannesburg Radio RSA in English
1500 GMT 25 Oct 91

[Text] Swaziland’s director of medical services, Dr. John
Mbambo, says Swaziland’s Health Ministry is concerned
about the increasing number of young people in the
country found to be infected with AIDS.

Dr. Mbambo said those infected included children
between the ages of 10 and 14. He said a new epidemi-
ology unit had been established in Swaziland to improve
the system of AIDS detection in the country so that the
magnitude of the disease could be assessed more realis-
tically.

Dr. Mbambo said the ministry is also alarmed at the
number of deaths being caused by infections, such as
tuberculosis, among the HIV sufferers.

TANZANIA

MP Calls for Action on Plague, AIDS

91WE0536B Dar es Salaam DAILY NEWS in English
30 Jul 91 p3

[Article: “Government Blamed Over Spread of Plague”]

[Excerpt] Debating the estimates last week MP for
Mlalo, Ndugu Charles Kagonji, complained that plague,
which was first reported in Lushoto District 11 years ago
had spread to more than 40 villages because the govern-
ment took no concrete action to fight the disease.

He told the House that the medical team brought to fight
the disease was confined to the affected villages having
the neighbourhood prone to effection.

The MP called for an intensive education campaign
against the disease to involve all villages bordering the
affected areas and adequate supply of drugs to arrest the
killer disease.

Ndugu Said Haji Chomeka (Uzini), explaining about
3,400 cases of Acquired Immune Deficiency Syndrome
(AIDS) had been diagnosed in the Mainland and nearly
300 others in Zanzibar, stressed preventive measures
against the virus, which was yet to get a vaccine.


SIPRS-TEP-91-023
12 November 1991

COSTA RICA

Official Statistics on AIDS Cases Released

PA2509184291 Hamburg DPA in Spanish 1920 GMT
22 Sept 91

[Text] San Jose , 24 September (DPA)—A total of 283
cases of Acquired Inmunodeficiency Syndrome (AIDS)
has been officially recorded in Costa Rica since the
disease was first detected in 1983.

According to official statistics, until August, and based
on the above mentioned total, 183 persons have died, 90
have survived, and the whereabouts of 10 persons are
unknown,

According to risk factors, 106 of the recorded cases were
homosexuals, 390 bisexuals, 27 hemophiliacs, other con-
tagions were caused by intravenous transfusions, perin-
atal infection, drugs, or by other factors.

It has been estimated that approximately 15,000 persons
in Costa Rica may be potential virus carriers.

CUBA

AIDS Sanatorium Opens in Matanzas Province

FL1209175391 Havana Tele Rebelde Network
in Spanish 1700 GMT 12 Sep 91

[Text] A sanatorium for AIDS patients in Matanzas
Province has opened this week with 20 patients from
that province. The total cost of the facility, including the
equipment and furniture, exceeded 550,000 pesos, and it
was finished in a little more than six months. The project
was built by a brigade from the Mario Munoz Monroy
Contingent, which is also in charge of building the
provincial hospital. The center for AIDS patients will
have 31 workers, including a staff doctor, five nurses,
and a dentist who will visit once a week. Each province
in Cuba will have a sanatorium of this kind, in great
contrast to highly developed countries, where the state
does not make budgetary allocations to help persons
affected by this disease.

HONDURAS

Health Ministry Reports Increase In AIDS Cases

PA2209153491 Mexico City NOTIMEX in Spanish
1720 GMT 20 Sep 91

[Text] Tegucigalpa, 20 Sep (NOTIMEX)—Honduran
Health Ministry confirmed today that the number of
Acquired Inmunodeficiency Syndrome (AIDS) patients
in Honduras had increased to 2,153, after 54 new cases
were detected during the month of August.

Enrique Zelaya, head of the Department of Epidemi-
ology stated to the local press that the confirmed cases

LATIN AMERICA 33

includes 492 women, 906 men, 48 minors less than 15
years old, 38 suspected cases, and 427 symptomatic
carriers.

In addition, there have been 444 deaths, 546 patients
still alive, and 408 persons whose whereabouts are
unknown, but who have been confirmed as infected and
are a potential danger to society.

According to the statistics from the Health Ministry, the
northern city of San Pedro Sula has reported 554 cases,
Tegucigalpa 178, Progreso 44, Comayagua 42, and Ceiba
39,

Epidemiologist Zelaya pointed out that 35 minors have
been infected by their mothers and that an AIDS
infected person can die immediately after contracting
cholera.

MEXICO

AIDS Seen Infecting at Least 250,000 by 1994

91WEOS59A Mexico City EXCELSIOR STATES
section in Spanish25 Aug 91 pp 1, 4

[Article by Eduardo Chimely]

[Text] Guadalajara—it is estimated that by 1994 this
country will have at least 250,000 people infected with
AIDS, Nuevo Leon University Epidemiologist Javier
Ramon Jimenez warned today.

During his participation in the Advances in Epidemi-
ology seminar, the specialist claimed that the number of
AIDS cases “‘is increasing faster, in a lesser amount of
time.” During the past decade, a range of diseases could
be treated in hospital epidemiology wards , but now the
“disease of the century” patients occupy every available
spot in those hospitals, he claimed.

The epidemic, he disclosed, continues to advance due to
factors such as the bisexuality of a large number of
husbands; drug addiction, which diminishes an individ-
ual’s psychological and moral defenses; and relations
with prostitutes.

According to Ramon Jimenez, AIDS is a predictable
disease because human behavior can prevent acquisition
of the virus.

He stated that the campaign for the use of condoms as a
protective measure does not address the root of the
problem, which involves educating people and warning
them that sexual promiscuity is incorrect.

In his opinion, campaigns should be educational, and
should be initiated gradually in the first years of elemen-
tary school, with simple issues, so as not to cause
anguish.

He also mentioned cholera, which has recently captured
a great deal of attention, and although the number of
those who die from this disease is definitely less than



34 LATIN AMERICA

those who die of AIDS, it has nevertheless resulted in a
30 and 40 percent decrease in the budget to combat
AIDS.

NICARAGUA

Health Ministry Issues Statistics on AIDS

PA2709212591 Managua Radio Sandino in Spanish
1218 GMT 27 Sep 91

[Text] On 26 September, one of the doctors in charge of
the Health Ministry program aimed at preventing the
spread of AIDS, reported that 17 people have died of
AIDS and 14 others are infected with the deadly virus in
the country. Health Ministry sources revealed that the
majority of the 14 people infected with the AIDS virus
are living in the capital and they were infected by people
who brought the virus from abroad. The Health Ministry
does not rule out the possibility that other people may
have been infected.

AIDS is once again returning to the media after EL
NUEVO DIARIO published a letter on 26 September
written by one of the 14 AIDS- infected persons, who
calls on another young woman to stop spreading the
disease among men by exercising her profession as a
prostitute.

PERU

Cases of AIDS Through June at 454

PY1010021291 Lima EXPRESO in Spanish 30 Sep 91
pA8

[Summary] According to statistics from the anti-AIDS
Program, a total of 454 AIDS cases were reported
through June, which means there are probably some
50,000 people infected with the AIDS virus who, in the
short or medium term, will develop the disease.

SJPRS-TEP-91-023
12 November 1991

ST. LUCIA

Of 31 Known AIDS Victims, 28 Dead

FL1110041691 Bridgetown CANA in English
2035 GMT 10 Oct 91

[Text] Castries, St. Lucia, Oct 10, CANA—The director
of the St. Lucia Bureau of Health Education, Edward
Emmanuel, has complained of a poor response from the
private sector to efforts aimed at curbing the spread of
the deadly AIDS disease. Emmanuel, speaking at the
launching of a Red Cross anti-AIDS programme, said the
response from non-governmental organisations was not
encouraging.

“The response from the non-governmental organisa-
tions, the community, private sector, and the churches
has been slow. The distribution of the AIDS virus is
islandwide, and the number of HIV (Human-Immuno
Deficiency) persons on record suggests that we in St.
Lucia still have a very good chance of controlling the
disease,” he said.

“The fight against AIDS is not a Ministry of Health fight
alone, but a battle which involves all sectors of society. It
has to be a collaborative effort...” he added.

Emmanuel said that the programme launched by the Red
Cross was timely in that “if the youth of this country is
not exposed to learning experiences that will cause them
to take the right action against AIDS, it will not be long
before many of our young people are infected.”

The Bureau of Health on Thursday said that the island
had so far recorded 31 cases of AIDS, 28 of whom had
already died. AIDS kills by destroying the body’s
immune system. There is no known cure.

URUGUAY

Over 800 AIDS Cases Registered Since 1983

PY1710151891 Madrid EFE in Spanish 1732 GMT
16 Oct 91

{Summary] Montevideo, 16 Oct (EFE)—A total of 803
AIDS carriers have been detected in Uruguay since
1983, of which 211 have developed the disease and 108
have died.


IJPRS-TEP-91-023
12 November 1991

types of infection-preventing measures, and this ought to
be integrated into the body of the law in a much clearer
way,” wrote the Rigshospital in its hearing statement.
Haukeland Hospital wrote that the law should stipulate
ina much ‘stronger way the responsibility of the hospital
in preventing hospital contagion, to the extent that it can
through hiring practices.

“We know that approximately 50,000 people every year
pick up infectious diseases in hospitals. American
studies show that a percentage of those afflicted die,” the
Radium Hospital stated in its hearing statement on the
new infection prevention law. AFTENPOSTEN has
learned that it will be nine months before the drafting of
the legislation is finished.

UNITED KINGDOM

Heterosexual AIDS Epidemic in Shires

92WE0016 London THE DAILY TELEGRAPH
in English 20 Sep 91 p 6

[Text] An epidemic of heterosexually-contracted AIDS
has begun in the shire counties, Oxford Regional Health
Authority said yesterday.

WEST EUROPE 49

It reported 549 HIV cases in the region covering Oxford-
shire, Buckinghamshire, Northhamptonshire and Berk-
shire, an increase of 71 over the previous year. This
included 64 people infected through heterosexual inter-
course—a “very concerning” development, said Dr
Richard Mayon-White, the region’s epidemiologist.

“There is no doubt the heterosexual epidemic has begun.
We are not talking about jet-setters and ... people who
live in council houses. This is across the board. It is
affecting anyone who is sexually active.”

The report, to be considered by authority members
today, shows that 135 people in the region have devel-
oped full-blown AIDS, 24 more than in the previous
year.

“It is not the result of promiscuity that is affecting people
outside the known high-risk groups of homosexual men
and drug-users,” said the doctor. “People are transmit-
ting the virus without knowing it.

“If people do not start heeding the messages about
having safe sex, this will pose a major threat to public
health. We are not saying people should abstain from
having sex. It just can’t be stressed too highly how
effective the use of a condom is in the reduction of the
transmission of HIV.”



2 CHINA

other venereal diseases—gonorrhea and syphilis—as
second grade infectious diseases.

In February, 1990, a national AIDS prevention and
control commission, and an expert committee, were
formed to guide the work and supervise the nation-wide
campaign against AIDS.

In South-west China’s Yunnan Province, where the
largest number of HIV positive persons has been identi-
fied, over 1.6 million yuan has been earmarked for AIDS
prevention programmes.

The campaign extends from the border areas to inland
cities, including Kunming, Dali, Baoshan and Lincang,
where anti-AIDS publicity programmes operate hand in
hand with the struggle against drug trafficking and
prostitution. The programme is extremely important
since most AIDS victims in China are drug addicts who
became infected when sharing needles to inject drugs.

The country has strengthened efforts to prevent other
venereal diseases which are regarded as a precondition
for the spread of AIDS. Informed sources say that the
incidence of venereal disease has increased dramatically
in many open cities over the past two years.

China now provides medical care programmes for those
who test HIV positive, and scientists have spared no
effort in the search for an AIDS cure. Their efforts have
resulted in a number of unique agents which are made
from traditional Chinese herbal medicines, and which
have proved to be effective in checking the development
of AIDS virus.

An official from the World Health Organization said
that China has an excellent country-town-village epi-
demic prevention system in rural areas, and that this
factor will be of great importance in curbing the spread
of the AIDS virus. In addition, the official said that such
activities will be of great benefit to mankind if the efforts
to combat AIDS are successful.

The Development of Enzyme-Linked
Immunosorbent Assay for the Detection of
Anti-Human Immunodeficient Virus Using
Synthetic Peptide Antigen and its Application
54004801B Shanghai ZHONGHUA CHUANRANBING
ZAZHI [CHINESE JOURNAL OF INFECTIOUS
DISEASES} in Chinese Vol 9 No 3 Aug 91 p 159

[Article by Zhou Wenda [0719 2429 6671], Cao Xikun
[92580 6932 09810], et al.]

[Abstract] An enzyme-linked immunosorbent assay
(ELISA) for the detection of anti-human immunodefi-
cient virus (anti-HIV) using synthetic peptides was
developed. Thirty-one anti-HIV positive sera were tested
with 5 synthetic peptides. The results showed that all of

IPRS-TEP-91-023
12 November 1991

31 positive sera reacted with peptide 1 (aa 584-609) and
30 of them reacted with peptide 2 (aa 604-618). None of
158 negative sera reacted with peptide 1 or 2. Peptide
antigens coated on microtiter plates were stable for 3
months at 4 degrees C. It is a simple, fast, highly specific
and sensitive method which is suitable for blood donor
screening and early diagnosis of HIV infected people.

Newspaper Says AIDS Sufferers ‘Ostracized From
Society’

HK3009092691 Hong Kong AFP in English 0838 GMT
30 Sep 91

[Text] Beijing, Sept 30 (AFP)—AIDS sufferers in China
are completely ostracized from society, denied proper
medical treatment in some areas and unable to find jobs,
a newspaper here said Monday.

The official HEALTH NEWS said that authorities in
Shanghai and in Guangdong province were trying to
devise ways to limit discrimination against carriers of
the deadly virus.

“The panic of the masses over AIDS and their discrim-
ination against carriers and sufferers is intensifying day
by day,” the paper said.

It said one man from nearby Hebei province, who
recently died in hospital here, was forced to come to the
Chinese capital for treatment after he caused panic in a
local hospital.

After being admitted, half the other patients moved out
for fear of contracting acquired immune deficiency syn-
drome (AIDS). Other local residents demanded that his
entire family be forced to leave the area.

In May, nurses at a hospital in Guangzhou, the capital of
Guangdong, refused to draw blood from a patient when
they were told he had the deadly disease.

In Zhejiang province, an AIDS carrier has been turned
away by all potential employers since he graduated from
university last year, while his parents have also run into
difficulties.

In other places, shops refused to take money from AIDS
carriers because of unfounded fears that the virus could
be passed on by touching the currency, the paper said.

The paper said the main reason for discrimination was
lack of knowledge about AIDS, which is usually passed
by sharing contaminated needles, exchanging bodily
fluids or blood transfusions.

Lack of adequate management of AIDS carriers was also
to blame, it said.

Latest figures show that China has nearly 500 known.
AIDS cases, with heroin addicts making up the bulk of
them.


IJPRS-TEP-91-023
12 November 1991 3 AIDS

JAPAN

Dainippon Discovers Material To Curb AIDS Virus /Tokyo KYODO, 19 Sep 91]
SOUTH KOREA

Number of AIDS Cases Reaches 158 {Seoul THE KOREA HERALD, 2 Oct 91] .....
MALAYSIA

Paper Reports on Death of 3 AIDS Victims Kuala Lumpur NEW STRAITS TIMES, 14 Sep 9] .. 23
Twenty-seven AIDS Victims Die; 1,365 Test HIV Positive
[Kuala Lumpur Radio Malaysia Network, 30 Sep 91]

NEW ZEALAND

Health Secretary Says Country Free of AIDS, HIV /Hong Kong AFP, 5 Oct 91]
PHILIPPINES

Government Conducts AIDS Education Campaign
[Danilo P. Lucas; Manila PHILIPPINES NEWSDAY, 26 Sep 91]
UN Body Warns of AIDS ‘Explosive Epidemic’ in Asia-Pacific

[Manila Far East Broadcasting Company, 7 Oct 91] 25
SINGAPORE
Health Ministry—10 More Infected With AIDS Virus
[Yap Koon Hong; Singapore THE STRAITS TIMES, 26 Sep 91] ....... 25

THAILAND

Twelve Million Dollars Allocated To Fight AIDS /Hong Kong AFP, 7 Sep 91]
Thai-U.S. Talks Underway on AIDS Vaccine Tests {Bangkok THE NATION, 27 Sep 91]
Minister Says U.S. AIDS Vaccine Test Needs Study /Bangkok THE NATION, 28 Sep 91]
Doctor on ‘Alarming’ AIDS Infection Rate in Songkhla /Bangkok THE NATION, 3 Oct 91]
Draft AIDS Law Dropped After Almost 3 Years’ Debate Bangkok THE NATION, 11 Oct 91]
Minister Urges Eradication of AIDS in G-24 Meeting

[Bangkok Radio Thailand Network, 12 Oct 91] . 28
Country To Become Testing Ground for AIDS Vaccine
[Anchali Worrachate; Hong Kong AFP, 15 Oct 91] ... 29
VIETNAM
AIDS Consulting Centers Set Up Nationwide /Hanoi VNA, 19 Sep 91] .... 29

EAST EUROPE
REGIONAL AFFAIRS
European AIDS Conference Opens in Prague [Prague CSTK, 22 Oct 91]
HUNGARY

Mandatory AIDS Testing Required for ‘High-Risk Groups’ /Budapest MTI, 16 Oct 91]
YUGOSLAVIA
Over 200 AIDS Cases Since 1985 Belgrade TANJUG Domestic Service, 10 Oct 91]



SJPRS-TEP-91-023
12 November 1991

might rise substantially as there are nearly 1,500 AIDS
positive cases that have already been identified. The
National Institute of Cholera and Enteric Diseases
[NICED] based in Calcutta, a body affiliated to the
Indian Council for Medical Research, has been helping
the Health department in Manipur to identify the cases
and suggest remedial measures. Dr. S. Pal, NICED
director, said in Calcutta on Wednesday that the “dis-
ease was fast manifesting itself and the death toll was
likely to go up because AIDS antibody has already been
found in 1,500 addicts”.

There are nearly 15,000 drug-addicts in Manipur who
are in the habit of injecting a solution of brown sugar in
their body thrice or four times a day. Of them, nearly 50
percent or 7,500 are suspected to have received the AIDS
virus. Till now, Eliza and Western Blot tests have traced
the AIDS antibody in 1,500 addicts. The presence of
AIDS antibody does not necessarily mean that the
person is carrying the virus. But past experience has
shown that nearly 50 percent of the people who have the
AIDS antibody later suffer from the full-blown disease.
It often takes years for the fatal ailment to surface.

Dr. Pal said quite a few among those who have died
showed signs of tuberculosis as was customary among
AIDS victims in Third World countries. In the devel-
oped worlds, AIDS patients often had outward symp-
toms of diseases like pneumonia. He regretted that
efforts to detoxify addicts or to ensure that they give up
their addiction had not yielded much result as yet. Most
addicts were still adhering to the unhygienic practices
like injecting the heroin solution into their blood-stream
with homemade syringes that were basically ink-
droppers with needles, which were not sterilized,
attached to them. Boiled water was never used for the
solution by the addicts which made them even more
susceptible to diseases.

Several international organizations have sympathized
with victims of the Manipur tragedy. The World Bank,
World Health Organization and the UNDP have
expressed concerned and are interested in funding
schemes to ameliorate the condition in which the AIDS-
infected addicts find themselves.

Campaign in Tamil Nadu

92WE0032D Madras INDIAN EXPRESS in English
4 Sep 91 p2

[Text] Madras, Sept 3—An intensified education cam-
paign, as part of WHO-assisted AIDS prevention pro-
gramme, will soon get under way in the State, with its
focus on measures to check the spread of AIDS.

The state government has received Rs 1.5 lakh as the
first installment of a total of Rs 15 lakh allotted this year
to Tamil Nadu under the programme that will end in
1995, Health Department special secretary C.K. Gariyali
said on Tuesday.

NEAR EAST & SOUTH ASIA 41

Target groups—students, workers, drivers, prostitutes
and other sections—will be educated on AIDS preven-
tion, for the first time the focus will be on explicit
prevention methods—such as the use of condoms. Offi-
cials are now gauging the manner in which they will
respond to such material, explained Dr. K.M. Rad-
hakrishnan, deputy director of Medical Education (plan-
ning and development).

In an interactive session with media persons, he said the
state could lose to time in launching such a campaign.
About 1000 HIV-positive cases had been reported in the
state so far, apart from 11 full-blown AIDS case and 2
deaths, said MMC medicine professor Jayakar Paul.
Prostitutes constituted the largest high-risk group.

Of the 1.1 lakh blood samples tested at MMC, 738 had
been found positive by the preliminary ELIZA test and
467 by the confirmatory Western Blot test, said Venere-
ology Asst. Prof. K. Kantharaj.

Since many of these positive cases had been accounted
for by prostitutes from various parts of the state, it could
not be said that the AIDS threat was restricted to
Madras.

Under the WHO-assisted programme, AIDS-testing
facilities would be provided to all 608 blood banks in the
country in the government sector, according to WHO
AIDS consultant J.R. Shankaran. So far, only 118 had
been provided with such facilities. Many of the 410
registered private blood banks would also have to be
covered, though a system had been evolved for sending
their blood samples to the government hospital blood
banks equipped with this facility.

Apart from ensuring the safety of blood supplied by
banks, the programme will also strive to strengthen
surveillance, improve technical facilities available and
develop professional skills at various levels in the man-
agement of cases. Hospital infection-control measures
would also be tightened.

While surveillance is being stepped up with the distribu-
tion of AIDS testing kits, many districts which did not
have these facilities would be eventually covered.

Those who briefed news persons on various aspects of
the new campaign included Dr. P.K. Dharmalingam,
STD Professor, MMC, Dr. Sunderraman, a social
worker, and Dr. Sugavanam, Blood Bank Officer, Roy-
apettah Hospital.

Study on HIV-2

92WE0032E Bombay THE TIMES OF INDIA
in English 4 Sep 91 p 3

[Article by Conrad Prabhu]

[Text] Bombay, Sep 3—An expert team of the World
Health Organization (WHO) was in the city last week to



JPRS-TEP-91-023
12 November 1991

Deriding doctors and nurses in India for showing
“panic” when faced with an AIDS case, the chairperson
of the workshop, organised by the Indian Health Organ-
isation, Dr. R.D. Lele said. “It is stupid and illogical for
any member of the medical fraternity to deny treatment
to an AIDS patient.”

He said voluntary blood transfusions must be promoted
to prevent blood from professional blood donors (many
of the HIV positive) from being accepted by “unscrupu-
lous blood banks.”

Dr. LS. Gilada, honorary secretary of the I.H.O. [expan-
sion not given] noted that condom usage among prosti-
tutes had increased in the last eight months. IHO mobile
van used to distribute five condoms a day eight months
back, now, it hands out nearly 4,000 per day, he stated.

However, its actual usage could not [be] monitored
accurately. Sharing the problems a counsellor encoun-
tered in Bombay hospitals with patients and doctors
themselves, Ms. Chitra Subrahmanian, psychotherapist
working at the counselling centre at G.T. hospital,
pointed out that patients were not given a frank analysis
by doctors. “More often than once, I have been told by
patients that all they knew about their condition was that
they had bad blood,” said Mrs. Subrahmanian.

“This creates a fear psychosis, confusing them and not
helping them tackle the problem the right way. Some of
them don’t even know their blood has been tested.
Others never see the reports.”

Ms. Subrahmanian said this was a more frightening
situation since an individual was not given a chance to
decide if he wanted to go through the testing, which was
his fundamental right.

Moreover, those testing negative were never seen again,
despite the fact that they may require to undergo the
tests a few months later.

“When questioned, residents, who have been instructed
by doctors to counsel HIV positive patients, plead
shortage of time,” noted Ms. Subrahmanian. She
pointed out that if counselling became a part of the
medical practitioners duties, with patients prepared
before undergoing the AIDS test, there would be less fear
involved.

Most Cases in Maharashtra
91WE0553 Madras THE HINDU in English 28 Aug 91
po

[Text] New Delhi, 27 Aug—Over the last three years
there have been 52 known cases of full blown AIDS in
the country and 48 of these persons have died. The
largest number of cases have been detected in Maharash-
tra, with Delhi coming a close second.

Nearly one-third of the total number of detected cases in
the last three years are in Maharashtra—17 of the total
52—and of these 15 are dead. In Delhi of the total of 10

NEAR EAST & SOUTH ASIA 39

detected cases, six persons have died. In Madras, 1991
was an AIDS-free year with not a single case detected.
There were six cases in Madras in 1989 and two in 1990.

The details of the cases over the last three years, spread
over 14 States and Union Territories, were given by Mrs.
D.K. Thara Devi, minister of state for health, in a
written reply to a question from Mr. Ramdas Agarwal in
the Rajya Sabha today. The statistics show that besides
Maharashtra (17), Delhi (10) and Madras (eight),
Manipur has on record four full blown AIDS cases. Two
each were detected in Kerela, Goa and Pondicherry and
one each in Chandigarh, Jammu and Kashmir, Gujarat,
Uttar Pradesh, Rajasthan, Assam and Andhra Pradesh.

AIDS Deaths, Prevention Measures in Kerala

92WP0020 Calcutta THE STATESMAN in English
12 Sep 91p 9

[Text] Trivandrum, Sep 11—Three persons died of sus-
pected Acquired Immune Deficiency Syndrome (AIDS)
in Kerala, the Health Minister, Mr. R. Ramachandran
Nair, informed the State Assembly during question-hour
today, reports UNI.

Mr. Nair said an AIDS detection centre and a clinic was
already functioning at the Trivandrum Medical College
Hospital and three more centres attached to the medical
colleges in Trichur, Alleppy and Kozhikode had also
been sanctioned.

Papers Give Details in Fight Against AIDS

Epidemic Proportions

92WE0032A Madras THE HINDU in English
21 Sep 91 p7

[Text] New Delhi, Sept 20—A World Health Organiza-
tion update on AIDS in the South East Asian region has
sounded the grim warning that the rate of increase of
HIV positive cases in Thailand and India between 1987
and 1990 is similar to the earlier stages of its spread in
sub-Sahara Africa, where today hardly any household
has been left unaffected.

The comparatively small number of detected HIV posi-
tive cases (AIDS) in India over the last few years offers
no comfort to WHO experts who have prepared an AIDS
update for the forthcoming 44th session of the South
East Asian regional committee to be held in the Maldives
from September 22 to 28. A table of cases in India shows
the alarming trend of doubling of cases each year from
1985-1986. At the current rate within two years the
annual number of HIV sero positive cases would cross
the 10,000 mark.

Long Gestation

What is worse, the percentage of persons testing sero
positive, from among the sample screened each year, is
also increasing. Between 1989 and 1990, the percentage
testing positive went up from 5.6 percent to 12.7 percent.



SJPRS-TEP-91-023
12 November 1991

who have known the greatest trials and tribulations in
recent years—drought, poverty, overcrowding and
unemployment all reach record levels in kwaZulu, and
the area is marked by exceptional rates of civil, political
and criminal violence.

To all that one must now add the unhappy certainty that
within South Africa the Zulus will be the first and
perhaps the greatest victims of the AIDS scourge. One
cannot but note how often in Africa AIDS appears to
feed on war and civil strife—in Uganda, Ethiopia, the
Sudan, Mozambique and Angola the coincidence is plain
enough. Partly this may just be because the social cate-
gories with the highest HIV positive rates are typically
students, prison inmates—and soldiers; and in Africa
war means civil war, typically with bands of young
soldiers marauding through the civilian population.

It is not merely that all diseases spread faster amongst a
war-weakened populace; war in Africa means famine,
accelerated population movement, widespread rape and
the dislocation of settled familial units. Natal/kwaZulu
has seen over 6,000 die since 1985 in what has, effec-
tively, been a Zulu civil war between Inkatha and the
ANC; perhaps one should have realised that where
comes war, AIDS follows not far behind.

But what will the effects of the epidemic be? Researchers
from East Africa speak of an hour-glass shaped popula-
tion pyramid, with the very old looking after the very
young and much of the intervening age group scythed
down.

In South Africa, which displays an exaggerated form of
rural dependence on remittances from urban wage-
earners, the deaths of a significant number of remitters
could lead to the widespread collapse of the rural
economy, with much of the country transformed explic-
itly into a vast refugee camp. And, of course, there are
many voices predicting a stunning demographic reversal,
with overall population decline setting in.

Many of the Durban conference felt that, however bad
the situation was, hysterical alarmism about AIDS was a
problem too. Alan Whiteside, the conference organiser,
pointed out that three of the four available projections
for Zimbabwe were for an actual population decline over
the next decade, but there was little real prospect of such
a gotterdammerung.

The same is true for South Africa. Although South
Africa’s total fertility rate has been slowing notably
through the Eighties—the average black woman has 5.1
births now, compared to 6.8 in the Fifties—Broomberg
and his colleagues found it was most improbable that
AIDS could do more than cut population growth to a
minimum of one percent per annum by 2005—when the
total population is still expected to be 50 percent up on
1985. South Africa’s problem is still going to be having
too many people, not too few.

The economic cost of AIDS will be high. As Whiteside
puts it: “South Africa is in the unenviable position of

SUB-SAHARAN AFRICA 9

facing a Third World epidemic with a population that
may expect First World resources to be devoted to the
care of the sick”.

The area of uncertainty is inevitably large here: people
don’t die from AIDS directly, after all, but from their
loss of immunity to other diseases. In South Africa most
deaths will probably result from run-of-the-mill diseases
like TB and dysentry.

Broomberg, Steinberg and Masobe estimated that
treating the epidemic would by 2000 consume between
19 percent and 49 percent of total health expenditure,
and 34 percent to 75 percent by 2005. Even if one takes
median figures of 34 percent and 54 percent a great deal
of “crowding out” of other forms of health care seems
inevitable.

The indirect costs of the epidemic—the loss of valuable
man-years of often highly-trained labour—clearly
depend in some measure on how the educated elites
behave. On the one hand, they typically have the
resources and opportunities to lead lives of considerable
promiscuity if they want to; on the other hand, they
ought to be amongst the most responsive to the counsels
of anti-AIDS information and propaganda.

All one can say thus far is that the auguries from the rest
of Africa are not good. Rolling direct and indirect costs
together, Broomberg and his colleagues from the Wits
Medical School suggest that AIDS could cost South
Africa up to four percent of its current GNP by 2000 and
up to nine percent by 2005; heavy costs indeed, but
sustainable nonetheless, provided—and it’s a big if—
that GNP growth picks up in the post-apartheid era.

Meanwhile, corporate South Africa—much in evidence
at the Durban conference—has begun to react; scholar-
ships endowed by large companies like the Anglo-
American Corporation now routinely require applicants
to undergo HIV tests.

The really big imponderables lie in the social, political
and psychological impact of the epidemic. It is widely
assumed, for example, that the coming of majority rule
will result in a major setback for women’s rights, as the
central norms of society cease to be set by the traditional
chauvinism of the white male and are dictated instead by
the far greater chauvinism of the black male. But AIDS
could well strengthen—and will certainly complicate—
the challenge to those norms now mounted by a younger
generation of African women.

Alarming Rates

At present all serious feminine assertion is undermined
by alarming rates of sexual harassment and rape, typi-
cally a major threat for black girls from the moment they
achieve puberty at school—not a few black teachers have
been necklaced for raping their charges and “jack-
rolling” (randomised rape-and-robbery) by teenage
gangs is an all too common feature of township life. But



JPRS-TEP-91-023
12 November 1991

In July this year, a spokesman for SAA said that the
airline “had no idea how many cabin attendants had
AIDS.” This is in line with the type of answer given to a
Parliamentary question put by Clive Derby-Lewis in
1988 concerning AIDS and SAA cabin attendants. The
query was simply brushed aside, and no definite answer
was given.

Book

A new book “AIDS in South Africa” by Dr. P.D.G.
Quirke (Conservative Alliance and the AIDS Protection
Society, Box 97740, Petervale 2151) illustrates the
incredible danger to, particularly, Whites in today’s
South Africa.

Dr. Quirke’s book describes in graphic detail the current
SA AIDS situation, what to do to avoid AIDS and what
will probably happen within the next ten years.

He gives detailed tables of infection rates: in Soweto and
Durban, for example, the rate of infection at the end of
1990 was between 4 percent and 6 percent, well above
the official national average of 0.87 percent. These
averages are about 12 months ahead of the general SA
average, and Zimbabwe is about one year ahead of them.

Natal

In January 1991, areas in Natal had a higher 6 percent -
10 percent HIV positive content. The radio reported that
blood for transfusion was no longer collected from
“outside” clinics as their HIV infection rates were five
times those of permanent clinics.

In early April 1991, a 20 percent rate of HIV positives,
and a seven out of thirteen (just under 50 percent) rate of
positives among pregnant women, was reported in
Soweto. Similar results were also reported near East
London.

Baragwanath Hospital has stopped routine AIDS tests on
ante-natal clinic patients, says Dr. Quirke. “Each patient
is treated as though she is infected. The tests are expen-
sive and the ”window* of infection is now so wide that
there are too many false negatives.”

Dr. Quirke states further that “a Black school near
Durban in late 1990 had 60 percent HIV positives,
rivalling the 80 percent in some Zimbabwean factories.”
This Durban figure will become commonplace in the rest
of Natal and Soweto in 1991.

Nobody really knows how many of SA’s population has
AIDS. But if doctors are not even testing in Soweto
hospitals any more, and assuming that everyone is
infected, a very serious situation is evolving in South
Africa.

Until the present government is removed, we must
simply hold on. Needless to say, school and hospital
integration should be avoided at any cost.

SUB-SAHARAN AFRICA il

Controversy Surrounds Police AIDS Testing

92WE0054A Johannesburg THE STAR in English
9 Sep 91 p6

[Article by Bronwyn Wilkinson and Guy Jepson:
“Dilemma of AIDS Tests on Police”)]

[Text] Members of the South African Police having
compulsory random medical examinations are also
being tested for AIDS—a move which has drawn criti-
cism from AIDS expert Dr. Ruben Sher, who said HIV
tests should be conducted only with the “informed
consent” of the individual.

Police spokesman Major Reg Crewe told THE STAR
that police members would be tested for AIDS, but that
this was “just one of several tests.”

He said he had not received any reports of officers
refusing to have the tests, but added that the Police Act
did make provision for members of the police force to be
compelled to undergo medical tests.

A high-level police source, who asked not to be named,
said the provisions of the Police Act would not be used to
conduct a witch-hunt against AIDS carriers. Neverthe-
less, as in the case of a force member who was physically
debilitated, a policeman who contracted AIDS or was
HIV positive would “not be fit to do the job.”

The SAP, he said, would have to devise a way to cope
with the rise and spread of AIDS. But the question of
tests for policemen was “a complex moral issue.”

Dr. Sher, of the AIDS Centre at the South African
Institute for Medical Research, said the ideal ethic was
that informed consent should be given by anyone who
was to undergo an AIDS test.

“There should really be pre-test and post-test counsel-
ling,” he said. Pre-test counselling would include telling
the patient why he was to be tested. If he were to test
positively, he should then be told what that would mean.

“I am against compulsory testing. I am for informed
consent,” he said. “We are in the process of trying to set
the medical ethic on this.”

If medical tests on the police force were being conducted
to establish a medical profile of its members, he said,
then a full range of medical tests should be conducted on
all policemen.

A senior officer said he believed AIDS should be a
notifiable disease and that every citizen should be tested.

“If, in terms of the Criminal Procedure Act, the drawing
of blood to test alcohol levels (in suspected drunk
drivers) is allowed, then why not compulsory AIDS tests?
AIDS is a killer.”

Law and Order Ministry spokesman Captain Craig
Kotze said the question was being approached by the
police with sensitivity and in a balanced fashion. “All



JPRS-TEP-91-023

12 November 1991 2 AIDS
Group Votes AIDS Not To Be Notifiable Disease (Johannesburg SAPA, 18 Oct 91] ... 14
Doctor Discusses Trends in AIDS, Medical Care [Ada Stuijt; Johannesburg SAPA, 22 Oct 91] . 14

Fifty-one AIDS Deaths Reported; Decrease Noted in Fatality Rate
[Johannesburg South African Broadcasting Corporation Network, 22 Oct 91] ... 15

Study Says About 100,000 Already Infected With AIDS Virus (Johannesburg SAPA, 26 Oct 91] . 15
SWAZILAND
Minister Says ‘Host’ of AIDS Related Problems Expected

[Mbabane Radio Swaziland Network, 26 Sep 91] .. 15
Health Official Estimates 4,500 AIDS Sufferers
[Gordon Mbuli; Mbabane THE TIMES OF SWAZILAND, 30 Sep 91] .... 15
Three Die of AIDS During Jul-Sep 1991
[Vusie Ginindza; Mbabane THE TIMES OF SWAZILAND, 23 Oct 91] .... 16
Health Ministry Alarmed at AIDS Rate Among Young People
[Johannesburg Radio RSA, 25 Oct 91) ... 16
TANZANIA
MP Calls for Action on Plague, AIDS [Dar es Salaam DAILY NEWS, 30 Jul 91) ..... 16
National AIDS Program Issues Report on Infections
[Dar es Salaam Radio Tanzania External Service, 30 Sep 91] 17
AIDS Figures for Zanzibar, Pemba Released
[Dar es Salaam Radio Tanzania Network, 15 Oct 91] . 17
UGANDA
Sixty Percent of TB Cases HIV Positive Alfredo Amodoi; Kampala THE STAR, 12 Aug 91]... 7

Museveni Addresses Group on Development, AIDS
[Kampala Radio Uganda Network, 29 Sep 91]

ZAMBIA

UNDP To Assist in HIV/AIDS Program [Lusaka TIMES OF ZAMBIA, 19 Aug 91]

ZIMBABWE

AIDS Claims 125 in Bulawayo Apr-Jun 1991 Harare THE HERALD, 15 Oct 91] ...
Official Says Men Seeking Virgins To Avoid AIDS
[Dawn Barkhuizen; Johannesburg SUNDAY TIMES, 27 Oct 91]

CHINA

Strategies for AIDS Control
[Beijing YIYAO XINXI LUNTAN [CHINA MEDICAL TRIBUNE], 30 May 91]
“Dwarf Mouse Produced [Zhang Zigiang and Wang Weixi; Shanghai WEN HUI BAO, 9 Jun 91]
China Spares No Effort in Fighting Spread of AIDS
[Beijing CHINA DAILY (NATIONAL), 24 Jul 91] +
The Development of Enzyme-Linked Immunosorbent Assay for the Detection of Anti-Human
Immunodeficient Virus Using Synthetic Peptide Antigen and its Application
[Zhou Wenda and Cao Xikun, et al.; Shanghai ZHONGHUA CHUANRANBING ZAZHI [CHINESE
JOURNAL OF INFECTIOUS DISEASES] Vol 9 No 3, Aug 91] 2:
Newspaper Says AIDS Sufferers ‘Ostracized From Society’ {Hong Kong

EAST ASIA
INDONESIA
Minister Discloses 11 Deaths Out of 35 HIV Cases [Jakarta THE JAKARTA POST, 4 Oct 91] ..... 23


32 LATIN AMERICA

increased.“ His surveys show that 50 percent of AIDS-
infected children are in the vertical-transmission group.
That is to say, they were infected by their mothers either
during the gestation period or during delivery, or also—
as a third possibility—during lactation.

Transmission

Dr. Naila Santos commented that in addition to the
rapid spread of the disease among women, there is
another aggravating circumstance, and that is the
manner of infection. She says that of the 1,933 women.
infected in the state of Sao Paulo, 31 percent contracted
the disease by using injectable narcotics. “Whereas in
northern and northeastern Brazil sexual relations con-
tinue to be the primary mode of transmission,” she said,
“in the state of Sao Paulo the use of injectable narcotics
is responsible for the majority of the transmissions.”

One statistic that is not yet official indicates the destruc-
tion of an AIDS myth that relates to women. According
to Alma Aldana of the Mexican Association for Sexual
Health—who also participated in the seminar—women
also transmit the HIV virus. “In the cities of Los Angeles
and San Francisco in the United States,” Alma
explained, “records show that 1,000 homosexual women
have been infected with the virus. It is an item of news
that should be studied by the experts in the field,
inasmuch as women had previously been considered as
incapable of transmitting the disease sexually.”

HIV Infected Estimated at 500,000 in Sao Paulo

91WE0515A Sao Paulo O ESTADO DE SAO PAULO
in Portuguese 17 Aug 91 p 8

[Text]

Referral Center Warns of Spread of Infection by
Contaminated Hypodermic Needles

The Sao Paulo AIDS Referral Center recorded 338 cases
of the disease in the state during June. This announce-
ment coincided with the visit of Michael Merson,
director of the WHO International AIDS Program, to
Emilio Ribas Hospital. From the time the first case was
detected—in 1980—to last month, the disease has been
diagnosed in more than 12,000 patients, of whom 8,300
(69 percent) have died.

These data highlight the spread of the disease by means
of contaminated hypodermic needles (35.4 percent of all
persons infected) and to a decrease in the rate of its
spread. In the first seven years of the epidemic the total
number of cases doubled annually, whereas from 1988 to
1991 this increase dropped to 60 percent per year. The
State Secretariat of Health expects the number of cases
to reach 5,700 by the end of this year.

“We cannot allow the situation in Latin America, and
especially in Brazil, to become analogous to the situation
in Africa,” Merson declared. According to WHO’s cal-
culations, there are approximately 6 million carriers of

JPRS-TEP-91-023
12 November 1991

the virus on the African continent, many of whom were
infected more than five years ago.

Merson believes that Brazil is in a position to reverse this
epidemic situation because the public health profes-
sionals have already known for more than 10 years what
the disease is, how it is transmitted, and how it is
controlled. “A stronger political will to combat AIDS by
means of prevention campaigns is needed,” he asserted.

WHO believes that the most appropriate means of
halting the epidemic is education. “Everyone needs to
know that the disease has increasingly spread beyond the
risk groups,” Merson said.

Public health specialist Maria Eugenia Lemos Fernandes
of the AIDS Referral Center agrees. “The government is
not giving the necessary attention to the problem,” she
said. According to the center’s calculations, approxi-
mately 500,000 persons are carriers of the virus in Sao
Paulo state. This figure was obtained on the basis of tests
conducted on blood donors and on prostitutes in Santos,
Sorocaba, and Campinas.

“This is a shockingly large number of people who will
shortly develop the disease,” Maria Eugenia warned. She
believes that the medical and hospital infrastructure in
the state will be insufficent to care for this many patients
when these casual infections begin to manifest them-
selves. “The care available is already quite uncertain,
even with only 4,000 patients,” she declared.

Fernando Zacarias, director of the Latin America AIDS
Program of the Pan-American Health Organization
(PAHO), declared that any position Brazil takes toward
AIDS prevention is of fundamental importance for all of
Latin America. “Brazil is traditionally adopted as an
example by the countries of Latin America,” he said.

According to Zacarias, AIDS is already epidemic not
only in Brazil but also in a number of countries of
Central America and the Caribbean. “The situation in
Latin America is different from the situation in Africa,”
he declared, “because people there do not even have a
chance to protect themselves from the disease.” He
believes that in Brazil the picture is different. “We do
not have ignorance as an excuse,” he said.

AIDS Cases In Greater Sao Paulo Increase

PY1010225391 Sao Paulo FOLHA DE SAO PAULO
in Portuguese 30 Sep 91 Section 4, P 1

[Summary] According to the Sao Paulo State Health
Secretariat, since 1980 a total of 12,873 AIDS cases have
been registered in this state. Of this total, 8,352 have
already died and 2,640 of those still alive are registered
as living in Greater Sao Paulo. The number of children
with AIDS has increased from one case in 1984, to 121
in 1990, with a total of 451 between 1980 and 31 August
1991.


20 SUB-SAHARAN AFRICA

Dr. Stamps has, predicted that 14 percent of all children
would be orphaned by the age of 10.

The government is planning to build orphanages to
avoid a similar crisis to that in Uganda where AIDS has
eroded the traditional African extended family to the
point where children have no relatives to take them in.
Ugandan diplomatic sources said there were 50,000
homeless orphans in June.

For the medical aid societies, the impact of AIDS will be
crushing. Cimus predicts a 208 percent increase in the
number of AIDS cases on its client roll within the next
four years. Mr. Hore believes his organisation will col-
lapse under the burden of AIDS.

Mr. Myles Zato, Harare city council amenities director,
said if the situation reached the same proportions as that
of neighbouring Malawi—35 percent of the population is
infected and local priests are reported to be conducting
40 to 50 cremations a day—Harare would run out of
cemeteries and coffin wood.

JPRS-TEP-91-023
12 November 1991

Apart from the human suffering, the disease also has
disastrous implications for business because 60 percent
of AIDS sufferers are between 20 and 40 and live in
urban areas.

Employers, faced with the prospect of losing 60 percent
of their workforce within the next 10 to 20 years, have
started AIDS education programmes on their shopfloors.
Many of the big companies, including Cimus, hand out
condoms with their pay packets every Friday.

For South Africans, the most ominous warning lies not
in the repeated claims by Zimbabwean medical practi-
tioners that South Africa could be in a similar boat
within five years, but in a recent report in a local
Zimbabwe newspaper.

The newspaper reported that a local boxer, refusing to
undergo the AIDS test that would allow him to fight in
his country, had relocated to South Africa to pursue his
career.



Epidemiology
AIDS

JPRS-TEP-91-023 CONTENTS 12 November 1991

[This EPIDEMIOLOGY report contains only material on AIDS. Other epidemiology topics are covered in a later
issue.]

SUB-SAHARAN AFRICA
CAMEROON

Progress of Anti-AIDS Campaign Assessed
[Peter M. Ndumbe; Yaounde CAMEROON TRIBUNE, 17 Jul 91] ...
Sixteen AIDS Cases Confirmed in South
[Matip Timohee; Yaounde CAMEROON TRIBUNE, 17 Jul 91]...
Latest AIDS Statistics Made Public {Yaounde CRTV Radio Network,

KENYA

Trans Zoia Hospital Finds 89 Positive for AIDS [Nairobi DAILY NATION, 15 Aug 91] ..
Kitale Hospital Finds 110 Positive for AIDS [Nairobi THE KENYA TIMES, 15 Aug 91
Physician Reveals 663 AIDS Cases in Eastern Province

[Nairobi Kenya Broadcasting Corporation Network, 15 Sep 91] .
Medical Services Director Refutes AIDS Figures [Nairobi KNA, 17 Oct 91]
Report of 700,000 With AIDS Virus [Nairobi KTN Television, 17 Oct 91] ...

MOZAMBIQUE

Data Show AIDS Increasing Among Women [Maputo NOTICIAS, 3 Aug 91]
Manica AIDS Program: ‘Satisfactory’ Results /Maputo NOTICIAS, 3 Aug 91]
First AIDS Counseling Course Under Way [Maputo NOTICIAS, 10 Aug 91].
Red Cross Role in Combating AIDS Described
[Joao Leopoldo da Costa; Maputo NOTICIAS, 7 Sep 91] ....
Swedish Red Cross Says Manica Could Have 1,000 AIDS Cases
[Maputo Radio Mozambique Network, 7 Sep 91]

NIGERIA
President Launches Anti-AIDS Battle /Onajomo Orere; Lagos THE GUARDIAN, 24 Aug 91] 1... 6
SOUTH AFRICA

WRN NN

a Ww aww

Figures Cited for Looming ‘AIDS Epidemic’

[R. W. Johnson; Johannesburg SUNDAY STAR MAGAZINE, 25 Aug 91]
CP Organ Reviews Country’s AIDS Situation Pretoria DIE PATRIOT, 6
Controversy Surrounds Police AIDS Testing

[Bronwyn Wilkinson and Guy Jepson; Johannesburg THE STAR, 9 Sep 91]
AIDS Causes Renewed Outbreak of Tuberculosis

[Shirley Woodgate; Johannesburg THE STAR, 12 Sep 91] ..... 12
Financial Burden of AIDS on Country Noted

[Blaise Hopkinson; Cape Town THE ARGUS, 12 Sep 91] 12
Experts Predict 12 Million AIDS Victims /Cape Town THE ARGUS, 25 Sep 91] 13
Number of HIV Infected in Cape Reaches 1,000

[Vivien Horler; Cape Town THE ARGUS, 25 Sep 91] 13
Professor Cited on AIDS Figures for Natal (Johannesburg , 8 Oct 91) 13
Minister Discusses Anti-AIDS Phone Program Johannesburg SABC TV 1 Network, 9 Oct 9. 13
Minister Says 300 Infected Wth HIV Virus Daily

[Peter Fabricius; Johannesburg THE STAR, 10 Oct 91] .... 14



44 NEAR EAST & SOUTH ASIA

It is hoped, with favor from the Council of Ministers and
the approval of this plan, that an effective step will be
taken to prevent the spread of AIDS in the country.

Dr. Sadrizadeh noted that the AIDS virus has a long
period of dormancy, and sometimes the AIDS symptoms
do not appear for up to ten years. He warned those
travelling outside the country that AIDS is waiting for
them and that only the observation of health care and
security precautions can be effective in preventing con-
tracting the AIDS virus.

In the same regard, the media will try to inform society
more than before about the dangers of AIDS, and it is
necessary that the insiders in the Ministry of Health
Care, Treatment and Medical Education create the nec-
essary protection in society by publishing information
about this dangerous disease.

Health Minister Notes 400 People Carry AIDS
‘irus

LD2209184891 Tehran IRNA in English 1702 GMT
22 Sep 91

{Text] Khorramabad (Lorestan) Sep 22, IRNA—Health
Minister Dr. Reza Malekzadeh on Sunday warned of the
dangers of the rapidly growing population. However,
Malekzadeh said, the growth rate of population has
dropped from 3.9 percent in 1986 to 2.85 percent
according to a report released by the Civil Status Regis-
tration Organization.

“But birth control and population growth in our country
has not yet reached a desired level,” Malekzadeh told
reporters. He called for elimination of some social priv-
ileges that will encourage an increase in the number of
births. The health minister also referred to his ministry’s
readiness to employ Iranian experts living abroad who
have a clear political background.

He said 400 people have been diagnosed as positive
carriers of the AIDS virus in Iran, and most of them were
afflicted with the deadly disease through transfusion of
contaminated blood derivations. Iran is immune, to a
larger extent than other countries, from the spread of
AIDS mainly due to its commitment to religious laws
and ethical values, the health minister said. He, however,
called for education of people to protect themselves from
the killer disease, as an effective means of fighting AIDS.
Testing arriving passengers and quarantining those
tested positive are among measures being studied by the
Health Ministry to prevent the spread of AIDS, he said.

ISRAEL

AIDS Virus Growing Among Heterosexuals
1A2410152491 Tel Aviv DAVAR in Hebrew 24 Oct 91
pl

[Report by ’Ezra Hen]

[Text] Over half of the people found to be carrying the
AIDS virus in Israel over the past two and a half years do

IJPRS-TEP-91-023
12 November 1991

not belong to “high-risk groups,” in other words, homo-
sexuals or intravenous drug addicts, DAVAR was told by
Professor Ze’ev Handzel, head of the Clinical Immu-
nology Department at Kaplan Hospital in Rehovot.

Some 100 new AIDS carriers are discovered annually.
Contrary to previous years when over 75 percent
belonged to the high-risk groups, in 1989, 1990, and in
the first half of 1991 it became clear that their numbers
have declined significantly and that they now make up
less than half of the new carriers.

“The sickness is definitely penetrating slowly into the
heterosexual population, although very slowly; that is a
clear conclusion from the data,” Prof. Handzel said. “It
is worthwhile mentioning again that in addition to the
carriers known to us there are people who were tested for
the virus but do not admit it and do not think they
should be checked since they do not belong to the
high-risk groups.”

Prof. Handzel said that the drop in the number of
carriers belonging to the high-risk groups is also because
more are avoiding being tested.

MOROCCO

Extent of AIDS Epidemic in Country Assessed
92WE0005A Rabat L’OPINION in French 2 Sep 91 p 5

[Article by the National AIDS Program in conjunction
with the National AIDS Committee and the Directorate
of Epidemiology and Health Programs, Ministry of
Public Health: “AIDS Epidemiology in Morocco”}

[Text] AIDS is a pandemic disease that poses a great
threat to humanity in the last years of the 20th century.
No country has been spared. It is increasing rapidly and
nothing seems to stop it.

Morocco too has been hit by this modern-day scourge. So
far, ours is one of the countries least affected by the
disease. But it remains vulnerable because of its geo-
graphic position as a bridge between Europe and Africa,
its tourism industry, and the existence of a large
Moroccan community abroad, particularly in Europe.

The disease is spreading rapidly in Morcco, at the same
rate as that seen in European countries, notably France.

As of 30 June 1991, the Sexually Transmissible and
Dermatological Diseases Service of the Directorate of
Epidemiology and Health Programs had documented 86
cases of AIDS, 23 cases of AIDS-related syndrome, and
71 cases of asymptomatic transmission since the HIV
virus infection first entered the country.



28 EAST ASIA

Chetsada said most intravenous drug users turned up to
have their blood tested but very few people who engaged
the services of prostitutes were willing to undergo the
AIDS test.

The doctor said the virus had also spread into the
province’s rural communities where new brothels had
been opened.

Chetsada said one graphic example of AIDS quietly
taking root in rural life was the uncovering of a male
teenager who tested HIV-positive.

The teenager was quoted as saying he had sex only with
female workers at factories in rural areas whom he
picked up on his motorcyle after work hours.

He said he and about 15 other men had been offering
free rides home to factory girls and then having sex with
them.

The teenager said he had had sex with more than 10
factory girls and was shocked to have contracted the
virus from one of the girls.

—A senior Public Health Ministry official said on
Tuesday that the number of AIDS patients in Thai-
land is the sixth highest in Asia.

Deputy Permanent secretary Dr. Pracha Em-amon said
the latest information from the ministry showed that
there were 171 AIDS patients and 34,701 AIDS carriers
in Thailand. Of the number of the disease carriers, 456 of
them were babies infected through their mothers with
498 of them being housewives, he added.

However, permanent secretary Dr. Uthai Sutsuk said
about two months ago that the statistics from public
health office nationwide as of July 15 indicated that
there were 364 known cases of full- blown AIDS, 364
cases of AIDS-related complex (Arc) and 31,928 AIDS
carriers.

Dr. Pracha did not name the five Asian countries with
higher numbers of AIDS cases than Thailand.

At present, the best way to prevent the spread of the fatal
disease is to educate the public, Dr. Pracha told reporters
after having delivered a lecture at the Bangkok Palace
Hotel to doctors and medical personnel at a panel
discussion on how to impart knowledge on the preven-
tion of AIDS to the public.

He said the event was jointly organized by the ministry
and UNICEF, which had arranged six panel discussions
in the past.

Dr. Pracha said he asked doctors to advise pregnant
women on how to avoid being infected with the disease.
Their babies could also be saved, he added.

He said the plan would be implemented in six prov-
inces—Chiang Mai, Chiang Rai, Payao, Chon Buri,
Songkhla and Narathiwat.

IJPRS-TEP-91-023
12 November 1991

AIDS, or acquired immune deficiency syndrome, is
caused by a virus that severely weakens the body’s
natural defence system against disease.

Draft AIDS Law Dropped After Almost 3 Years’
Debate

BK1110013191 Bangkok THE NATION in English
11 Oct 91 p A2

[Text] A highly controversial draft AIDS law that has
been debated for almost three years was summarily
dropped after 90 minutes of discussion at Government
House by doctors, legal experts and political scientists
yesterday.

The Draft AIDS Law Review Sub-Committee, chaired
by PM’s Office Minister Khunying Saisuri Chutikun
ruled that a law for controlling the spread of AIDS in
Thailand is “not necessary at this time”.

Authors of the draft, Thammasat law professor Kaewsan
Athibho and adviser attached to the PM’s Office Police
Major Yongyut Sarasombat, defended their case against
criticism that the law would cause discrimination against
AIDS patients.

“This law would not automatically mean that people
with AIDS get locked up. It will be selectively enforced
depending on the case ...measures will depend on the
good judgment of government officials,” said Kaewsan.

But Dr. Wirasit Sitthirai of the Chulalongkon University
Population Studies Institute argued that such a system
would be open to abuse and lead to the violation of
human rights.

The focus of much criticism was the draft’s Section III,
which empowers government officials to test “persons
with AIDS or suspected persons with AIDS”, and mete
out various levels of punishment to those who fail to
comply with regulations.

Minister Urges Eradication of AIDS in G-24
Meeting

BK1210101191 Bangkok Radio Thailand Network
in Thai 0530 GMT 12 Oct 91

[Excerpt] Public Relations Department correspondent
reported on the meeting of the G-24, or group of devel-
oping countries, which began this morning at the Queen
Sirikit National Convention Center, venue for the
annual meeting of the World Bank and the International
Monetary Fund.

The G-24 comprises mainly African countries. The
morning session lasted until about 1030 before a short
tea break.

In the meeting, delegates exchanged their views mostly
on the problems of poverty in developing countries and
assistance from developed countries.



SIPRS-TEP-91-023
12 November 1991 NEAR EAST & SOUTH ASIA 37
Maharashtra Tops Government Apathy

Sixty-eight AIDS cases have been reported in the country
with Maharashtra accounting for 24 of them, the Lok
Sabha was informed on Monday.

The Health and Family Welfare Minister, Mr. M.L.
Fotedar, said in a written reply to Ms. S.D.K. Bhandari,
that the second highest incidence of AIDS was reported
from Delhi (10), and Chandigarh/Punjab and Tamil
Nadu 8 each.

No clinical trial has been so far carried out on Human
Immune Deficiency (HIV) infected patients to test effi-
cacy of herbal medicines, Mr. Fotedar said. [passage
omitted]

Situation in Calcutta
91WE0519B Calcutta THE TELEGRAPH in English
2 Aug 91 p7

[Article by Barun Ghosh: “5 AIDS Patients in Serious
Condition”]

[Text] Calcutta, 1 August—Five of the 17 persons from
in and around Calcutta so far found infected by the
AIDS virus have developed symptoms of the dreaded
disease and are in a serious condition, according to
specialists dealing with them.

All of the five, including a prostitute and an intravenous
drug addict from Nagaland, are undergoing treatment at
the outdoor clinic of the School of Tropical Medicine
(STM), which conducts tests on AIDS.

What is more disturbing is that four haemophiliac chil-
dren are suspected to have contracted the Human
Immuno-Deficiency Virus (HIV), or AIDS virus,
through “accidental infection,” possibly during blood
transfusion. They have been kept under close observa-
tion.

Dr. Manish Chakraborty, head of the Department of
Virology, STM, told his correspondent that the names of
the five persons had been kept confidential to prevent
panic similar to “when the first AIDS patient died in the
city in 1988.” He said counselling was being provided to
the five at the STM clinic every day.

Dr. Chakraborty said two daily wage earners who had
been infected by the virus while working in Bombay were
tested HIV positive last year. “They are getting regular
checkups at the STM clinic along with three others who
have been detected HIV positive this year.”

Asked about the children who suffer from haemophilia,
he said he had no knowledge about them. However, Dr.
Sukumar Mukherjee, head of the department of medi-
cine, Calcutta Medical College, confirmed that the chil-
dren might develop AIDS in the future.

The state government is yet to wake up to the problem
even after more than 13,000 people have fallen into the
high risk group since 1986. The much publicised four-
bedded ward for AIDS victims, supposed to be set up at
the Medical College, is yet to get off the ground. A sum
of Rs 10 lakhs which was sanctioned by the Union
government last year for the purpose has not been used
by the state government. A further sum of Rs 80 lakhs
sanctioned this year by the Centre in collaboration with
the World Health Organisation (WHO) “remains unused
till date,” a state government official said.

He also admitted that surveys, which are considered
essential to cope with the dreaded disease, are almost nil
in West Bengal. Health workers assigned to conduct such
surveys in red light and other vulnerable areas lack the
motivations, the official said. “We have no statistics of
the people residing in red light areas because no survey
has so far been done,” he said. “For this reason, we have
entrusted some non-government voluntary organisations
to carry out the surveys.”

Previous attempts by the health department to conduct
surveys in red light areas had failed miserably even with
the help of the police. “Prostitutes and their customers
should be provided with proper counselling instead of
coersion by the police,” the official, however, felt.

It is learnt that a state AIDS committee has recently been
formed with the state chief secretary, Mr. N. Krishna-
murti, as its chairman.

Cases in Tirupati
91WE0519C Secunderabad DECCAN CHRONICLE
in English 3 Aug 91 p 5

[Text] Tirupati, 2 August—Eighteen AIDS sero-positive
cases were detected in the municipal limits of Tirupati
since August 1988.

The municipal health officer announced this at the
council meeting, which met here on Wednesday. Of the
51 sero-positive cases detected by the department of
S.T.D. and microbiology, SVRR Hospital, 18 cases were
in the municipal limits of Tirupati.

The meeting passed a resolution to continue the NMRs
who were working in the municipality for the last three
years. It also resolved to regularise the NMRs who
completed five years of service.

The meeting also resolved to send a Rs. 40 crore master
plan for the all-round development of Tirupati to the
government for its approval. The municipality would
seek a loan of Rs. 30 crore from the HUDCO [Housing
and Urban Development Corporation] for the develop-
ment programmes designed under the master plan.

Mr. V. Muniratnam, Municipal Chairman, presided
over the meeting.



SJPRS-TEP-91-023
12 November 1991

INDONESIA

Minister Discloses 11 Deaths Out of 35 HIV
Cases

BK1110025091 Jakarta THE JAKARTA POST

in English 4 Oct 91 p 11

[Excerpt] Jakarta (JP}—Eleven Indonesians have died
from AIDS, says Health Minister Adhyatma.

Adyatma said here Wednesday the 11 were among 35
Indonesians affected by the HIV (human immunodeffi-
ciency virus).

Speaking to reporters upon arrival from Maldive Islands,
the minister said the Indonesian Government was deter-
mined to take serious measures against AIDS by edu-
cating the country’s young people about the disease.
[passage omitted]

JAPAN

Dainippon Discovers Material To Curb AIDS
Virus

OW 1909011291 Tokyo KYODO in English 0044 GMT
19 Sep 91

[Text] Tokyo, Sep 19 KYODO—Dainippon Ink and
Chemicals Inc., along with university professors, has
discovered a new material which restrains multiplication
of the AIDS [Aquired Immune Deficiency Syndrome]
virus, an industrial daily reported Thursday.

The material is a derivative of oligosaccharide, which is
highly effective in controlling the AIDS virus but fea-
tures extremely low toxicity, the NIHON KOGYO
SHIMBUN said.

It was proved within a test tube its toxicity is less than
one- 100th of that in AZT, the only medicine in use at
present for AIDS, the paper said.

SOUTH KOREA

Number of AIDS Cases Reaches 158

SK0210022791 Seoul THE KOREA HERALD
in English 2 Oct 91 p 3

[Text] The Ministry of Health and Social Affairs said
yesterday that a man in his 20s was found infected with
the AIDS virus in September.

The 28-year-old man, identified only as An, said he had
sexual relations during his recent overseas trip,
according to the ministry.

So far, 158 Koreans have been found infected with the
acquired immune deficiency syndrome, of which 13
have died, one has left the country, and the remaining
144 are under special government care, the ministry
said.

EAST ASIA 2B

MALAYSIA

Paper Reports on Death of 3 AIDS Victims

BK1609125691 Kuala Lumpur NEW STRAITS TIMES
in English 14 Sep 91 p 10

[Text] Kuala Lumpur, Fri—Three AIDS carriers,
including a foreigner, died at the General Hospital here
recently, National AIDS task force chairman Dr. Jones
Varughese said today.

This brings to 26 the number of people who have died
from the incurable disease in the country. Four others
have been admitted with the terminal disease.

Dr. Varughese declined to say if the latest victims of
AIDS belonged to any of the high-risk groups.

In an interview, Dr. Varughese, who is also the director
of health services in the Health Ministry, said to date,
1,365 people had been infected with the Human
Immuno-deficiency Virus (HIV) which causes AIDS.

“We don’t want to give such figures as we do not want to
create panic but alert the public on the seriousness of the
disease,” he said, adding AIDS was no longer restricted
to high-risk groups.

The Ministry was also concerned with the continued
misconception among locals that AIDS was a foreign
disease, although many locals have died from it, he
added.

Said Dr. Varughese: “We have now established that local
transmission of AIDS is occurring and steps have to be
taken to contain the problem.”

He reminded the public that apart from the high-risk
groups—intravenous drug users, prostitutes and prison-
ers—even ordinary people could be AIDS victims if they
practised high-risk behaviour.

He said what was tragic was that the disease could be
passed on to an innocent spouse or the couple’s children.

The baby or children of a spouse of an AIDS victim faces
a 20 to 40 percent risk of becoming a HIV carrier
according to recent studies.

Those not infected with the HIV may end up being
orphans after their parents’ deaths from AIDS.

Dr. Varughese added that to curb the AIDS problem, it
was imperative that the public revert to traditional
values and change their life-styles.

Twenty-seven AIDS Victims Die; 1,365 Test HIV
Positive

BK3009145091 Kuala Lumpur Radio Malaysia
Network in English 1330 GMT 30 Sep 91

[Text] Twenty seven of the 32 known AIDS victims in
the country have died, while 1,365 people have tested
positive for the human immuno-deficiency virus, HIV,



JPRS-TEP-91-023
12 November 1991

SOUTH AFRICA

Figures Cited for Looming ‘AIDS Epidemic’

92WE0002A Johannesburg SUNDAY STAR
MAGAZINE in English 25 Aug 91 pp 6-7

{Article by R. W. Johnson: “On the Brink of an AIDS
Tidal Wave”; first paragraph is SUNDAY STAR MAG-
AZINE introduction]

{Text] South Africa faces an AIDS epidemic and it has
been estimated that millions of people will die from the
virus, writes R. W. Johnson. What can we do about the
impending disaster, and what effects will it have on the
country?

An AIDS epidemic is coming to South Africa. The
countries with the highest AIDS incidence in the world
are grouped in East-Central Africa—Burundi, Tanzania,
Uganda and Malawi are probably the greatest sufferers
of all—and gradually the virus has been making its way
southwards.

It is possible, indeed, to work out what South Africa’s
“HIV prevalence lag time” is behind others: nine years
behind Burundi, eight behind Tanzania, Uganda and
Malawi, seven behind Zaire, Zambia and Rwanda, five
behind Kenya and Angola—and so on.

South Africa has been protected not only by its position
on the continent’s southern tip but by its social and
economic isolation: trade sanctions and the inhibitions
on tourism to South Africa have to that extent been an ill
wind blowing some good. The progress of the virus is,
however, ineluctable—60 percent of the world’s AIDS
victims are to be found in Africa—and there is no
prospect of South Africa avoiding this scourge.

What this means is that we shall soon see an epidemic of
African proportions raging in a far more highly devel-
oped society than any thus far similarly affected.

Unique Situation

It is an awesome thought—and indeed, a unique situa-
tion. For South Africa is a relatively sophisticated
society with levels of medical care and expertise unpar-
alleled elsewhere in Africa and, because the virus is
coming to South Africa relatively late, far more is known
about the virus, its treatment, likely economic effects
and so on, than was ever the case in the less developed
societies to the north. It is a bit like sitting in an
oceanographic laboratory, waiting for a tidal wave to
hit—and the evidence suggests that we now have
months, not years to wait.

No responsible authority now believes that an epidemic
can be averted. Already, during 1990, the predominant
incidence of the virus moved from a relatively restricted
“ghetto” of mainly white male gays into the far broader
(and predominantly black) heterosexual population.

SUB-SAHARAN AFRICA 7

Everything we know about that population’s already
vulnerable health status, its powerful resistance to coun-
sels of sexual abstinence and contraception, and even its
lack of access both to condoms and to AIDS informa-
tion—suggest that the epidemic cannot possible be
stopped.

But how bad will it be? In a paper to a recent conference
in Durban on the economic impact of AIDS, Jonathan
Broomberg, Malcom Steinberg and Patrick Masobe con-
structed a complex actuarial model to take into account
the fact that the epidemic’s doubling time is likely to
slow down as it progresses.

In the very early stages the number of adults aged 15-34
who are HIV positive doubles every six months—a rate
seen in South Africa in 1986. But the doubling time
should rise to 14 months in 1991, 16 months in 1992,
and so on up to a plateau level of 34 months in 1995. By
that point nearly 1,6 million people will have the virus—
but the long incubation period of up to ten years means
that the cumulative total of AIDS deaths will be only 47
000.

Thereafter, say Broomberg et al., the snowball effect will
really begin to tell. For 2000 they predict 5,2 million
HIV positive cases and 666,000 cumulative AIDS
deaths; for 2005 7,4 million HIV positive cases and 2,9
million deaths, and for 2010 8,2 million HIV positive
cases and 6,6 million cumulative deaths.

It is worth noting how, in the mature period of epidemic,
the fatality rate catches and even passes the infection
rate. That is, between 2005 and 2010 the number of HIV
positive cases increased by less than 1,2 million, but
more than 3,6 million extra AIDS deaths occur in the
same five year period because by then a really large
“backlog” of HIV positive cases has been built up.

Under-reporting
All such projections are, of course, extremely sensitive to

the assumptions made—and all data on the incidence of
the disease have to cope with more or less large-scale
under-reporting. For purely technical reasons some
under-reporting is inevitable under African conditions,
but it also occurs because AIDS is an extremely sensitive
subject, particularly given the assumption—widespread
on all sides—that AIDS is, or will be, a predominantly
black disease.

Blacks are keenly aware that many whites greet as almost
heaven-sent any force likely to curb the explosive growth
of the black population. Moreover, blacks are bitterly
aware that they are stereotyped by many whites as
disease-ridden, sexually hyper-active and promiscuous.
There is, accordingly, a pronounced—one could almost
say fatal—tendency for discussions of AIDS to get side-
tracked into furious attempts to deny that stereotype.

Such misplaced sensitivities, and also a fear of scaring
off tourists and investors, have led some African govern-
ments into deliberate cover-ups—most grievously in the



JPRS-TEP-91-023
12 November 1991

Epidemiological Statistics

The malady exhibits a Western epidemiological profile
in our country. The majority of victims are males (86
percent) and a large percentage belong to high-risk
groups (50 percent).

The average age of patients is about 33.5.

The disease entered Morocco from abroad, but quickly
established an indigenous base.

The prevalence of the various modes of transmission is
as follows:

High-risk groups:

homosexual: 11 cases, 12.8 percent; .
bisexual: 5 cases, 5.8 percent;

intravenous drugs: 17 cases, 18.7 percent;
homosexual + intravenous drugs: 5 cases, 5.8 peréent;
perinatal: 5 cases, 5.8 percent.

Other groups:

¢ heterosexual: 25 cases, 29 percent;
* transfusion-related: 9 cases, 10.4 percent;
* unknown: 9 cases, 10.4 percent. ~—~

Out of the 75 cases where the etiology is known, 54 of the
86 AIDS victims have died [as published].

Of those stricken with AIDS, 12 are women (almost 14
percent of the total), a proportion close to what is seen in
France (16 percent).

In France and Europe, the most common mode of
transmission to women is intravenous drug abuse. In
Morocco, heterosexual transmission is more prevalent.

The five children who have contracted the disease are all
males, and three of them are deceased. Their ages are 8
months, 9 months (two children), 18 months and 2 and
‘% years. They represent 5.8 percent of the total. This
percentage is almost three times as high as corresponding
figures for France (2.6 percent) and Europe (2.4 percent).

The mode of transmission to children is vertical, i.e.,
mother to fetus.

The percentage of opportunistic infections observed
among our AIDS victims is about 76.7 percent (66
cases); the incidence of malignancies is 22 percent (19
cases).

Tuberculosis is common among our patients, having
been observed in 19 cases (about 22 percent of the AIDS
victims), a percentage close to the average for developing
countries.

NEAR EAST & SOUTH ASIA 45

Sero-epidemiological studies undertaken thus far indi-
cate HIV2 is virtually nonexistent in Morocco.

AIDS and Transfusion

Nine cases of post-transfusion AIDS have been recorded,
of which five were acquired abroad, notably in France.
Most of those infected by transfusion contracted the
virus prior to 1988. Six of them are dead. We note that
since March 1990 the country’s 37 blood transfusion
centers have maintained a perfect safety record.

Analysis

So far Morocco has not been hard hit by the malady, but
it is dangerously exposed. Its present situation is com-
parable to what prevailed in 1982 in France, where today
AIDS victims number in the thousands. This is why
energetic and rapid action is needed, if our country is to
avoid being faced several years from now with the
serious problems now prevalent in many other countries,
particularly in Africa.

The indicators leading us to conclude the epidemic is
increasing in Morocco are as follows:

*: The cumulative number of AIDS cases is almost
doubling each year;

* The illness is no longer confined to high-risk groups
but is beginning to spread to the general population;

* The epidemiology has become established locally,
after having at first been an imported epidemic.

PAKISTAN

AIDS Spreading Rapidly
91AS1280A Lahore NAWA-I-WAQT in Urdu 10 Jul 91
p3

[Article: AIDS Patients Increasing*]

[Text] Islamabad (Staff Reporter)—According to reliable
sources, the disease of AIDS is spreading rapidly in the
country. The number of AIDS patients in Pakistan has
increased from 60 to 100 during the last few months.
Less than 5 percent of these may survive. It is reported
that doctors have been working very hard to save the
lives of AIDS patients in various hospitals; however,
their efforts have been unsuccessful so far. The existence
of AIDS in Pakistan was discovered about 10 years ago
when a foreigner had visited Karachi. The foreigner
established relationships with several females during his
Stay in Karachi and spread this disease. The sources
revealed that the government was considering some
emergency actions to control the spread of this disease.
According to the sources, sexual permissiveness is
helping spread the sickness. The government is also
considering banning sexual activities in all the “red
light” districts in the country in order to eradicate AIDS.



SPRS-TEP-91-023
12 November 1991

BELGIUM

Quaterly AIDS Statistics Published

91WE0529A Brussels LE SOIR in French 23 Aug 91
pl7

{Article: “Three HIV Positive Cases ,Found Daily in
Belgium”]

[Text] Although the most: recent prevention campaign
filled the screens all summer long and others.are planned
(including using the BD {expansion not given] as sup-
port), the Institute of Hygiene and: Epidemiology (IHE)
is releasing the latest figures on the progression of AIDS
in Belgium. The total number of cases by 30 June was
896, an increase of 44 since the previous quarterly
report. . .

Reality: Triple Official Figures

A total of 6,864 HIV positive cases have been detected,
meaning that the incidence of the disease remains stable.
On the average, three new HIV positive cases are found
daily. However, experts estimate that the actual number
of HIV positive cases is triple the official figure inas-
much as many people are unaware that they are carriers.

Among the 896 cases of AIDS (including 481 Belgians),
431 deaths (216 Belgians) have been reported and 103
persons have vanished. Half of the patients known to
reside in Belgium live in Brussels or the surrounding
region.

An examination of patients of Belgian nationality shows
that half of the adults fall into the 20-39 age bracket. The
ill include 11 children. The proportion of men to women
is 5.9 to 1. Homosexuality and bisexuality remain the
main risk factor: A reading of IHE records shows that 67
percent of all cases among male adults are related
thereto. Heterosexuality is identified as a risk factor in
33 percent of all adult cases (24 percent among men and
60 percent among women).

51 Percent Belgian

For the 6,864 confirmed HIV positive cases, information
relating to sex and age is available on 5,892: 71 percent
are men. The 25-29 age bracket takes in 23 percent of all
cases, 19 percent of them men and 27 percent women.

For 3,366 persons of known nationality, Belgians com-
prise 51 percent of all cases, compared with 33 percent
Africans.

According to the latest figures from the World Health
Organization (WHO), Belgium ranks ninth among Euro-
pean countries hit by the disease, with an incidence of
8.6 per 100,000 inhabitants.

Switzerland, which holds the dubious record, has a rate
of 26.8 per 100,000 inhabitants. France, Italy, and Spain
are not far behind, registering 14,449, 9,053, and 8,199
reported cases of AIDS.

WEST EUROPE 47

~ DENMARK

AIDS Epidemic Feared in Greenland; Nine New
Cases

91P20490A Copenhagen BERLINGSKE TIDENDE
in Danish 10 Sep 91 p4

[Ritzaus News Agency report: “Fear of Greenland AIDS
Epidemic’’—first paragraph is BERLINGSKE
TIDENDE introduction]

[Text] Nine new cases of HIV infection in Greenland—
five of them women. Danish researchers are now pro-
ceeding systematically with a study of why it seems that
HIV infection spreads more quickly in Greenland than
in Denmark. Researchers fear a real AIDS epidemic in
Greenland where 32 cases havebeen diagnosed in all.

One of the theories researchers will test is whether the
HIV virus destroys the immune systems of Greenlanders
more quickly and makes them more vulnerable.

An HIV-positive individual will gradually become more
vulnerable as the body’s immune system breaks down.
Experience from Africa shows that the disease breaks
down the body’s defense system more quickly there. At
present, analysis in Greenland points in the same direc-
tion, says Dr. Mads Melbye of the National Serum
Institute.

According to the doctor another explanation could be
that gonorrhea and syphilis are very widespread in
Greenland and that raises the risk of becoming infected
with HIV because open wounds on sexual organs make it
easier for the virus to enter the body.

Mads Melbye says that the speed with which the disease
is spreading in Greenland is very troublesome. The fact
that the disease in Greenland is a heterosexually trans-
mitted disease also worries the doctor, especially since
the disease came to Greenland later than to Denmark.

Five of the nine Greenlanders who have been diagnosed
with the HIV virus this year are women. And Mads
Melby fears that there could be talk of a real epidemic if
the infection cannot be successfully contained.

IRELAND

Health Department Gives Statistics on AIDS

91WE0511A Dublin IRISH INDEPENDENT
in English 26 Jul 91 p 5

[Article: “85 Die From AIDS”]

[Text] AIDS has killed 85 people in Ireland and 207
full-blown cases have now been diagnosed, according to
the latest Department of Health figures.

Those who have died include 30 homosexuals or bisex-
uals, 23 intravenous drug users, 11 haemophiliacs, five



10 SUB-SAHARAN AFRICA

such confrontations will soon be further sharpened: in
AIDS-prone societies such crimes can easily amount to
murder.

The larger question is the effect of AIDS on race rela-
tions. Epidemics are highly divisive social events, fre-
quently leading to the blaming of the ill and the ill
seeking to revenge themselves on the healthy—dangers
which seem particularly likely in South Africa where the
different racial groups are forever trying to blame others,
while seeking the moral high ground for themselves.

In the past many blacks have tended to accept almost as
a law of nature the fact that whites typically enjoy safer,
healthier lives than they do, but at the very least the new
black elites will hardly accept that.

The inevitable conflicts over the direction of health
spending—how far it is to be targeted at the hapless
masses, how far at the elites—could, of course, be fought
along class and not racial lines. It is even possible that
AIDS will be seen as a national crisis, necessitating a
united response from all social and racial groups—but it
seems sadly more likely that AIDS will feed on, perpet-
uate, and perhaps further inflame historic inter-ethnic
rivalries and grievances.

As yet these are but dark imaginings: at present the
media and the elites of all races are far too rapt by the
lobster quadrille of negotiation politics to give much
attention to something as arcane and embarrassing as
AIDS. South Africa sits mute, awaiting the deluge with
only half an ear cocked for the sound of the great wave to
come.

CP Organ Reviews Country’s AIDS Situation

92WE0033B Pretoria DIE PATRIOT in English
6 Sep 91 pl

[Text] A report in the NATAL WITNESS: “Pediatric
AIDS Cases Jump by 14 Percent” (15.8.91) describes the
astonishing increase in the number of babies born with
AIDS in Kwa Zulu in the last six months.

According to Infection Controller and Deputy Director
of Kwa Zulu hospitals Murray Short, a rise in AIDS-
related deaths in pediatric cases as Edendale and
Ngwelezane hospitals was detected in February this year
and appears to be climbing.

The percentage of HIV-infected mothers in Kwa Zulu is
actually much higher than 14 percent because research
world-wide has established that between 25 percent and
45 percent of children born to HIV mothers develop
AIDS only after two years.

Short admits that the only way to control the spread of
the disease is “counselling,” and community health
education programmes. Edendale hospital’s head of
department of medicine Jim Muller says that control of
the disease can only be successful “if school children take
up the (preventive) campaign themselves.”

IJPRS-TEP-91-023
12 November 1991

This is unlikely to happen. According to the SA Institute
of Race Relations (SAIRR), there is a “chilling happy-
go-lucky attitude to AIDS.” A survey conducted in July
1990 on the attitudes of Kwa Zulu schoolchildren
“between 17 and 23 years of age” revealed that a third of
the respondents believed AIDS to be a “joke” and 90
percent said they would never use a condom, according
to SAIRR.

Many Blacks felt that warnings about AIDS were a
sinister propaganda drive aimed at reducing African
population growth. “Medical doctors believe that these
attitudes are not uncommon among African youth,” says
the SAIRR report. “There is little doubt that AIDS cases
in SA are under-reported, yet no consensus exists about
the extent of the under- reporting.”

Privacy

The current court case involving an action by an alleged
Brakpan HIV- carrier against his doctor concerning the
latter’s alleged breach of doctor/patient confidentiality
throws up another important element in the AIDS
debate: although current belief is that AIDS can be
transmitted solely through sexual contact, drug needles
and blood transfusions, the Brakpan case reveals that the
underlying reason for the doctor’s breach of confidenti-
ality is that he feared that his friend, a dentist, might
contract AIDS from his patient who was also the den-
tist’s patient.

If medical doctors believe that mouth mucous mem-
brane contact is sufficient for the transmission of AIDS,
why has the government not made AIDS a notifiable
disease, and why is the sexual/blood transmission
dictum still rigidly adhered to?

Wide publicity was given in the United States to the
death of five people who contracted AIDS from their
dentist, who later died of the disease. One patient,
Kimberley Bergalis, died in a blaze of publicity,
denouncing the American public health system which
was more concerned with protecting “the wayward” than
in saving the innocent. (Human Events, Washington,
13.7.91).

Shortly before the dentist’s death, he urged his more than
1,700 patients to test for HIV. Four more patients tested
positive.

SAA

It has now been learnt that South African Airways is
considering compulsory crew tests. Fhis follows disclo-
sures that more than 40 cabin attendants may have died
of AIDS-related diseases since 1983.

A recent incident involved a case where a man continued
to serve passengers on SAA until just a few weeks before
his death, and airline staff (especially pilots) have
refused to accept liquid refreshment from cabin stewards
unless the containers are sealed.