16 EAST ASIA

In the case of pregnant women in Hong Kong, they are
routinely being tested for the presence of venereal dis-
ease and hepatitis B, he said.

“After all, their blood is being taken for other purposes
and you’re just taking the excess of the blood to test for
HIV,” he said.

The problem with unlinked testing is that no follow-up
of those found positive could be made which could
defeat the public health program, he said.

Voluntary screening of high-risk groups should go side
by side with this anonymous testing.

Dr Yeoh said it was thought that the procedure would be
more useful if homosexuals were tested, but this would
be difficult to do in Hong Kong.

“The difficulty is finding those populations. In Hong
Kong we don’t have clinics dealing with homosexuals
where we can do this testing.

“So the only other thing we might consider is unlinked
anonymous testing in antenatal clinics because that
would give you a baseline as to how many pregnant
women may be infected and whether we may expect any
infections among children,” he said.

Once the baseline has been established, Dr Yeoh said the
Government could monitor the infection rate by
repeating the testing each year.

Hong Kong has so far detected 133 people infected with
HIV and 25 who developed the full-blown AIDS.

Latest WHO figures show that a total of 435 AIDS cases
have been detected in Asia, and there has been concern
of its further spread if governments do not carry out
proper health education and surveillance.

THAILAND

Senior Army Medical Officers Discuss AIDS

Arun on Mandatory Testing

90WE0058A Bangkok SIAM RAT in Thai
7 Nov 89 pp 1, 3

[Excerpt] [Passage omitted] In a speech before the Press
Association of Thailand, which was presented at Televi-
sion Channel 11 on the evening of 6 November, Maj Gen
Arun Chaowanasai, an advisor to the Medical Depart-
ment, talked about “AIDS and Social Problems.” He
said that the first case of AIDS was discovered at the end
of 1987. The King Monkut Hospital began testing people
for AIDS in February 1988. Studies were initiated, and
the number of patients increased continually. The first
thing that was done was to educate people and ask people
with AIDS to cooperate by informing their doctors and
dentists that they had AIDS. But not everyone did this.

JPRS-TEP-90-001
18 JANUARY 1990

As for the second project, the advisor to the Medical
Department said that most of the AIDS patients at the
King Monkut Hospital are drug addicts. Twenty-five
patients have been given psychological tests. These tests
have shown that the behavior of these people is very
different from other people. That is, all of these people
are very frightened, and many have become depressed
and blame themselves. Many have thought about killing
themselves, and some have actually done so. These
people must be dealt with carefully. Some have denied
that they have the AIDS virus and said that they will
continue to shoot drugs with others and visit prostitutes
without taking preventive measures. This group refuses
to believe that they have AIDS.

“The most important group that we identified in our
study was this group. They want to take revenge and are
intentionally acting in ways that will harm others,” said
Maj Gen Arun. He added that they “want to spread the
disease. They visit prostitutes without taking preventive
measures. They think that because they have the disease,
others should have the disease, too. They are trying to
take revenge. In treating them, we must try to change
their behavior and persuade them to cooperate with us.”

Maj Gen Arun said that the army has established a
center to provide advice to those with the virus. Meet-
ings are held with their families. This project will have to
be carried on for a long time, because the number of
people with first-stage AIDS continues to increase. Many
of these people are still on active duty. The next project
is to make testing mandatory for every army official. The
army has to have healthy people who can carry out their
duties effectively. The army must be free of people with
AIDS, because in time of war, people have to donate
blood on the battlefield. If a soldier at the battlefield has
AIDS, this disease will spread.

Maj Gen Arun said that servicemen will be tested in such
a way that people will not know who has been tested or
who has the AIDS virus. After the AIDS carriers have
been identified, senior commanders who can be trusted
will be informed. They will be advised to take preventive
measures. This is feasible, because this is the army. The
final project is to build a center to take care of those who
are in the final stages of the disease.

“This will be a small unit that will take care of AIDS
patients who are seriously ill. Our objective is to make
them as comfortable as possible and enable them to die
in peace. The people in this unit will all be volunteers,”
said the advisor to the Medical Department. [passage
omitted}

Panya on Budgetary Considerations

90WE00S8B Bangkok NAEO NA in Thai
26 Oct 89 pp 1, 20

[Excerpt] [Passage omitted] In an interview on 25
October, acting Maj Gen Panya Yuprasoet, the director
of the Medical Department, talked about controlling
AIDS. He said that it probably won’t be possible to do



JPRS-TEP-90-001
18 JANUARY 1990

developing a prognosis considerably worse than that
occurring among the adult population, because most of
those stricken do not live to be a year old.

The “shock action” proposed in Spain to halt the
advancement of AIDS is encountering difficulties of all
types, ranging from meager attention on the part of
certain risk groups (such as drug addicts) to moral
criticism.

The distribution of condoms has been discredited by the
Church as an institution and advised by the majority of
experts as a practical barrier for preventing contagion.
Nevertheless, the proliferation of recommendations has
also fostered an over-production of this item, which has
not always met the quality requirements.

AIDS Cases in Spain

Province ‘Number of Cases
Catalonia 730
Madrid 612
Basque Country 310
Andalucia 269
Valencia 237
Balearics 94
Galicia 70
Castilla-Leon 60
Asturias 37
Huesca-Saragossa-Teruel 51
Canaries 31
Castilla-La Mancha 38
Navarra 35
Murcia 32
Cantabria 30
Extremadura 25
La Rioja 16
Ceuta 4
Melilla

AIDS Campaign Urged; Vatican Posture Scored

90WE0054A Madrid DIARIO 16 in Spanish
19 Nov 89 p3

[Editorial: “Between Unconsciousness and Dogma-
tism”]

[Text] According to a report from the World Health
Organization, Spain is showing the greatest advance-
ment in the spread of AIDS in all of Europe. In our
country the disease is progressing at the rate of 30 cases
appearing per week, and the number of persons with the
disease already exceeds 3,000. That report adds that, if
this course continues, starting in 1992 the Spanish State

WEST EUROPE 37

will have to spend about 60 billion pesetas per year on
treatment for those stricken with this horrifying “20th
century plague.”

The progress of the disease is due largely to the society’s
unconsciousness, On the one hand, we have just wit-
nessed in public the trial of the director and several
high-ranking officials of the Bellvitge health institution
in Barcelona, where several infections occurred from
transfusions of contaminated blood not subjected to the
pertinent checks. This gives the impression that, at least
until quite recently, health conditions in our country
were favoring the spread of the disease from completely
avoidable types of infection.

On the other hand, it is obvious that the highest risk
group at present in Spain, that of drug addicts, is not
implementing the simple rules of hygiene that could curb
the development of AIDS. And, similarly, perhaps for
obscure reasons of deliberate unconsciousness, the pop-
ulation as a a whole is reluctant to admit the seriousness
of the risk. As Italian Prime Minister Andreotti recently
declared on the occasion of the international conference
called by the Vatican, “there is disregard for the true
data” concerning the disease; as if the rationalism of our
time, a conquest of modern civilization, had been
destroyed upon the sudden emergence of this biblical
type of plague that has changed the sexual mores of a
large part of the world’s population.

AIDS poses, primarily, a strictly health problem. Current
medicine, despite its high degree of development, has
not yet managed to give a response to the malignant
virus, which continues to be a mortal danger. Some
prestigious specialists have predicted that, by 1992, there
will be a first vaccine; nevertheless, there is no effective
remedy now other than prevention. AIDS can be con-
trolled, and even eradicated, by taking certain precau-
tions in sexual relations (or, of course, refraining from
those entailing any risk), and by banishing certain prac-
tices causing the infection of drug addicts (especially
avoiding the multiple use of needles for intravenous
injection). Hence, it seems clear that society must under-
take a major prophylactic campaign to foster prevention
and check the tragic advancement of the disease.

As has been stated, the Vatican has shown signs of
sensitivity to the problem by calling a major interna-
tional conference to which representatives of all sectors
involved in the problem were invited. There emerged
from it the plausible recommendation to offer under-
standing to those with the disease, who are not foul
persons but rather victims of a painful destiny. Never-
theless, at this forum puritanical morality was unneces-
sarily intermingled with the essential issue. The Pope
categorically condemned the use of the condom, talking
about “immunodeficiency of fundamental values.” To
the supreme hierarchy of the Catholic Church there is no
licit sexuality other than that intended for procreation,
although this radical position is not accepted by large
sectors of that religious denomination.



IPRS-TEP-90-001
18 JANUARY 1990

He stated the likelihood was that this trend would
continue for at least the next three or four years.

Mr Flanagan was addressing 48 AIDS counsellors from
the UK, Iceland, Norway, Sweden, Finland, Nether-
lands, Denmark and Ireland at a week-long international
workshop at Dublin Castle.

He pointed out that the AIDS problem in Ireland, as in
other countries, was the most significant challenge in the
public health field for decades. Since monitoring was
introduced a total of 110 AIDS cases had been reported.

The conference was organised by the World Health
Organisation to tackle the need for more counselling
services. Counselling is seen as a critical weapon in
preventing the spread of the AIDS infection.

Dr James Walshe, national AIDS co-ordinator said 52
people here had already died from AIDS, and a further
900 were HIV Positive. “The very best scenario for the
problem in Ireland is that it will get very much worse
before getting better.”

He said the main danger group for the spread of AIDS
were drug addicts using infected needles who then had
sexual relations with people in the main stream. The
devastating effect of the drugs on their minds meant the
incidence of AIDS among them could not be completely
controlled.

Meanwhile a group of Japanese researchers yesterday
said they had developed monoclonal antibody which
apparently killed only cells infected with the AIDS virus
while leaving normal cells intact.

So far the antibody is successful only in the laboratory,
and researchers still need to determine its efficacy in
clinical trials on AIDS patients.

SPAIN

Figures Showing Spread of AIDS Published

30 New Cases a Week

90EWO05S5A Madrid DIARIO 16 in Spanish
19 Nov 89 p 15

[Report by Arturo Cenzano]

AIDS is spreading faster in Spain than in the rest of the
European Community countries, according to the latest
surveys of the World Health Organization. The disease is
spreading at an average rate of 30 new cases a week, and
the number of patients now exceeds 3,000.

Specialists believe that by 1992 Spanish citizens suf-
fering from what has been called the “plague of the 20th
century” will cost the State more than 60 billion pesetas
a year.

The Basque Country, which has the highest incidence in
Europe and where drug addicts are the main risk group,

WEST EUROPE 33

will have to spend around 50 billion pesetas to treat
those who have developed the disease. This means that a
single disease will absorb some five percent of the
general budget.

The outlook for the spread of AIDS in the coming years
is alarming. Estimates are that 10 years after contracting
the infection 40 percent of the carriers will wind up
developing the disease and that close to 20 percent of the
regular partners of heroin addicts who are serum-
positive have already been infected through sexual rela-
tions.

As far as the WHO specialists are concerned, the AIDS
situation in Spain is one of the most worrisome in
Europe. This is because drug addicts, who are the hardest
hit group in our country, are much more difficult to
monitor than homosexuals. Thus, whereas Italy and the
United Kingdom are succeeding in slowing the spread of
the disease, Spain is unable to monitor drug-addict
carriers in spite of the major efforts that it has put forth.

A truly tragic consequence of the disease’s incidence
among addicts is that it has been spread by drug-
addicted mothers. Spain has officially acknowledged
some 30 such cases and, along with Italy, is at the top of
the European list in this subgroup, with an incidence
easily double the international average.

Moreover, we should bear in mind that the thorough
verification demanded by the WHO to officially declare
someone an AIDS sufferer means that the statistics lag
considerably behind the actual situation. The specialists
consulted by DIARIO 16 say that more than 70 cases
have effectively been verified and that the actual number
of such AIDS cases is around 200.

The failure to monitor Spain’s population of drug
addicts is also causing a worrisome increase in diseases
that were thought to have been practically eradicated,
including, most prominently, congenital syphilis.

The previews of the first clinical report that is being
drafted on pediatric admittances to Basque hospitals
reveal that 92 percent of the cases under study were due
to maternal drug addiction. The report is being coordi-
nated by Professor Delgado Rubio.

The infected infants show the same clinical symptoms as
adults. The course of the disease tends to be considerably
faster however, so much so that babies born with the
disease generally do not live longer than | year.

The other causes of infection lag far behind. The pres-
ence of a previous hepatitis-B infection was detected in
58 percent of the cases, and only 8 percent of the
transmissions were due to sexual contact.

The clinical manifestations of the disease during preg-
nancy mean that the infant will almost certainly be born
with AIDS. Hence, a significant number of therapeutic
abortions are expected among drug-addict mothers, all
the more so when the link between pregnancy and the
triggering of the virus is being clearly demonstrated.



a2 WEST EUROPE

Subsidized Syringes as Anti-AIDS Measure

90WE0037A Madrid DIARIO 16 in Spanish
19 Oct 89 p 17

[Article: “Basque Government Will Subsidize Purchases
of Syringes and Condoms”]

[Text] Drug addicts will be able to purchase syringes and
condoms in nearly 1,000 pharmacies in the Basque
Country. These items will be subsidized by the Basque
Department of Health and will be sold for a price of 50
pesetas. This is part of a program designed by the health
officials to prevent AIDS.

Yesterday in San Sebastian the Basque government’s
health and consumer affairs director, Jose Manuel
Freire, signed a cooperation agreement covering this
program with the presidents of the Colleges of Pharma-
cists of the three Basque provinces. This agreement will
take effect on 1 November 1989.

The pharmacists have agreed to sell condoms and
syringes and to inform and remind heroin addicts of the
dangers of infection they risk by sharing syringes and by
having sexual relations without using condoms.

For 50 pesetas, drug addicts will be able to purchase a
syringe with a hypodermic needle already inserted; both
items will be sold packaged in a hard plastic case with a
cap. The users will be asked to place the syringe and
needle back in this case after use, and then to throw the
package away.

The same package, to be sold in a plastic bag labelled
“No to AIDS, Yes to Life,” will also contain a condom
and instructions for using both the syringe and the
condom.

The purposes of the plan to distribute these items
through pharmacies are: to keep drug addicts from
sharing syringes, to encourage them to use condoms, to
keep used syringes from posing a risk to the general
population, and to set up an information and education
outreach program, so that health officials will be able to
reach the drug users’ community on a regular basis.

Freire acknowledged that the step his department has
taken may be “controversial,” but he emphasized that it
has been effective in other countries, and expressed his
conviction that in AIDS prevention, “the greatest danger
is doing nothing from fear of the dangers involved.”

The socialist official said that AIDS is the major public
health problem in the Basque Country today. The
number of HIV-positive cases now numbers close to
5,000 persons; to date, 416 persons have been diagnosed
as actually having AIDS. On a proportional basis, these
figures are the highest in Spain.

Of the 416 patients who have been diagnosed as having
AIDS, 78 percent either are or have been intravenous
heroin users; about 5 percent contracted the disease by
having sexual relations with infected partners.

JPRS-TEP-90-001
18 JANUARY 1990

Of the AIDS patients, 2.6 percent are the children of
heroin addicts, and a similar proportion of the cases are
homosexual drug addicts.

Before deciding to distribute syringes through pharma-
cies, the Basque health officials studied other possible
distribution methods, such as vending machines, mobile
vans, and health centers or hospitals. These possibilities
for distribution were rejected.

The final decision was made after reviewing the experi-
ence in Holland, where health services have begun to
distribute syringes and information through pharmacies
and health centers.

SWEDEN

AIDS Spread Less Than Forecast

90WE0074A Stockholm DAGENS NYHETER in
Swedish 22 Nov 89 p7

[Article by Micke Jaresand: “HIV-Spread Less Than
Feared”)

[Text] There were 2,267 HIV-positive persons in Sweden
as of 31 October of this year. Of that figure 349 had
contracted AIDS and of those 349, 168 had died.

This is what the most recent statistics for the spread of
AIDS look like in Sweden. Numbers that are far better
than the alarming reports of only 3 to 4 years ago.

The spread of HIV has leveled off and today about 30
new cases per month are reported. According to the
prognoses of 1986, the number ought to have been
almost 10 times greater, but the feared AIDS epidemic
has failed to appear.

Several county councils have drawn the consequences
from this. The special AIDS committee in Stockholm has
been discontinued and in its stead there is a plan for
incorporating the work on HIV/AIDS into the general
healthcare system.

No other disease has involved so many physicians,
researchers, volunteers, and authorities in such a short
time as AIDS. Conferences and information campaigns
succeeded each other.

Warning Remains

No cure or vaccine has yet to be discovered. That is why
physicians and other experts are still warning against the
risk of relaxing and believing that the danger is past.

“You have to view the disease in a Jong range perspective
and make reasonable biological judgments,” said Robert
Olin, former head of the AIDS committee at the
National Social Welfare Board, in a recent interview
with the DAGENS NYHETER.



10 SUB-SAHARAN AFRICA

More Blacks Reportedly Test AIDS Positive

54000008a Johannesburg THE CITIZEN in English
20 Oct 89 p 2

[Text] There has been a significant increase in the
number of Black people testing positive for HIV anti-
bodies, a member of the AIDS Advisory Committee,
Professor Denis-Pudifin, said in Durban yesterday.

About 200 people in the country had tested positive for
virus antibodies since July, and an increased percentage
of these were Black.

This indicated a disturbing increase in the spread of the
disease in this community.

Education was necessary to slow down the spread of the
disease and individuals needed to take responsibility
against the possible transmission of the killer virus, Prof
Pudifin said.

Meanwhile, in Sandton yesterday, American AIDS spe-
cialist, Dr Glen Margo said AIDS was a big problem in
Africa and South Africa.

Dr Margo, director of the US AIDS com programme,
was involved in implementing AIDS prevention pro-
grammes in developing countries.

He was speaking at the South African Institute for
Medical Research congress.

“HIV infection is everyone’s problem, anyone is poten-
tially at risk and no-one can afford to ignore AIDS,” he
said.

“People are not practising safe sex. There is no mobilised
community response to AIDS and not even the resources
for any kind of reaction,” he said.

Dr Margo said the migrant labour system encouraged
AIDS and the mines were potentially high risk areas,
with workers spreading AIDS across countries’ borders.

He said AIDS policy should encourage voluntary, confi-
dential testing, counseling and treatment.

“Discrimination against those who are HIV infected
should be prohibited and confining HIV carriers must be
forbidden. A single official policy spokesman should be
designated to speak publicly about HIV infection,” he
said.

“Commitment and responsibility in dealing with the
HIV virus needs to be institutionalised if it is to be
effective,” he said.

One of the most controversial issues has been HIV
testing and the purpose for which testing and test results
are used,

Those being tested must do so voluntary, he said.

JPRS-TEP-90-001
18 JANUARY 1990

Government, Private Sector To Fight AIDS

54000011 Cape Town THE ARGUS in English
12 Oct 89 pI

[Article by Bruce Cameron]

[Text] The government is trying to establish a founda-
tion in partnership with the private sector to fight AIDS.

The move comes against the latest figures being pro-
duced by AIDS researchers which show the incidence of
HIV positive cases is now doubling every six months in
South Africa.

A spokesman for the Department of National Health was
loath to comment on the proposed foundation apart
from confirming that the department “is looking into the
possibility of establishing a foundation.”

Mr Mike Ellis, Democratic Party health spokesman, said
in an interview that he hoped the government did not
intend to abrogate its responsibilities by attempting to
establish the foundation.

Raise funds

According to people involved in the negotiations the
main purpose of the foundation would be to raise funds
to finance an AIDS campaign.

The government has indicated that it sees AIDS as a
“social” and not a “health” problem and feels the private
sector should be closely involved in combating the
spread of the disease.

Mr Ellis said that the government’s AIDS programmes
have not been “overly impressive so far.”

An AIDS Foundation could be seen as a way for the
government “to opt out of its responsibilities and this
possibility cannot be ignored.”

“It is also probably directly related to the severe state of
our economy and the fact the government does not have
the money to embark on expensive programmes no
matter how necessary they are.

“If this is the case the foundation must be seen in a
positive light as the potential saviour of hundreds of
thousands or even millions of lives.”

Mr Ellis said a foundation might prove less reluctant to
embark on real educational programmes than the gov-
ernment had been.

He pointed out that the government had been criticised
for its ineffective action in fighting AIDS.

“There is a very real need for an extensive and on-going
educational programme which would include radio, tele-
vision and the Press as well as a programme for use in
schools.



20 LATIN AMERICA

were infected by their husbands, who brought the disease
home with them from trips to foreign countries. Lily is
no exception. While picking avocados for breakfast, she
says that she is the leader of the “neighbors’ organiza-
tion” (a patient organization) that is concerned with
disciplinary problems, complaints, requests for trips by
patients, etc. Her husband, who also is a patient, is a
doctor and also works here in Los Cocos as an assistant
physician.

Many mechanics, nurses, and others continue working,
but now they do it in the sanatorium. All patients receive
their pay as they did formerly. Those who did not have
jobs get 110 pesos a month. Foodstuffs and medicine are
free. Some 28 married couples live here; 17 of them were
married in the sanatorium.

Pregnant Women with AIDS

“We have two pregnant women. We recommend abor-
tion, but we have no authority to compel anyone to have
an abortion,” Perez says. “Some 38 percent of the
patients are homosexuals. They even pair off and live
together, but we don’t interfere.”

However, Antonio is able to say that there are many men
among the patients in the sanatorium who do not want to
be regarded as homosexuals. At the same time, he states
emphatically that there is a good feeling of unity
although party members, former convicts, housewives,
soldiers who have fought in Angola, journalists, and
others are there. “AIDS hits all social groups in Cuba,”
Perez says.

The sanatorium is open every day for visits by family
members. All patients from the province of Havana go
home every Sunday. Those who come from the other
provinces go home for four days out of every 45 days.
The rule is that only married couples can leave the
sanatorium without being accompanied by one of the
sanatorium’s employees “to prevent sexual contact with
strangers.”

“If the patient has a partner, we inform him or her of the
tisk involved in sexual intercourse and recommend the
use of contraceptives in any case. But we do not go into
the bedroom with them. The patients whom we are
considering, together with the patients’ organization, are
conscious of their responsibility for their own health and
that of others, and they only go home every Saturday and
Sunday,” Perez says, and he adds that their relationships
with their families are not always free of problems.

Many get divorced when the wife has to accept both
infidelity and the disease. But generally the family sup-
ports the patient once they have overcome their preju-
dices. “I have seen brothers who shrank from embracing
their sick brothers out of fear of getting infected, and I
have seen relatives who unobtrusively wiped off the
chairs when they sat down. At the beginning it was also
hard to get entertainers to come out here and perform,
but that changed entirely after the first ones had been
here.”

JPRS-TEP-90-001
18 JANUARY 1990

Perez, who has only been the director for 3 months,
emphasizes the fact that the sanatorium is not the way it
was in 1986. “We know more about AIDS now. The
population is better informed. Therefore the system for
treating AIDS should not be viewed exclusively as a
statistical phenomenon. We send people home now
without escorts. The next step that has been discussed is
to let the patients keep their jobs and to let people live at
home in certain cases. The most important thing is to
have a patient treatment method as accurately suited to
the individual as possible,” he says.

Criticism of Cuba

Assistant Minister of Public Health Terry admits that
there is much criticism of the Cuban model program
internationally.

“Isolating people smitten with AIDS is not an ideal
solution, but if a stop is to be put to the disease I do not
see any alternative. Cuba is one of the few countries
where the disease has not spread proportionally, and
where the percentage of HIV-positive individuals has
been reduced. In 1986, it was 0.016 percent and in 1988
it was 0.005 percent. Time will tell whether the Cuban
strategy is correct or not.”

In spite of the Catholic Church’s disapproving attitude,
Cuba has carried out a quite extensive educational
campaign regarding AIDS with question-and-answer
programs on television and instruction in the highest
primary-school grades, in the secondary schools and the
universities. Posters hang in workplaces and polyclinics
that state specifically that AIDS is not transmitted by
toilet seats, mosquitoes, handshaking, etc. On the dan-
gerous side is sex with varying partners without contra-
ceptives and sex with foreigners.

In Cuba, where machismo makes homosexuality
extremely unpopular, the authorities’ campaign has not
concentrated on male homosexuals’as a source of AIDS.
The chief danger is foreigners, and especially tourists.

A male tourist guide said to me, “Previously, one might
be tempted, but now I might have bad luck with a
foreigner, and I will stick with the Cuban girls, and
consequently with my wife.”

Obligatory Tests

“Today the population is better informed, but that has
not changed people’s habits pronouncedly. Sales of con-
traceptives are increasing too slowly. The young people,
especially, believe that they are immortal, although they
are the ones who have the most sexual relations. But the
interest we observed in TV programs, particularly,
makes me feel optimistic,” Terry says.

Furthermore,the Cuban fight against AIDS will call for
an extensive, voluntary and obligatory testing of the
population. On 1 September 1989, 5,000,000 AIDS tests
were performed, with the discovery of 333 HIV-positive
individuals as a result.



38 WEST EUROPE

In view of the progress of this unsolvable disease, it
would appear essential to instill the idea of prevention in
the society by all possible means. There is no question
that, if the condom can reduce infection among those
who do not share the strict moral precepts of the Cath-
olic Church, its use should be promoted. And it is equally
logical for states to sponsor sensitization and conscious-
ness-raising campaigns among all citizens, because the
threat has transcended the initial risk groups (homosex-
uals and drug addicts). In short, the AIDS threat must be
confronted realistically and pragmatically, setting aside
all dogmatism and battling persistently against collective
unconsciousness.

Discrimination Against HIV Positive Carriers

90WE0039A Madrid DIARIO 16 in Spanish
24 Sep 89 p 14

[Article by Amparo G. de la Gama: “The AIDS ‘Apart-
heid””; first paragraph is DIARIO 16 introduction]

[Text] A new outbreak of discrimination appeared sev-
eral days ago in a school attended by a girl with AIDS
antibodies, bringing renewed attention to the fear
present in Spain of this fatal illness that is continuing to
spread throughout the nation. There are already 3,353
cases of AIDS in Spain. The policies of some hospitals
about mixing AIDS patients in with people suffering
from ordinary diseases has created uneasiness among
hospital patients and staff. A heroin addict with the
AIDS virus told DIARIO 16 that he had been chased out
of a disco with sticks when the people there found out
that he had AIDS.

Curro has just died of AIDS on the third floor in the
hospital. He had been using intravenous drugs for 5
years and nothing had happened to him until he met “a
kid who was really into the drug scene in the neighbor-
hood,” with whom he shared syringes.

For the past few months, Francisco has been living in a
hospital, suffering from pneumonia. After he developed
the first symptoms of the disease, he lost all hope of
living, and the only thing that gave him any pleasure at
all was the feeling of pumping out his infected blood with
a syringe, in a vain attempt to fight the disease.

While convalescing in the hospital he skipped out several
times and went back to his neighborhood, unable to
stand being hospitalized. One day the police found him
lying on the side of the road, his arm covered with needle
tracks. After that he entered the terminal phase of the
disease, and the doctors could do nothing more for him.

The last of the patients who lived with him [in the
hospital] complained about the hospitals’ terrible patient
placement policies.

“I have been paying Social Security for 15 years, and
because of this damned operation I needed, I’ve had to
lie beside a degenerate whose arms are riddled with
needle tracks, and, to top it off, he’s dying of AIDS,”

SJPRS-TEP-90-001
18 JANUARY 1990

Lorenzo exclaimed indignantly, speaking in the hospital
corridor where he is convalescing from appendicitis.

Many patients like Lorenzo are not willing to share their
hospital room with people suffering form Acquired
Immunodeficiency Syndrome. “They say we’re racists,”
protests Elvira, “but I don’t see why I should have to put
up with these creatures’ filth while I am recovering from
my illness.”

On 12 October Luis Rubio, the head of hospital services,
agreed that “feelings among the patients are running
very high. It bothers the majority of them to have to live
for several days next to a person with AIDS.”

The medical personnel who take care of these patients
have also expressed their concerns: “Even though we’re
very careful when we take blood or give them injec-
tions,” said Angeles Menchero. “You just can’t avoid
cutting yourself without realizing it. We really are very
much afraid of getting infected with AIDS.”

AIDS patients are assigned to rooms in Spain’s hospitals
based on the disease for which they are hospitalized at
that time. “We don’t try to isolate them,” said Carlos
Hita, deputy director of hospital services, “so we can,
once and for all, put an end to the social disease stigma
with which these patients are burdened.”

In Spain drug addiction is the leading risk factor for
AIDS, and is responsible for 43 percent of the AIDS
cases, followed by homosexuality, which is responsible
for 26 percent, followed by hemophilia, 20 percent.

Guillermo is gay and has had AIDS for 5 years. “When
I learned I had AIDS I was totally overwhelmed. It was
traumatic for my family to learn what was wrong with
me, and after a television program in which I described
my experiences, many doors were closed to me.”

Guille is a dancer, but in the evenings he volunteers at
the Anti-AIDS Citizens Committee to help other people
who suffer from the same disease he has. “For a number
of years we’ve been trying to dispel the anguish that some
of our comrades suffer, for the idea that they are the
living dead has been drummed into them.”

“Now,” continues Manuel, who is also an AIDS patient,
“We have grown stronger from being with other people
like us. Even though the virus is leaving us without
defenses, we have an inner strength that no virus can
take away from us.”

At the committee’s weekly meetings, everyone is aware
that they are facing death; “‘We all know about death, but
none of us wants to believe in it,” commented one
member.

The case of Maria, the girl people wanted to expel from
school because she has AIDS antibodies, has been dis-
cussed a great deal by these patients. “They discriminate
against us,” said Victor. “The other day I was chased out
of a disco with sticks when they found out I had AIDS.”



IJPRS-TEP-90-001
18 JANUARY 1990

ANGOLA

AIDS Leads to 28 Deaths, 156 Cases

90WE0069A Lisbon DIARIO DE NOTICIAS in
Portuguese 27 Nov 89 p 26

[Text] AIDS has caused 28 deaths in Angola since 1985,
the coordinator for the program to control that disease in
that country, Dr Elsa Montes, revealed yesterday, adding
that those deaths occurred together with some 150 cases
that have been confirmed since the health authorities
began monitoring carriers of the virus.

A report on the disease emphasized that “the AIDS
situation in Angola constitutes a disquieting public
health problem, although it has not yet reached alarming
proportions.” On the other hand, June 1987 data from
the Ministry of Health on the spread of the disease
indicate a mortality rate of 50 percent among known
cases, a rate which has since declined to 25 percent due
to better treatment from the medical community, which
has allowed those afflicted hope for a prolonged life.

In this country there are currently 156 individuals who
have tested positive, who are monitored by the national
technical commission created in October 1987 to coor-
dinate the programs against Acquired Immune Defi-
ciency Syndrome, said Elsa Montes.

The vast majority of the afflicted are of Angolan nation-
ality and only sporadic cases of contamination have been
detected among foreign citizens of Zairian, Cape Verd-
ian, or Namibian nationality.

“They all belong to high-risk groups, which include
heterosexuals, pregnant women, and blood donors,” said
that authority.

According to the official report on the disease, “the only
common factor that characterizes almost all the cases is
that the carriers had lived for many years in neighboring
countries,” in a clear reference to the republics of Congo
and Zaire.

“Until now, a greater number of HIV-1 virus infections
have been detected in the RPA, although some studies
have later indicated the existence in circulation of HIV-
2, which makes the epidemiological situation and con-
trol of the disease in this country more complex,” the
report warns.

The provinces with the greatest number of cases are
located in the north of the country, particularly Uige,
Zaire, Cuanza-Norte, and Luanda.

According to Elsa Montes, sporadic cases of AIDS have
been detected in the other regions of the country.
500,000 Additional Cases Worldwide

Meanwhile, the director of the program against AIDS in
the World Health Organization, Jonathan Mann, said
that more than 500,000 additional people could contract

SUB-SAHARAN AFRICA 1

AIDS over the next 2 years if the current rate of
contamination is maintained.

In the year 2000 that number could reach 6 million if a
vaccine or efficient treatment is not found by then, the
WHO official added, during a symposium on AIDS
organized by the Ministry of Health of Great Britain.

The epidemic progresses rapidly, said Jonathan Mann,
who called upon all countries to follow efforts to contain
it. WHO estimates that there are currently between
600,000 and 610,000 people contaminated by the virus.

Last 1 November WHO had recorded 186,803 cases of
AIDS in 152 countries, after it had been notified of 4,000
additional cases in October.

KENYA

Country Named AIDS Research Center

34000223Z Nairobi DAILY NATION in English
8 Nov 89 pS

{Article by Emman Omari: “Kenya Chosen by WHO”]

[Text] The Minister for Health, Mr Mwai Kibaki, yes-
terday said Kenya has been chosen by the World Health
Organisation (WHO) as a centre coordinating research
into the cure of the dreaded Acquired Immune Defi-
ciency Syndrome (AIDS).

The minister said the Kenya Medical Research Institute
(Kemri) was chosen as a regional centre because of its
facilities and qualified doctors.

Mr Kibaki said this while answering questions on the
Voice of Kenya’s (VOK) Press Conference programme
last night.

He told a panel of journalists that Kenya reports AIDS
cases to WHO appropriately because “we do not want to
hide anything.”

The minister said there were now over 6,000 confirmed
AIDS cases in Kenya.

He said his ministry was now setting aside wards in every
provincial hospital including Kenyatta National Hos-
pital for AIDS victims.

“Isolation does not mean they will be taken to remote
places. It means putting them in separate wards where
they can be looked after by more qualified staff,” he said.

Mr Kibaki, who spoke on a wide range of subjects, said
the ministry was now discussing with the nurses associ-
ation about a recent request by nurses for special wear
and allowance to those who looked after AIDS victims.

On the subject of cost-sharing, set to begin next month,
he said it would improve services in all hospitals.



SJPRS-TEP-90-001
18 JANUARY 1990

Other weak points were also verified: The majority (70.8
percent) of those questioned stated that they have no
reason to change their sexual behavior. This position was
observed most strongly among women (84.7 percent), in
the Athens area (76.4 percent), and among married
people (83 percent). The people who stated that they
have already changed their sexual behavior are mainly:

1. Men (21.7 percent).

2. Men and women in the age groups 18-24 (21.3
percent) and 25-34 (24.2 percent).

3. Residents of urban areas (20.8 percent).

The meaning of change for 15 percent is limited to a
more careful selection of lovers, without the use of a
condom.

Ceaseless Information

I asked Professor Matsaniotis: Why did you address
yourself predominately to males? He answered: ”The
makeup of the sample (70 percent men, 30 percent
women) was dictated by many definable, but also unde-
finable, factors. I will cite the most significant:

1. It is accepted that, among the semi-urban and rural
population which is married, the possibility of an extra-
marital affair is greater among men than women. It is
also accepted that the possibility of the questionnaire
being reliably completed would be greater among men
than women, especially among older people.

2. The perception prevails that, even in our day, at least
among older people, the man is more sexually aggressive
than the woman, and, by extension, more sensitized

WEST EUROPE 31

3. The risk of AIDS is great among homosexual and
bisexual men and non-existent among women with cor-
responding sexual behavior. (Editor’s note: as concerns
female contacts).

Public Opinion Poll on AIDS

The questionnaire was composed by professors N. Mat-
saniotis and D. Trikhopoulos and Market Research,
which completed the technical part of the survey.

1. Knowledge About Diseases/Infections

The chief diseases or infections which are considered a
threat to health and life were mentioned spontaneously
by those questioned in the poll are:

AIDS, 71.3 percent; cancer, 62.4 percent; and heart
diseases, 35.6 percent, while significantly lower percent-
ages are shown by syphilis, 9.4 percent; hepatitis (a), 9.6
percent; hepatitis (b), 7 percent and drug addiction, 6.3
percent.

2. Degree of Seriousness/Concern
AIDS is considered by those questioned in the poll:

An extremely serious threat by 83.6 percent and a very
serious threat by 13.7 percent for the health of each of us.
The degree of seriousness shows significantly high per-
centages equally among all the age groups, 18-54, in all
areas, educational levels and family situations.

While the degree of seriousness does not vary among the
various subgroups, that is, age, sex, etc., the degree of
concern shows significant deviations according to sex,
age and family situation.

y

It is clear that people with very strong sexual activity,
that is, unmarried men aged 18 to 34, are most con-

about AIDS. cerned about AIDS.
Specifically, the “picture” is as follows (in percentages):

Total Men 18-24 25-34 Unmarried
Tam (extremely/very/somewhat)con- 39 41.4 54 45.3 58.5

cerned

Athenians and Salonicans show higher percentages of concern than the residents of urban and semi-urban/rural areas (in percentages):

Total Athens Salonica Urban Semi-urban/rural
1 am (extremely/very/somewhat) con- 39 43.8 46.1 38.7 33.8
cerned
The following have the least concern about the threat of AIDS (in percentages):
Total Women 35-44 45-55 Married
Lam not concerned 56 63.9 55.1 74.1 65.8



SJPRS-TEP-90-001
18 JANUARY 1990

blood tests on all servicemen, because that would be very
expensive and it would have psychological effects. Thus,
tests are now being done on a random basis in order to
determine which groups are at risk of contracting this
disease. This will allow us to conduct analyses and focus
on the right points.

The director of the Medical Department said that the
army will take care of those found to have this disease. It
will not discharge them. As for draftees who have com-
pleted their 2-year tour of duty, the army will coordinate
things with the Ministry of Public Health in looking after
them. The army will take steps to ensure that these
people are not discriminated against. They will be
treated like everyone else and encouraged to feel that
they will live for many more years. Because people who
test positive for the AIDS virus do not always come
down with the disease, doctors will not reveal this
information and will tell only the individual and his
commander so that he can conduct himself appropri-
ately.

Acting Maj Gen Panya stressed that an effort will be
made to educate soldiers in every unit so that they can
protect themselves. The most important thing is that
men in our society have to know what types of behavior
put them at risk of contracting such diseases so that they
can protect themselves and their families. Soldiers
should take more responsibility for themselves so that
the army doesn’t have to control things. Because once it
is known that a person has AIDS, this will have social
and psychological effects. It will affect his family and
friends, who may not want to be around him.

Acting Maj Gen Panya said that he is opposed to testing
senior officers for similar reasons. He added that he is
opposed to establishing an AIDS colony because of the
cost involved. The economic situation is different from
before. An example is the leper colony, which is now of
little use but which is damaging socially and psycholog-
ically. If those with the AIDS virus have considered
things carefully, they probably won’t do anything to
harm society or spread the disease. They must accept
their situation. We will try to bolster their morale and
help them live an ordinary life. [passage omitted]

Budget Provided for Testing

90WE0058C Bangkok MATICHON in Thai
18 Oct 89 pp 1, 24

[Excerpt] [Passage omitted] Lt Gen Singha Saowaphap,
the former director of the Medical Department, said that
the men in the Ist Royal Guards Infantry Regiment were
tested for AIDS, and two men were found to have the
AIDS virus. The results of the testing done at the
Chulachomklao Royal Military Academy aren’t yet
known. Men in other units will not be tested until the
RTA CINC gives the order. Besides this, the RTA CINC
has been informed that senior officers should be tested
for AIDS, too. This will be done on a voluntary basis.
However, the RTA CINC has not yet approved this. He

EAST ASIA 17

has approved budget funds to procure AIDS testing
solutions for use in the army. [passage omitted]

Supreme Command Officer Comments

90WE0058D Bangkok SIAM RAT in Thai
18 Oct 89 pp 1, 2

[Excerpt] [Passage omitted] In an interview after the
ceremony to turn over his position as director of the
Medical Department to Maj Gen Panya Yuprasoet, Lt
Gen Singha Saowaphap, an officer attached to Supreme
Command Headquarters, said that even though he is
turning over this position to another person, he will
continue to carry out special duties assigned by the RTA
CING, that is, he will continue to fight AIDS in military
units. He will coordinate things closely with the director
of the Medical Department. He has also been asked to
serve as the army’s representative in coordinating things
with the Ministry of Public Health in fighting AIDS.

Lt Gen Singha said that during the yearly physical
examination given to noncommissioned officers and
officers, they should also be tested for AIDS. This should
be done on a voluntary basis. But the RTA CINC has not
yet approved this. The actions taken by the army to fight
AIDS have achieved good results. Soldiers are aware of
the danger and have voluntarily taken steps to protect
themselves. Gen Chawalit Yongchaiyut, the RTA CINC
and acting supreme commander, has approved budget
funds to procure AIDS testing solutions so that privates
throughout the country can be tested. Every private will
be tested.

VIETNAM

AIDS Prevention, Control Campaign Reported

BK3011061189 Hanoi International Service in English
1000 GMT 29 Nov 89

[Text] The English section of the Voice of Vietnam has
continually received letters from listeners asking the
same questions: Is there AIDS in Vietnam? Is there a
national AIDS committee in Vietnam and what mea-
sures have been taken so far in the struggle against this
deadly disease? Some even go further asking what groups
have the greatest potential to introduce AIDS to
Vietnam and so on.

We have actually dealt with some questions raised by our
listeners in some of our Sunday shows broadcast over the
year. Today, we would like to take this opportunity to
gather all questions put to us and to give answers in an
effort to provide our audience with a clear picture of
AIDS in Vietnam.

So far, no case of AIDS has been reported in Vietnam.
This has been confirmed following antibody tests to
screen for HIV infections from over 6,500 people
belonging to high-risk groups in the four major cities in
Vietnam: Hanoi, Haiphong, Danang, and Ho Chi Minh
City. These people include AIDS suspects—VD patients,



JPRS-TEP-90-001
18 JANUARY 1990

To this end, she noted, specialized personnel in six
subcommittees are explaining to the rural community
the ways that the infection can be contracted and are
warning them about the use of syringes.

The AIDS cases were reported to the various medical
centers in the state; 54 percent were reported to the
Health Institute and the rest to the IMSS [Mexican
Social Security Institute], ISSSTE [Institute of Social
Security and Services for Government Workers], and
ISSEMYN [expansion unknown], she added.

Meanwhile, of the 12 AIDS cases detected in Queretaro
this year, 4 have died, including 1 woman, the director of
the Homeotherapy Center in this state, Maria de la Luz
Obregon Medina, reported, adding that the patients with
the disease are from the capital, Chiapas, and the
northern border.

The disease is not a serious problem in Queretaro,
because the sufferers “are imported” from other cities.
Nevertheless, an epidemiological survey is being con-
ducted among those who were in contact with the AIDS
sufferers to see whether they have contracted the disease.

Obregon Medina reported that the only woman who has
died of AIDS received a blood transfusion in the Gua-
najuato city of Celaya, where she probably contracted
the disease.

Blood Bank Threat Cited

90WE00SOC Mexico City EXCELSIOR in Spanish
11 Nov 89 STATES section pp 1, 4

[Report by Eduardo Chimely]}

[Text] The state secretary of health, Palemon Rodriguez
Gomez, has warned that clandestine blood banks are
operating in this state and must be uncovered, because
“the epidemiological outlook for the transmission of
AIDS through transfusions is worrisome.”

He went on to say that there are 14 new cases of AIDS in
Jalisco precisely because of blood transfusions, which
were apparently done in 1988.

Asa result of this situation, he said, all plasma banks are
obliged to report any case and also conduct laboratory
tests, because otherwise the families of those contracting
the disease can take legal action against these centers.

The clandestine blood banks have to be uncovered, he
added, “but the responsibility does not lie solely with the
Health Secretariat; it also rests with all hospitals, clinics,
and other responsible institutions, such as the officially
recognized blood banks.”

The 14 new AIDS patients, who are beginning to develop
the disease, received contaminated blood in 1988, and
the appropriate investigations are now under way, the
secretary asserted.

LATIN AMERICA 23

For his part, the technical secretary of the State Council
for AIDS Control, David Diaz Santana, indicated that
these 14 new cases bring to 137 the total number of
infections caused by carelessly done blood transfusions
in this state.

The sale of blood is banned, he recalled, as a preventive
measure against AIDS, adding that since January 1988
402 cases have been detected, plus the 14 new ones due
to transfusions, 4 of them being underage children.

The ban has led to a decrease in the incidence of AIDS,
but the clandestine blood banks must still be closed
down, he said in conclusion.

Veracruz Statistics

90WE0050D Mexico City EXCELSIOR in Spanish
14 Nov 89 STATES section pp 1, 3

[Report by Gustavo Cadena Mathey]

[Text] During the past month 30 new cases of AIDS have
been detected in this state, bringing to 321 the number of
people with this disease, 66 of whom have died, the chief
of Coordinated Public Health Services, Jose Rodriguez
Dominguez, reported today.

So far this year, he added, the number of AIDS cases is
up 53.9 percent.

Of the 321 cases, 152 already have the disease; 169 are
carriers of the virus and have not yet shown the first
symptoms, but are infecting their partners, and the
remaining 66 have died, he indicated.

The number of cases of the disease, which was discov-
ered 4 years ago in this state, is doubling annually. This
year 82 have been detected, which is 53.9 percent of the
total number, he noted.

The main mode of transmission, the official noted, was
homosexual, accounting for 60 cases, with bisexual and
heterosexual accounting for 30 cases each.

He also said that the number of carriers of the virus is
increasing by the day and now stands at 169 as of the end
of October; 20 of them live in the Health Jurisdiction of
Poza Rica, 95 in the port of Veracruz, and 13 in
Cosamaloapan, among other cities, he added.

Nationwide, he went on to say, the states with the highest
rates are the Federal District, with 93.5 cases per
100,000 inhabitants; Jalisco with 82.2, and Colima with
60.2.

As for the breakdown by occupation, public service
workers top the list with 238 cases; administrative
employees are second with 191, followed by profes-
sionals with 112, education workers with 112, and
housewives with 102.

These are the five most common occupations among the
3,116 AIDS cases that have been detected and studied
nationwide, Rodriguez Dominguez stated.



JPRS-TEP-90-001
18 JANUARY 1990

CUBA

Danish Journalist Visits AIDS Sanatorium

90EM0042A Copenhagen LAND OG FOLK in Danish
28 Oct 89 p 4

[Article by Trine Jacobsen: “AIDS in Cuba”; first para-
graph is LAND OG FOLK introduction] .

[Text] LAND OG FOLK’s correspondent in Havana is
the second Western journalist who has gotten permission
to visit a Cuban AIDS sanatorium.)

AIDS? “That is something that is foreign to Cuba.”

That is the usual view among Cubans, but the situation
seems different to the more than 300 individuals regis-
tered as HIV-positive in Cuba. They are all interned in
Cuba’s two AIDS sanatoriums. Cuba has satisfied all of
the WHO’s requirements in the fight against AIDS and
has added two requirements of its own that are being
vigorously discussed internationally: a general check of
the population and mandatory isolation.

The Los Cocos sanatorium appears among sugar planta-
tions and mango groves about 20 km outside of Havana.
Originally it was two rich families’ luxurious residences;
it became a recreation center later, and in April 1986 the
whole thing was fenced in, a guard was put at the gate,
and Cuba’s first AIDS sanatorium was dedicated 2
months after the first AIDS case was confirmed.

Not Discussed

“The government’s decision to isolate all AIDS patients
was not subjected to public discussion. Hardly any
information was given to the people. The whole thing
happened with lightning speed in an attempt to halt the
spread of the disease,” says Jorge Perez, the director of
Los Cocos.

In September 1989, Cuba had registered 333 HIV-
positive individuals; 63 of them have the disease, and 17
have died (including one woman). Living in Los Cocos
are 289 of them.

“The first test is performed with test material produced
in Cuba. To avoid mistakes, all individuals who have an
HIV-positive reaction are also checked with foreign test
material,” says Hector Terry, the Assistant Minister of
Public Health for Health and Epidemiology. “If a test is
questionable, it is repeated every 3 months for a year
before the step of moving the patient to the sanatorium
is taken,” he adds.

“I refused to believe it when a representative of the
health authorities came to our residence and said that I
was HIV-positive,” says Antonio, who has lived in Los
Cocos for 2 years. He is a bleeder, and is among the 1.7
percent of the patients who were infected by means of
blood transfusions before Cuba began to check all
donated blood in 1986. The rest of the patients were
infected by means of sexual contact in—and especially

LATIN AMERICA 19

outside of—Cuba. Furthermore, a 2-year-old girl who
was born with AIDS is living there with her parents, both
of whom have the disease.

Antonio says, “They told me about the sanatorium and
asked how much time I would need to put family matters
and social relationships in order. I said, ‘a week,’ but the
thing seemed totally unreal to me. My wife, who was not
smitten with the disease, helped me a lot. She followed
me to Los Cocos. I did not want to come here, but I was
just forced to do so.”

Prolongs Their Lives

It is not hard to climb over the fence, which is as tall as
a man, but those who have done so have been brought
back again.

“When the symptoms begin, their negative attitudes are
changed because they realize then that the treatment the
sanatorium provides prolongs their lives,” Perez says.
“We get the appropriations we need from the govern-
ment—even appropriations for the purchase of medicine
abroad. Furthermore, we have had good experiences
with Cuba’s own preparations.”

A hand-picked team of doctors, psychologists, psychia-
trists, and social workers is constantly available to the
patients. Obtaining medical treatment is a voluntary
matter, but it is apparent that everybody is interested in
as much supervision by physicians as possible “until a
vaccine is contrived”—a thing for which many expressed
a hope.

Patients with AIDS are treated in the sanatorium’s little
hospital. Today there is only one patient, a 43-year-old
homosexual. He is one of the “older” patients here in the
sanatorium, where the majority of the patients are
between 20 and 35 years old. He is very ill and his wasted
body hardly raises the bedspread at all. When he catches
sight of the director, he snaps, “I am tired of ham and
other meats. Tell that cow there,” he says, and points at
the nurse, “to get me a pizza or something else that’s
normal.”

“He is in the fourth stage. In the fifth stage, the patients
are moved to the hospital for tropical diseases, where
there are better facilities for treatment and alleviation of
pain. Furthermore, that is done to spare the other
patients psychologically,” Perez says.

Patient Houses

We visit many of the patient houses, which are scattered
among the mango and avocado trees. Two people live in
each house. Each house contains a kitchen, a toilet, a
living room, and a bedroom and each has a refrigerator,
color television, and air conditioning. The residents try
to live as “normally” as possible everywhere. They are
happy to invite people in, and they talk freely about their
life, but they do not want to be photographed.

Lily is scrubbing the floor when we arrive. Some 27
percent of the patients are women, almost all of whom



32 WEST EUROPE

3. Opinions About Transmission of AIDS

JPRS-TEP-90-001
18 JANUARY 1990

The “picture” which emerges in the total sample after the opinions expressed by those questioned as concerns the transmission of AIDS is the fol-

lowing (in percentages):

‘Agree Disagree
AIDS is transmitted by kissing 15.5 756
AIDS is not transmitted on cutlery and glasses 149 16.8
AIDS is not transmitted by mosquitoes 63.5, 24
AIDS is communicated by swimming in contaminated waters BS 10.9
Vaginal intercourse is more dangerous for the transmission of AIDS than anal intercourse 23.8 53.3
AIDS can be transmitted even by needles used once 32.5 62.7
‘One cannot be infected by AIDS while giving blood 62.7 31.9
A condom impedes the transmission of AIDS 85.7 10
If someone is pricked with a contaminated (by AIDS) needle, it is very possible (more than 95 2.2
50 percent) he will be infected
Sooner or later, a homosexual will be harmed by AIDS 617 24.8
Sooner or later, a drug addict will be harmed by AIDS 70.4 ; 22.6
If one is not a homosexual and does not use drugs, he runs no risk of being harmed by AIDS 20.2 75
If someone spends a night making love with a person infected with AIDS, without a condom, 94.6 3.2
it is very possible (more than 90 percent) he will contract AIDS
It is safer to treat/take care of AIDS patients than to smoke 37.9 41
Today in Greece it is more possible to be harmed by AIDS than by lung cancer 19 53.7
Sometimes AIDS can be communicated from very dirty toilets 219 59.5
‘One cannot be infected by AIDS when he is not a drug addict and has sexual relations only $2.4 43.4
with one person of the opposite sex
Prevention measures against AIDS must be taken only by homosexuals, drug addicts and 3Lt 66.2
those who have multiple and irresponsible sexual relations
The AIDS virus was created in laboratories by man himself 35.9 27.4

4, Opinions About People Who Are Carriers/Suffer From
AIDS

Most of those questioned (34.3 percent) stated that they
absolutely disagree with the position that “one cannot
work next to someone infected by AIDS.” The disagree-
ment was stronger among younger age groups, 18-24
(46.6 percent) and 25-34 (36 percent), as well as those
who have a high school-lyceum education (46 percent), a
technical/advanced school education (45.9 percent) and
a graduate school education (48.4 percent). Conversely,
the majority (31 percent) of those who had no education
at all or had only completed elementary school stated
that they agree absolutely with the above position. The
same is true for the majority (26.1 percent) of the lower
socioeconomic class, although in this case an almost
equal amount (24.8 percent) stated that they disagree
absolutely.

It is not easy for us to say how much those questioned
think that people infected by AIDS are responsible for
their fate, since there are almost equal percentages across
the whole scale “‘agree-disagree”.

Finally, 40 percent of those questioned disagree abso-
lutely with the “isolation of those who have been
infected by AIDS so they cannot transmit it to others,”

while a majority agree (69.1 percent absolutely and 25.5
percent somewhat) that those who have been infected by
AIDS must be dealt with understanding, discretion and
respect.

IRELAND

AIDS Problem in Ireland Said at Record Growth

54500033 Dublin IRISH INDEPENDENT in English
24 Oct 89 p 8

[Article by Alan O'Keeffe]

[Text] Ireland now has the fastest growing AIDS problem
in the EC, an international seminar on the deadly disease
was told yesterday.

And AIDS counsellors from eight countries heard from a
top civil servant that there were clear indications this
country was now entering the “epidemic phase of a
disease” which, to date, had claimed 52 lives. ©

Liam Flanagan, secretary of the Department of Health
revealed that alarmingly, from our point of view, “the
number of cases of AIDS in Ireland is doubling roughly
every nine months,” while in Britain, it doubled every
two years every 2-1/2 years in France and Germany.



HONG KONG

Concern Shown at Late AIDS Diagnosis

54004053 Hong Kong SOUTH CHINA MORNING
POST in English 15 Nov 89 p 3

[Article by Mary Ann Benitez]

[Text] Hong Kong’s first published research on its AIDS
patients shows that their chance of staying alive longer
was being impaired by late diagnosis.

The report, published in the latest issue of the
JOURNAL OF THE HONGKONG MEDICAL ASSO-
CIATION, said: “The survival of the local AIDS patients
is poor in contrast to the 49 percent one-year survival in
the United States.”

“This is related to the larger proportion of patients
presenting at a late stage.”

About 68 percent of the patients only knew they were
infected shortly before the disease, acquired immune
deficiency syndrome, was diagnosed.

The research by Government doctors Patrick Li and
Yeoh Eng-kiong covered 22 AIDS patients up to last
June. Since then, seven others have been diagnosed with
AIDS.

All of the 22 patients were adults, except for one teenage
haemophiliac who was infected by contaminated blood
products.

The doctors said the patients survived an average of five
months.

A total of 13 had died and six patients were still alive
about eight months after diagnosis. Three patients had
left Hong Kong.

The doctors said earlier detection of HIV infection
allowed close monitoring of their immune status and
earlier diagnosis and prompt treatment of “opportunis-
tic infection.”

With late diagnosis, 15 of the 22 patients had seriously-
compromised their immune system, resulting in a poor
survival rate of under four months.

For seven others whose HIV infection had been detected
earlier, the mean survival rate was 7 1/2 months.

The drug AZT has been shown to decrease the incidence
of these infections and prolong survival. Another drug,
aerosolised pentamidine, is being used in Hong Kong for
patients suffering from a rare type of pneumonia that
affects AIDS patients.

“Hopefully, with earlier detection of HIV infection and
better awareness and recognition of the manifestations
of AIDS among the local medical profession, the survival
of the AIDS patients may be improved,” they said.

EAST ASIA

JPRS-TEP-90-001
18 JANUARY 1990

The report also estimated that 60 people would develop
AIDS from 123 HIV carriers and there would be a total
of 1,000 AIDS patients in the next decade.

The pattern of so-called opportunistic infections in Hong
Kong has been found similar to that in the United States,
with 60 percent of the AIDS cases suffering from a type
of pneumonia known as pneumocystis carinii.

But tuberculosis in the local cases was rare, compared
with an incidence of 20 to 60 percent among minorities
in the United States, the report said.

Warning as Four New Cases of AIDS Detected

54004049 Hong Kong SOUTH CHINA MORNING
POST in English I Nov 89 p 1

[Article by Mary Ann Benitez]

[Text] Four new cases of AIDS were confirmed in Hong
Kong in October, the largest number detected in a single
month this year.

The four cases bring the total of confirmed AIDS cases to
29, of whom 15 have already died, according to the
Department of Health’s surveillance up to yesterday.

The latest four are all men. Only one is Chinese.

All were infected sexually, but only two were previously
known to carry HIV after testing positive to the antibody
at the Government AIDS clinic.

Four newly-infected HIV carriers, including one woman,
were detected last month.

This brings the number of people exposed to the virus
without developing the full-blown disease to 132.

Government consultant and chairman of the AIDS sci-
entific working group, Dr Yeoh Eng-kiong, said the four
patients had been discharged from hospital after being
treated.

One of them was a ‘tourist who fell ill while in Hong
Kong. He has since flown out of the territory.

The four new cases brings the number confirmed so far
this year to 14, almost equal to the 14 cases detected in
the past three years.

Dr Yeoh also said that Asia, including Hong Kong,
should prepare itself for a change in the AIDS pattern
from homosexual to heterosexual infection.

While 60 percent of AIDS cases in thé United States
comprised homosexuals, an increasing number, about 20
percent, were heterosexuals who were intravenous drug
addicts, he said.

This was happening in Hong Kong with the recent
detection of an HIV-infected local intravenous drug
addict. Of the 132 carriers, 19 were heterosexual men
who said they had casual contacts with women overseas
and in Hong Kong.



women’s rally organized as part of World AIDS Day
celebration, Mrs Babangida said: “As women, we must
be prepared to face the challenge of this epidemic which
will erode into our families. We must be concerned about
how to talk to our husbands and children about AIDS.”

She remarked that since there was no cure for AIDS, and
no vaccine to prevent it and there had been much panic
and misinformation about how it might be spread, there
was need to heighten women’s awareness on AIDS, their
understanding of AIDS and their role in control mea-
sures.

According to her, AIDS prevention messages may not
reach women due to their lack of education or confine-
ment in the home.

Explaining women’s vulnerability to the enlightenment,
Mrs Babangida noted that poverty, rapid urbanization
and economic depression in many developing countries
were forcing millions of women into prostitution,
thereby exposing many to the virus.

She also pointed out that economic and psychological
dependence and fear made many women unable to insist
on their partners fidelity or to negotiate condom use.

“AIDS virus have cast a shadow over childbearing,” she
said, adding that reports have shown that more than 30.5
perent of antenatal clinic patients in some African coun-
tries have the virus.

She observed that Nigeria now has 87 AIDS patient and
255 seropositive and of all the seropositive diagnosed,
eight were pregnant women while the babies are still
being closely observed.

She, therefore, urged the women, as great mobilizers of
the society, to come together in the fight against AIDS
and the fear of AIDS.

In her opening remarks, the chairman of the occasion,
Dr (Mrs) A. Okoisor, said, AIDS was no respecter of
persons, rank, occupation, professional or social status.

Dr Okoisor, therefore, urged the women at the rally, to
mobilize for the improvement of the health of their
families. .

Ina paper titled, “AIDS In The Home” Dr I. Akinsete of
Lagos University Teaching Hospital (LUTH) said a
person with AIDS was in need of both psychological and
physical support of the family.

SOUTH AFRICA

Rising AIDS Figures Released

54000013B Johannesburg THE CITIZEN in English
7 Nov 89 p 11

[Text] The number of AIDS cases reported in South
Africa is rising steadily with a total of 283 cases reported
since 1982—and of these only 43 percent have survived.

SUB-SAHARAN AFRICA

JPRS-TEP-90-001
18 JANUARY 1990

According to figures released by the Department of
National Health yesterday, this year alone a total of 114
cases had been reported. In 58 of these cases fatalities
have already been reported.

The majority of the cases reported up to now involved
White homosexual males living in the Johannesburg area
but the number of Black heterosexuals contracting the
disease is on the increase.

Of the total number of reported cases 184 White, two

. Black, two Indian and seven Coloured homosexual

males have contracted the disease.

Among heterosexuals, six White men, two White
women, 18 Black men, 25 Black women, one Coloured
man and one Coloured woman have contracted the
disease.

Blood transfusions and hemophiliac treatment have
resulted in 15 White men, 3 White women, five Black
men and two Coloured men contracting the disease.

Among Blacks, a total of nine cases were reported where
the mother passed AIDS on to her unborn child.

Most of the cases—135—have been reported in Johan-
nesburg. Fifty-one have been reported in Cape Town, 37
in Durban, 21 in Pretoria and 10 in Bloemfontein.

Efforts To Halt Spread of AIDS Viewed

54000008b Johannesburg THE WEEKLY MAIL in
English 29 Sep-5 Oct 89 p 12

{Report by John Perlman: “AIDS is Moving Fast—But
Can the Health Authorities Keep Up?”; first paragraph is
introductory paragraph]

[Text] AIDS is spreading through South Africa at an
accelerating rate. John Perlman reports on health offi-
cials’ attempts to stop the incurable disease.

In the time that has elapsed between the government’s
last public awareness effort around AIDS and the cam-
paign launched this week, the official number of people
with the disease in South Africa has risen from around
110 to 276.

The real figure is almost certainly higher; there is under-
reporting of AIDS cases everywhere in the world. Here,
some, like Professor Dennis Pudifin of the University of
Natal, believe our caseload could be 30 percent higher
than reported.



IJPRS-TEP-90-001
18 JANUARY 1990

[Text] A quick HIV test has come on the market but is
not yet in the pharmacies. In the opinion of Docent Pauli
Leiniki, it would also be suitable as a do-it-yourself test
if modified to a certain extent. The positive results that
are obtained with the quick test must always be verified
by other procedures. Quick tests are used in Finland in
various places, including in forensic autopsies, because
they improve the work safety of personnel participating
in the autopsies.

HIV-Positive Drug Users Demand Methadone

90WE00524 Helsinki HELSINGIN SANOMAT in
Finnish 7 Nov 89 p 13

[Article: “Persons With HIV-Positive Readings Demand
Methadone for Their Drug Habits”)

[Text] The Nordic organizations of HIV-positive per-
sons are demanding that everyone in the Nordic coun-
tries boycott HIV and AIDS conferences in countries
that restrict HIV-infected persons from traveling. The
boycott demand also applies to the AIDS conference that
is to be organized in San Francisco next summer.

The organizations of HIV-positive persons in the Nordic
countries, which met in Stockholm last weekend,
demanded that the governments of their countries bear
social as well, as scientific medical responsibility for
infected persons. In the opinion of the organizations, the
training of both labor market organizations and health
care personnel should be strengthened, so that infected
persons do not run into difficulties at the workplace and
in health care.

In their own opinion, as far as information is concerned,
HIV-positive persons have remained in the shadow of
preventive information.

Methadone Demanded for Drug Users

To avoid HIV infection and other diseases, the organi-
zations demanded that the synthetic drug methadone be
permitted as an alternative for the users of intravenous
drugs in all the Nordic countries. In the opinion of the
organizations, the distribution of free syringes and their
collection from the users would also reduce infections
and crime.

Methadone, which has an effect like heroin and mor-
phine, is not used at present in caring for drug users in
Finland. Medicines containing methadone are taken
orally, and, thus, do not cause infection through dirty
needles.

The specialist Pekka Heinala of the Hyks drug treatment
unit personally considers methadone a good agent in
caring for drug users if it can be used in supervised
conditions. In Finland, however, the whole drug culture
is so different from that in the other Nordic countries
that the use of the substance is not regarded as necessary.

WEST EUROPE 29

In Finland there are now about a dozen HIV infection
carriers who were infected through needles. According to
Heinala, all of the Finnish intravenous drug users are
so-called mixed users.

GREECE

AIDS Spread, Public Ignorance Discussed

90WE0056A Athens TO VIMA TIS KIRIAKIS in Greek
26 Nov 89 p 33

[Text] This year’s World AIDS Day on 1 December,
which will have as the main theme “AIDS and the
Young,” will find that Greece has 250 diagnosed cases of
the “scourge of the century” (already 102 of the victims
have died), 15,000 to 20,000 carriers of the virus, an
absence of public information that is criminal, a dan-
gerous complacency among the young and the authori-
ties as well as the minister of health who is also the
president of the National Committee on AIDS.

Greece continues to have the fastest growth rate in the
spread of the disease of any of the European countries
and America—every week one or two new cases turn up
and ittis estimated that the number will reach a total of
600—but continues also to have a relatively lower
number of cases. Men are always affected more than
women (226 diagnosed male victims), while children (9)
constitute approximately 4 percent of the cases.

Homosexuals comprise 49.4 percent of those diagnosed
as having AIDS, heterosexuals, 24.9 percent (while in
Europe they comprise 7.8 percent and 4 to 5 percent in
the USA), those receiving multiple blood transfusions
10.8 percent, those infected by one blood transfusions,
7.6 percent, and drug addicts, 3.2 percent.

Nevertheless, there has not been the dramatic increase
among drug-addicted diseased individuals in Greece (the
disease spreads faster in this high-risk group than in
other groups) that has been observed in other countries,
mainly in Europe.

As a matter of fact, it is estimated that in Europe the
number of drug addicts ill with AIDS will surpass that of
the homosexuals in 1990. Also, in Greece no victims of
medical origin have been reported yet (the few physi-
cians and hospital personnel who suffer from AIDS
belong to high-risk groups), although certain members of
the medical and hospital personnel have been exposed to
the virus through their contact with AIDS patients.

It Is a Matter of Luck

The fact that there are no medically caused infections
with the AIDS virus should rather be considered a result
of luck in view of the fact that preventive measures are
not, as a rule, enforced in Greek hospitals. The recent
study done by the Social Medicine Department of the
Salonica University and the Athens Public Health
School in public and private clinics in Athens and
Salonica is very revealing because it indicates that only



26 NEAR EAST & SOUTH ASIA

sitting on the edge of a volcano. There are approximately
3,000 to 4,000 carriers of the virus who are not reported.
The infected person can be a carrier for 10 to 20 years
before developing symptoms so that it is difficult to
know what will be.”

Moreg added that in the Armed Forces, the danger is
great because one wounded soldier is likely to infect
another. Such occurrences must be taken into account,
he said, in the basic education of the general public and
the Army. Moreg reported that the Education Ministry
intends to request 2 million shekels for activities on this

JPRS-TEP-90-001
18 JANUARY 1990

subject including | million for education, and he asked
the MKs for help with the budget.

Eitan suggested that annual blood tests be conducted for
the entire population, including the Army, and he
expressed doubt that extensive education for prevention
of AIDS will bring about a drop in the rate. He also
argued that if AIDS continues to spread, the human race
could be destroyed in 200 years. MK Pinhas Goldstein
(Likud) proposed including AIDS education in the ele-
mentary schools.



IJPRS-TEP-90-001
18 JANUARY 1990

of national and international energies and resources for
global control and prevention of AIDS.

The 40th World Health Assembly (May 1987) called
upon all member states to establish or reinforce AIDS
control and prevention programs, in cooperation with
the GPA, as was done by the UN General Assembly at its
42nd Session in New York (October 1987). To date over
130 nations have requested cooperation from the GPA
for the development of national plans.

An attempt is being made to have all the backing for
national AIDS prevention and control programs coordi-
nated and directed according to that program. It is also
intended to make the establishment of national plans
represent an invitation and opportunity for all the active
institutions in a country to participate, depending on
their potential, in the effort to curb the transmission of
the HIV infection and to care for those suffering from
AIDS. The following affords a general view of the
national planning process.

Formation of a National AIDS Commission

The formation of a National AIDS Commission (CNS) is
the first critical step in the development of an AIDS
prevention and control program. It is the concrete
expression of the nation’s readiness to deal with the
complex problems associated with HIV infection. Fur-
thermore, it provides mechanisms for carrying out all the
necessary, integrated activities to prevent and control
AIDS.

In fact, the CNS must act as a consultative body of the
Health Ministry, considering all aspects of the program’s
development and implementation, including the legal,
ethical and financial management areas, the interna-
tional aspect, and technical considerations.

The composition of the CNS must be sufficiently large to
ensure representation of all of the society’s leading
sectors and organizations.

The CNS decides on basic principles and a plan of action
to which the program will adhere, guiding the future
development of strategies and activities. Obviously,
treatment will differ from one country to another.

However, there are certain features that appear in nearly
all countries which require consideration in the CNS,
and which can ensure explicit guidance, for example:

Vigilance and reporting of AIDS cases and persons
infected by HIV in the country;

Advice for persons infected by HIV, for AIDS cases, and
for families and other contacts, including decisions on
who is to be informed of test results (the issue of
confidentiality);

Distribution of responsibilities for the program through
intersectorial cooperation, involving nongovernmental
organizations (NGOs) and use of existing health
resources and infrastructure.

SUB-SAHARAN AFRICA 3

Short-Term Plan

There must be an initial epidemiological evaluation to
review and make a critical analysis of the data existing in
the country on HIV infection and AIDS cases; and, when
necessary, the collection and analysis of new informa-
tion.

Initial resources must be tallied to determine the
capacity of the existing health services to support the
epidemiological, educational, laboratory, clinical, and
preventive components of a national AIDS program.

The resources tally should consider the availability of
resources in the private sector, NGOs, and governmental
and international volunteer organizations. The areas
considered include: vigilance and epidemiology; labora-
tory diagnosis; equipment and supplies; diagnosis of
patients; care, treatment, and conduct; education and
training of all health workers on all levels in the health
services; blood banks and transfusion systems; resources
for receiving patients; organizations that can participate
in public health communication and educational pro-
grams; guidance and practice for use and re-use of
needles, syringes, and other surgical and dental instru-
ments; lancets used to diagnose malaria and other instru-
ments that perforate the skin, wherever they are used;
communication of information; educational systems;
and legislation.

This initial epidemiological inventory and that of
resources are typically on an immediate and short-term
basis, so as to provide the necessary support urgently.

Medium-Term Plan

A medium-term program (PMP) serves two important
purposes: it acts as an instrument for implementing the
national control program, identifying the activities to be
carried out (where and when, the costs, and the individ-
uals to assume responsibility); and it constitutes a doc-
ument that can be used to mobilize external funds.

The medium term is considéred to be between 3 and 5
years. However, in view of the uncertainty regarding the
future development of AIDS, it is unlikely that any
country will prove capable of preparing a PMP that will
not require revision during this period of time.

The PMPs typically adhere to a structure of strategies
aimed at objectives:

Prevention of sexual transmission, requiring interven-
tion for health promotion leading to changes in sexual
conduct;

Prevention of transmission through blood, involving
technology (for example, blood analyses), as well as
health promotion programs (for example, among users of
injectable drugs);

Prevention of perinatal transmission, involving the
training of health workers and a variety of directed
information, educational programs, and advice.



Patients will be required to pay a fee whose amount will
depend on the service given. The cost sharing will start
on | December.

Mr Kibaki allayed fears that the introduction of cost-
sharing would deny some Kenyans medical treatment.

He said the dispensaries would continue to provide free
services. Those that will charge fees will be run by a local
board, he said.

The local boards would ensure that desperate cases got
free medical services.

“What we are saying is that we have expanded so much
that we no longer can continue to shoulder everything.
The communities should come in to help run the ser-
vices,” he said.

The money collected would be used by the hospitals and
the boards would be accountable for its use, he stressed.

The minister said more clinics would be built to cater for
mental patients. He said that in addition to Mathari
mental hospital there was another at Gilgil which was
being expanded.

Mr Kibaki said the ministry would increase the number
of medical personnel through training which was cur-
rently inversely proportional to health requirements.

He said a new medical school would soon be opened at
Moi University, Eldoret, to supplement that of the
University of Nairobi.

MAURITIUS

AIDS Information Campaign; Four Cases

90WE0076A Port Louis LE MAURICIEN in French
27 Nov 89 p 12

[“Official: Four Cases in Mauritius”; passage within
slantlines published in Creole]

{Excerpt] Mauritius has thus far had only four cases of
AIDS, and it has only six known seropositive cases.
These figures are given by Dr Chan Kam, national
coordinator for AIDS, who just presented the press with
documentation relative to the observance of |
December, the second World AIDS Day. He also said
“One cannot assume an exact number of seropositive
cases, but the information gathered until this date, on the
basis of blood donors and high-risk groups—30,000 and
3,000 individuals, respectively—is reassuring. However,
vigilance and prudence are required.”

Hence the emphasis of the Health Ministry’s AIDS Unit
on information; the only means of preventing AIDS.
Travelers are warned against casual contacts in countries
where AIDS is very widespread.

“Almost all (Mauritian) seropositive cases were infected
abroad, in countries where AIDS is widespread, partic-
ularly in East Africa and Europe,” said Dr C. Chan Kam.

SUB-SAHARAN AFRICA

JPRS-TEP-90-001
18 JANUARY 1990

He, nevertheless, does not disregard the importance of
making the population aware of the risks of infection in
Mauritius. That is not always an easy task since “AIDS,
because of its sexual connotations, still is a mysterious
disease for many, above all in countries like Mauritius
where its prevalence is still low.”

In order to combat “harebrained notions” and “‘danger-
ous and negative reactions that do immense damage to
those already involved,” the AIDS Unit emphasizes the
nature of AIDS.

It is said that “the cause is a virus that was identified in
1983 and that is known as HIV or virus of human
immunological deficiency. This virus is transmitted in
only three ways: sexually; from one infected person to
another; by infected blood; and from an infected mother
to a baby during pregnancy or while giving birth.

Above all, it is not transmitted in the air, in the water, in
food, by mosquitoes, etc. It is, therefore, much easier to
prevent AIDS than to catch it.

AIDS Day will include the following activities: On 30
November, a press conference by the Health Minister
and a representative of the World Health Organization
[WHO]. The same day, an exhibit will open at the
Emmanuel Anquetil building (ex-Registrar Building),
Port Louis. On 1 December, during a radio broadcast,
young people can question the heads of AIDs programs
in Geneva for ten minutes. There will also be a projec-
tion that day on the MaBC/TV of the film, “AIDS: We
Are All Concerned,” produced by the Broadcasting
School and the Health Ministry. Open Door days will
provide arrangements for conversations with counselors
and requests for tests.... [passage omitted]

All men and women will be welcomed who, for one
reason or another, “think they might have been exposed
to the virus during the preceding years,” particularly
those who have been in countries where AIDS is very
widespread. Two thousand posters will be distributed on
the theme “Young/AIDS—/Avek nou, pena sime/.” Cas-
settes on AIDS will be distributed free at various centers.

On 1 November 200,000 cases of AIDS throughout the
world had been reported to the World Health Organiza-
tion, although the WHO estimates the number of
infected persons at 500,000. There are 7 or 8 millions
contaminated but not yet sick.

MOZAMBIQUE

Nationwide Anti-AIDS Campaign Reviewed

90WE0062A Maputo NOTICIAS in Portuguese
6 Nov 89 p 4

[Text] The Special Program for AIDS (SPA) was for-
mally established by WHO on 1 February 1987 (now
called the Global Program for AIDS (GPA), and was
assigned responsibility for the immediate mobilization


IJPRS-TEP-90-001
18 JANUARY 1990

“It highlights the point that you can get the infection
sexually locally. People have got to pay attention to this
problem and start taking precautions now,” he said.

Dr Patrick Li Chung-ki, head of the AIDS Counselling
and Education Service, said his group was preparing a
pamphlet about safe sex.

He said this was prompted by a recent survey which
showed that only 44 percent of those attending venereal
disease clinics said they used condoms frequently.

Another survey found that many locals believed that
unprotected sex with a casual partner was not risky.

“The Chinese tend to be more complacent, believing that
the possibility of transmission is remote,” Dr Li said.

Council on AIDS To Be Set Up Soon

54004054 Hong Kong SOUTH CHINA MORNING
POST in English 11 Nov 89 p 2

[Article by Mary Ann Benitez]

{Text] A high-powered group will be established soon to
draw up policies to prevent the spread of AIDS, the
chairman of the Medical Development Advisory Com-
mittee, Dr Léong Che-hung, said yesterday.

The committee endorsed the proposal for the creation of
an Advisory Council on AIDS put forward by the
Department of Health.

The move came only two weeks after the Department of
Health revealed four new acquired immune deficiency
syndrome cases in October, the largest number diag-
nosed in a single month this year. This brings the total
AIDS cases to 29, of whom 15 have died.

He said the administration felt that now was the time to
set up an advisory council even if the incidence of AIDS
was low.

“] don’t think it’s alarming but there is a need because at
this point we don’t know how to treat AIDS and there-
fore we need to propagate to the community the problem
and the possible ways of containment and prevention,”
he explained.

Dr Leong said the World Health Organisation has
advised member countries to form national advisory
groups to develop a more coordinated strategy on the
disease.

Council members would be appointed by the Governor
and would come from among health professionals and
various sectors of the community.

He refused to say if any representative from the homo-
sexual community would be appointed, saying that the
matter had not been discussed.

He believed such a committee would be more effective in
setting policies and programs than the present system
done on a piecemeal basis by expert committees.

EAST ASIA 15

The council’s most pressing task would be to find ways to
check the spread of AIDS and to educate the public so as
not to catch the virus.

It could also recommend compulsory AIDS education or
screening but this would depend on its terms of reference
which have yet to be defined, he said.

It would have two subcommittees dealing with health
education and with scientific matters. It would also
incorporate the existing expert committee formed in
1985 by the Department of Health.

The expert committee has implemented a monthly sur-
veillance program in which high-risk groups are tested
for the presence of AIDS anti-bodies and also set up the
AIDS Education and Counselling Clinic which doubles
as a screening’ clinic and a public health education
service.

Experts Propose Testing Pregnant Women for
AIDS

54004050 Hong Kong SOUTH CHINA MORNING
POST in English 27 Oct 89 p 3

[Article by Mary Ann Benitez]

[Text] Hong Kong’s expert committee on AIDS
(acquired immune deficiency syndrome) is considering
testing pregnant women to determine the extent of
infection in the territory in line with recommendations
of the World Health Organization (WHO).

Dr Yeoh Eng-kiong, a member of the committee and
chairman of the AIDS scientific working group, said the
tests would be used as a public health surveillance tool
and not to identify people infected with the virus.

Only a representative sample will be tested and identities
will not be traced.

The testing for the presence of the AIDS antibody will
not replace the voluntary screening of intravenous drug
addicts, people who attend venereal disease clinics and
hemophiliacs, which fas been carried out since 1985.

The move was recommended at a WHO workshop on
AIDS surveillance which Dr Yeoh attended as an adviser
along with about 80 other public health representatives
from 25 Western Pacific countries in Manila last week.

The participants in the workshop believed voluntary
screening led to a “selection bias”.

“So the question came up of unlinked, anonymous
testing. It means that when you do the test it cannot be
traced back,” Dr Yeoh said.

Many countries such as the United States and Britain
already carry out such testing.

Patients’ consent is not needed as they are already being
tested for other ailments.



SJPRS-TEP-90-001
18 JANUARY 1990

change their sexual behavior to avoid contracting the
dreaded Acquired Immune Deficiency Syndrome
(AIDS).

Lt.-General Bali gave the warning in Lagos yesterday at
the armed forces and police day of action against AIDS.

Lt.-General Bali, who spoke through the acting director
of army medical services, Brigadier Sunday Simikaye,
noted that the potential sources of AIDS were through
sexual intercourse and blood transfusion.

He warned: “There is no doubt that we have to change
our sexual behavior if we are to avoid the spread of this
enigmatic disease.”

He said the warning became necessary because most of
the military hospitals spread across the country lacked
facilities for screening AIDS in donated blood.

While Gen. Bali hoped that the Federal Ministry of
Health would help provide AIDS screening equipment,
he advised participants at the occasion to educate their
colleagues and other ranks on the preventive methods.

Last month, Health Minister Prof. Olikoye Ransome-
Kuti, in a keynote address at the first all-African confer-
ence of armed forces and police medical services noted
that members of the armed forces worldwide were sus-
ceptible to acquiring AIDS.

He said 10 of the 25 military personnel from African
countries on a military training programme in Nigeria
were found to be AIDS carriers.

Speaking on yesterday’s theme: “AIDS your enemy, fight
it” a surgeon at the University College Hospital (UCH),
Ibadan, Prof. Toriola Solanke, suggested that all mem-
bers of the armed forces and the police should be
screened for AIDS with immediate effect.

Prof. Solanke, a World Health Organization (WHO)
consultant, also suggested the setting up of a coordinated
blood transfusion center by the armed forces to work in
concert with the National Blood Transfusion Center to
make donated blood safe for them.

He warned against the use of fake condoms which, he
said, were common in the market, stressing that people
should always buy their protective condoms from gen-
uine pharmaceutical stores.

During question-and-answer session, Federal Health,
Ministry’s representative, Dr Gabby Williams, said that
the WHO had approved a N300 million ($40 million) for
the fight against AIDS, in Nigeria.

Medical Experts Baffled by AIDS Rate
540001104 Lagos DAILY TIMES in English
28 Nov 89 p 15

[Article by Laide Shokunbi]

[Text] Nigerians low incidence of AIDS affliction and
human immunodeficiency virus (HIV) baffles medical
experts and scientists.

SUB-SAHARAN AFRICA 5

A medical expert with the World Health Organization
(WHO) Lagos Country Office, Dr G. M. R. Munube, in
a paper he presented at the opening of this year’s World
AIDS Day commemorative activities, said experts were
of the view that the situation ought to be different.

“With a huge population of about (112 million) and a
highly sexually active adult populace.” Dr Munube won-
dered why the current AIDS picture should be the
relatively low: 16 deaths, 35 patients and seropositivity
of 255 persons.

He said it was possible that there had been underrecog-
nition and underreporting of AIDS cases, as well as
seroprevalence studies having too small samples that are
not representative of the actual Nigerian population.

He warned that with the trend in travelling mainly to
West African countries where male-female sexual
activity is one major mode of HIV transmission and
rural-urban migration, the chances are that AIDS will
spread more rapidly and particularly to rural areas where
the disease is as yet not a serious issue.

On the attitude of some people who still regard AIDS a
myth, Dr Munube said “what many people would like to
see is hundreds of AIDS victims before they can believe
that AIDS is a threat to the nation...or if relations or *big’
people were to come down with AIDS.”

In his paper at the AIDS Media Day activity, Prof.
Andrew Moemeka of the Department of Mass Commu-
nication, University of Lagos, said that the media had
created positive awareness of the disease among the

populace.

Unfortunately, he went on, media messages had gener-
ated a near-zero behavioral and attitude change that the
AIDS campaign demands.

Prof. Moemeka’s submissions, based on a study which
started with 110 respondents, included the finding that
most people (about 60 percent) were unwilling to discuss
what action they had taken to reduce the risk of getting
infected with HIV.

Another 10 percent, he said, had not done anything and
would not take any steps to prevent catching AIDS.

The implication, Prof. Moemeka said was that inter-
personal communication was missing from the campaign
and must be added for effectiveness.

Women Urged To Wage Total War on AIDS

54000110C Lagos DAILY TIMES in English
30 Nov 89 pp 1 & 10

[Text] The First Lady, Mrs Maryam Babangida, yes-
terday in Lagos enjoined women to throw aside their
coyness and be more open and frank in tackling the issue
of Acquired Immune Deficiency Sysdrome (AIDS).

In an address delivered on her behalf by the wife of the
Chief of General Staff, Mrs Rebecca Aikhomu, at the



SJPRS-TEP-90-001
18 JANUARY 1990

AIDS tests are given automatically to everybody who is
found to have a venereal disease. AIDS is covered by the
law on venereal diseases, which requires the infected to
give the names of their sex partners.

Furthermore, all pregnant women, all people who are
hospitalized, all convicts, everybody who works in the
ports, for airlines and travel agencies and all seamen are
checked. Furthermore, all soldiers, students, social
workers, etc., who have lived abroad are checked before
they come home. On | July 1989, it was decided to
intensify the control by checking all Cubans, such as
entertainers and politicians, who have been out of the
country. They are trying to get the rest of the population
to allow themselves to be checked voluntarily, through
the CDR [expansion unknown} committees (a kind of
residents’ organization). Under the slogan “AIDS is still
incurable, but not unavoidable,” the CDR committees
are to carry out their biggest health job to date: getting
the entire population checked and getting contraceptives
down off of the pharmacies’ shelves.

DOMINICAN REPUBLIC

Health Minister Cites AIDS Increase

90WE0002 Santo Domingo LISTIN DIARIO in
Spanish 7 Sep 89 p 15

[Text] Yesterday the public health secretary and the
director of the Program for Sexually Transmittable Dis-
eases (PROCETS) reported that AIDS is still increasing
at a fast pace, and that over 200 persons in the country
have died from the disease.

Speaking at a press conference, the two officials
explained that approximately 30,000-60,000 Domini-
cans are infected with the AIDS virus.

Drs Rafael Gautreau and Ernesto Guerrero pointed out
that it is difficult to obtain exact figures on the mortality
rate from Acquired Immunodeficiency Syndrome
(AIDS) because many individuals are dying in their
homes.

They claimed that the vast majority of patients suc-
cumbing to AIDS in their homes are not reported to the
authorized agencies.

Dr Guerrero remarked: “It is unfortunate that many
persons are still engaging in sexual promiscuity, which
unquestionably contributes to a heightening of the risk of
contracting AIDS, a disease that is causing devastation
among the Dominican populace.”

The official noted that the average life expectancy of an
individual in whom AIDS symptoms have been detected
is about 1 year. He observed: “We are living in an era in
which it has become essential for very strict matrimonial
fidelity to be maintained.”

LATIN AMERICA 21

The PROCETS director announced that this agency is
planning a drive for AIDS prevention through the
media, to be entitled: “Do you know everything about
AIDS...or just half?”

He remarked that the Public Health Secretariat had
installed a new telephone number which concerned
individuals may call to request any type of information
regarding AIDS, pointing out that it had received the
cooperation of the Dominican Telephone Company
(CODETEL) for this purpose.

Dr Guerrero commented: “We have telephone numbers
541-4400 and 1-200-1170 at our disposal, at which a
team of professionals consisting of physicians, educa-
tors, and psychologists can provide all the information
sought about AIDS by persons requesting it.”

He stressed: “Of the 30,000-60,000 persons currently
afflicted by the AIDS virus, a sizable percentage could
have remained healthy if they had followed the advice
offered since 1983, free of charge, by the Program for
Sexually Transmittable Diseases.”

The official emphasized that, before engaging in the
sexual act, individuals should take precautionary mea-
sures, such as the use of condoms, or be certain that their
partners are not suffering from the’ AIDS virus.

HONDURAS

Reportage on AIDS Cases

374 Victims

90WE0022 Tegucigalpa LA TRIBUNA in Spanish
3 Oct 89 p 48 .

[Text] The number of confirmed cases of Acquired
Immune Deficiency Syndrome (AIDS) has reached 374,
the president of the AIDS Campaign and Supervisory
Commission, Enrique Zelaya, has announced.

This official said that with the confirmation of 15 new
cases, the figure now comes to 374, with the previous
categories remaining the same. Patients between 15 and
49 years of age account for 92 percent of the total, while
the others are individuals over 50.

Zelaya said that 70 percent of the new patients are male,
and the balance female, and he added that in general
terms, 62 percent of those infected are men, and the rest
are women.

He added that as to location, San Pedro Sula has about
39 percent of the cases and El Progreso and La Ceiba 4.5
percent, while the remainder is distributed among the
other departments in the country.

He said in conclusion that of the 374 confirmed cases of
AIDS, 182 of those infected with this 20th. century
disease have died. The commission is now following only
67 cases, since the rest of the patients have disappeared.



JPRS-TEP-90-001
18 JANUARY 1990

Foreicn
Broapcast
INFORMATION
Service

——_—_J PRS Report—

Epidemiology

AIDS

Reproduced From
Best Available Copy

REPRODUCED BY

U.S. DEPARTMENT OF COMMERCE

NATIONAL TECHNICAL INFORMATION SERVICE |
SPRINGFIELD, VA. 22161

oe oe I

980 2118661

[Dro Quatrry mvspEorep §



8 SUB-SAHARAN AFRICA

part of a solution. We believe that if you look after
yourself you can improve your health.”

But for most people with HIV and AIDS, Van Rooy says,
that has been an uphill battle. What prompted him to
help start up Body Positive was a visit to a friend who he
had met at the HIV clinic.

“He had absolutely nothing in his flat, just a duvet which
he wrapped around himself. He had to give himself an
injection everyday for Kaposi's Sarcoma (a common
opportunistic infection in people with AIDS) but he had
no fridge in which to keep his medication,” Van Rooy
recalls.

Dealing with destitution has been one of Body Positive’s
principle activities. “A disability pension pays out R251
a month,” says Van Rooy. “There is not much else
available.”

A major problem, he says, is that people who are HIV
positive are losing their jobs, often through subtle pres-
sure. “One guy who worked at a hotel began doing some
AIDS education at work and dishing our condoms.

“When management asked him what he was doing he
said he himself had tested positive and wanted to help
warn other people. He was moved into the furthest office
they could find, they insisted that he use his own mug,
and eventually he left.”

Body Positive is cautious about portraying people with
AIDS and HIV as helpless victims. “We didn’t wait for
the health authorities or the government to help us,” says
Van Rooy.

But he insists that isolating people who are HIV positive
is contributing to the spread of AIDS. “It is clear that
stress can activate the virus in people who are still
asymptomatic,” he says.

It is a view Miller shares. ““With people who experience
isolation, guilt and stress, the disease progresses at a
much faster rate. They last less time.

“It is very different with people who have a strong sense
of self. A decent welfare policy for people with AIDS and
HIV would, in the long run, be an investment.”

Experts Give Predictions on AIDS

54000017B Johannesburg THE STAR in English
30 Nov 89 p 14

[Article by Jenny McMahon: “Modern-Day Plague
Sweeps On”; first paragraph is THE STAR introduction]

{Text] Health authorities and community organisations
throughout the world will tomorrow focus attention on a
modern plague that is sweeping Earth—the deadly AIDS
virus, which is claiming thousands of victims, but for
which there is still no cure in sight. Jenny McMahon
reports.

JPRS-TEP-90-001
18 JANUARY 1990

The World Health Organisation’s AIDS Day today
focuses our attention on the modern plague that has
swept the earth in the last 10 years.

“AIDS could prove to be more of a threat to humanity
than the worst outbreak of the bubonic plague in the
mid-14th century when at least one third of the popula-
tions of Europe and Asia died as a result.”

This is the view of Mr Keith Edelston in his book “AIDS:
Countdown to Doomsday”.

South Africa has not escaped the scourge. Since 1982
when the first three cases of AIDS were reported here,
160 people have died of the disease. This year alone 114
new AIDS cases had been reported by October 26. We
still have one month of 1989 left before the total figures
for the year are known.

These figures appear to be a drop in the ocean when
compared with the 20 South Africans who die of tuber-
culosis each day. The difference is that TB is curable.

The number of South Africans infected with the human
immunodeficiency virus (HIV) which causes the disease
is unknown although Dr Steven Miller, consultant at the
Johannesburg Hospital’s HIV Clinic, estimates it to be
about 39,000.

Currently, it is felt that about 60 percent of carriers of
the virus will contract full-blown AIDS although some
health officials believe this figure to be much higher.

People infected with HIV do not necessarily show any
symptoms. This is because the virus has an incubation
period during which time the infected person looks and
feels well. It is now thought that the incubation period
could be as long as 15 years, says Dr Jack van Niftrik of
the AIDS Policy Research Centre.

The Department of Health says that the Blood Transfu-
sion Service in South Africa has been safe since 1985.
Even so, there are at present 10 haemophiliacs here
suffering from blood transfusion AIDS.

According to the Department of Health, HIV is trans-
mitted primarily through homosexual and heterosexual
intercourse in South Africa. Nine South African chil-
dren, however, have been infected through mother-
to-child transmission.

Scenario

A survey in May 1987 of women attending antenatal
services at Baragwanath Hospital found one in every
2,130 to be HIV positive. In August, only 15 months
later, that figure had changed to one in 360.

Mr Edelston, a financial consultant and member of the
AIDS Economic Research Unit, says we should allow for
6 percent of all South African whites being killed by
AIDS by the turn of the century.


= |

IJPRS-TEP-90-001
18 JANUARY 1990

The extent of the problem cannot, however, be gauged
just from the number of AIDS cases. There are also an
unknown number of people infected with the human
immunodeficiency virus (HIV) which causes AIDS.

Interviewed on television last week, a senior Department
of National Health official, Dr Hans Steyn, said there
could be as many as 20,000 people with HIV infection.

Others believe that figure could be higher. According to
Professor Steve Miller, president of the Sexually Trans-
mitted Diseases Society and a doctor at the HIV clinic in
Johannesburg, 35,000 is more realistic.

Recent surveys indicate an alarming rise in HIV infec-
tion. A study at the Durban clinic for sexually trans-
mitted diseases (STD), conducted between June 1988
and February this year, found more than three in every
100 women and nearly two in every 100 men tested were
infected with HIV. e

And a survey of nearly 85,000 blood samples taken from
pregnant black women by the South African Blood
Transfusion Services in Johannesburg found that in
mid-1987 one in 2,753 tested positive. By October last
year, that figure was one in 461.

This picture of AIDS spreading in leaps and bounds is
not surprising—nor is it unique to South Africa.

But it does beg two questions: with so much evidence
that AIDS has already made deep inroads here why has
it taken the government more than a year to move from
one public awareness campaign to the next?

And looking to the future, is this campaign going to be
part of a stepped-up effort which tackles AIDS on other
levels? If so, what else is going to be done? Steyn did,
after all, say on Netwerk that his department was “very
worried”.

It would be wrong to say that the government has done
nothing in between the two public awareness campaigns.
Centres to train AIDS educators and counsellors have
been set up in Durban, Cape Town, Port Elizabeth and
Bloemfontein this year at a cost of R5,5-million.

And while the money allocated to making the public
aware is hardly impressive—the two campaigns have
cost just over R2-million, less than half the cost of the
Info song—this campaign is more informative and more
frank that the last one.

The campaign does not address the political suspicion
that has surrounded previous AIDS prevention efforts.
But it at least avoids the racially specific advertising used
before—grafitti on a wall for whites, a grim funeral scene
for blacks—which many felt was counterproductive.

But however good the advertising and brochures may be,
their contribution to stopping AIDS will depend on what
else is done. Department representatives said as much in
pointing out that the advertisements were part of “an

 SUB-SAHARAN AFRICA 7

ongoing process. Any education campaign is not a one-
off effort but needs regular reinforcement to stimulate
awareness, bring about behavioural change and to sus-
tain such behaviour change.”

But if that is to achieved, three areas are crucial. First,
while the brochures tell people concerned about AIDS
where they can get immediate help, the disease confronts
individuals and communities with a range of needs.

The experience world-wide has been that many of these
needs—education, counselling, support for people with
HIV and with AIDS—are best met by community and
peer groups who can best ensure that they reach their
target audiences. Most important people with HIV and
AIDS have a major role to play.

It has been a criticism of the central government’s AIDS
effort in the past that these groups have not been drawn
on. There are no representatives of gay organisations—
who have a longer involvement in AIDS education work
than any others—on our only consultative body, the
AIDS advisory committee. Nor are there any black
members.

There has also been little attempt to channel resources to
community groups. On the contrary, organisations like
the Gay Association of South Africa in Cape Town, have
had to battle to get a fund-raising number.

Second, to what extent is the government going to let
moral issues colour what should be objective public
health advice? While the brochure’s frankness is an
improvement, the message on Netwerk was sometimes
equivocal and even contradictory.

The brochure described condoms as “the best preventive
measure against AIDS besides not having sex and prac-
tising safe behaviour”.

But the TV programme’s main focus on condoms was to
show a short clip from a US network which showed that
many condoms had been tested and found defective.
This was immediately followed by Steyn stressing that “a
man and a woman must stay together”.

And third, what steps are going to be taken to ensure that
people with AIDS and with HIV are taken care of—both
those already infected or ill, and those who are certain to
follow?

The current picture is not an encouraging one. In April
this year, a small group of people with AIDS and people
with HIV infection formed an organisation called Body
Positive. Based in Johannesburg, it started with 36
members; there are now about 400.

“Our emphasis is on living with HIV, not on dying from
it,” says Body Positive chairman Johan van Rooy. “We
don’t believe in simply associating HIV infection with
death.

“People with AIDS and HIV have been labelled as
victims and part of a problem instead of being seen as



40 . WEST EUROPE

Over half of the doctors polled lack confidence that the
disinfectants ordinarily used in hospitals (such as Beta-
dine or Hibitane) can destroy the AIDS virus. In the case
of hospital nurses, that proportion rises to 80 percent.

AIDS Situation in Country’s Prisons Viewed

90WE0073B Madrid DIARIO 16 in Spanish
28 Nov 89 p 16

[Text] In connection with the presentation of lectures on
the topic of AIDS in prisons, to be held on 11, 12, and 13
December in Alava, the chairman of the Federation of
Citizens Anti-AIDS Committees and Commissions of
the Spanish State, Peio Lopez de Munain, scored the
regrettable situation existing in our country’s prison
system, while at the same time disclosing that, “in Spain
five inmates die from AIDS every month,” according to
an LID [expansion not given] report.

The necessity for entering prisons and informing the
inmates about the AIDS problem represents the two
priorities that prompted the Federation of Citizens Anti-
AIDS Committees and Commissions to schedule these
lectures. The fact that the site for the latter is Vitoria and
that the Basque Government has provided all types of
facilities was the deciding factor for holding the event in
Alava on 11, 12, and 13 December, although there are
many concerned people in Catalonia as well.

The presentation of these lectures will be attended by
experts on the AIDS problem, in an effort to prevent this
disease from continuing to spread in jails. Nevertheless,
there will be some highly significant absences, because
no representative from the General Directorate of Prison
Institutions, the Health Ministry, or even such a prom-
inent center as the Carabanchel Jail will be present.

According to Peio Lopez de Munain, their failure to
attend may perhaps be due to the fact that “they might
not want the dirt underlying it to come out,” because
“ever since this disease became known, 9 years ago, the
prison institutions have made no effort to check it.”

This federation, created 4 years ago, “‘in view of the need
for taking preventive measures, providing information,
and helping those stricken,” according to its leaders,
wants the 30 percent of the prison population, currently
totaling 32,000, who are not sero-positive, to have a
chance to be saved.

Currently, 50 percent of the inmates are persons jailed as
a result of drug-related convictions, and of that number
between 60 and 70 percent could have AIDS. Lopez de
Munain does not consider the results of the poll taken by
the state in jails to be at all reliable, because, “Since
taking drugs and having homosexual relations are pro-
hibited, it would be stupid for anyone to tell the poll
taker that he did engage in such actions.” Hence, he
believes that worthwhile measures must be adopted
because, “although there is silence and it is claimed to be
due to other causes,” the fact is that five inmates are

JPRS-TEP-90-001
18 JANUARY 1990

dying from AIDS each month at present, “whether for
lack of treatment or because of very advanced stages of
the disease.”

Furthermore, some 400 AIDS victims from Europe, the
United States, and Canada will meet in Madrid next
spring to hold the fourth international congress on this
subject, based on a decision made in the Spanish capital
by several representatives.

Hector Anabitarte, spokesman for the Citizens Anti-
AIDS Committee, explained to EFE that this congress,
supported by the World Health Organiztion (WHO), the
Red Cross, and the Autonomous Community and City
Hall of Madrid, will deal with the AIDS problems in jails
and heterosexual transmission of the disease.

First Doctors Tried for Negligence Involving
AIDS Infections

90WE0054C Madrid EL INDEPENDIENTE in
Spanish 14 Nov 89 p 26

[Text] The Prosecuting Ministry has requested a prison
term of | year and 8 months for Josep Maria Capdevila,
former medical director of the Principes de Espana
Hospital in Bellvitge (Barcelona), where two patients
were infected with AIDS from a transfusion between
1986 and 1987.

The prosecutor requested the same sentence for Carmen
Ferran Campos, chief of the hematology service, and for
Antonio Rubio Baget, head of the blood bank. All three
have been accused of the crimes of issuing deteriorated
medication, issuing medication without fulfilling the
regulatory formalities, and wanton negligence. Fortu-
nato Frias, former manager of the hospital, has been
accused of the first two crimes, for which a prison term
of 1 year and 3 months has been requested.

The prosecutor has also sought compensation of 10
million pesetas for each of the two patients, and the
requirement that the three indicted physicians must
guarantee compensation totaling 15 million if those
infected should develop the disease. The particular
charge (also brought by a third patient, although the
blood transfusion contaminated with the virus to which
he was subjected preceded the ruling issued by the
Generalitat [Catalonian Legislature]) requests penalties
similar to those sought by the prosecutor.

Witnesses From the Generalitat

Starting today, about 100 witnesses, including two coun-
cillors from the Generalitat de Cataluna, will file into the
room of the Barcelona Court’s ninth section of criminal
proceedings, in what will be the first trial in Europe
involving infection by AIDS antibodies in a hospital. In
other European countries the legal claims on these
grounds are being settled in civilian courts. The Bellvitge
hospital failed to comply with an order requiring the
analysis of all donations. As has been established in the
2,000 pages comprising the summary, the Generalitat’s


28 WEST EUROPE

in the province. Among the casualties in 1989 was a
newborn—the first born in B.C. with AIDS.

As of Oct. 2, there were 337 known AIDS-related deaths
in B.C. over a six-year period.

Rekart said the next few years look increasingly grim with
the annual jump of about 40 percent in new cases since
1987 expected to continue until, “at least the mid-1990s.”

He says B.C. has a good school program that discusses
the threat of AIDS with youngsters. [passage omitted]

The conference continues at the Hyatt Regency Hotel
until Tuesday.

DENMARK

Greenland Official Warns of AIDS Threat

90WE0077C Nuuk GRONLANDSPOSTEN in Danish
24 Nov 89 p 3

[Fear of AIDS in Greenland; ‘Greenland Could Become
Like Africa,’ Chief Medical Officer Warns”; first para-
graph is GRONLANDSPOSTEN introduction]

[Text] “Let’s get right down to it: Currently there is no
indication that Greenlanders have any particular protec-
tion against becoming infected with HIV and later devel-
oping AIDS. There is still reason to fear that in the future
Greenland can experience a heterosexual AIDS epidemic
on a far wider scale than is expected in, for instance,
European countries, In particular, results of research in
areas of Africa form the basis for such an assumption.”

Jens Misfeldt, the chief medical officer [of Greenland],
together with Mads Melby, the Fight Against Cancer
[Association], and Jorn Olsen of the National Health
Service Institute have just issued a report on the AIDS
situation in Greenland which states that the population of
Greenland could experience conditions like those in Africa
if, today, continuance is not given to the Greenland AIDS
campaign which can put a stop to an independent epi-
demic.

The first case of HIV infection among Greenlanders was
detected in the summer of 1985, when one HIV-infected
individual was reported. In 1986, on the other hand, there
were no new cases, while in 1987 four were reported, and
in 1988 there were seven new antibody-positives.

“The more HIV positives there are, the harder it is to stop
an epidemic. Our program starts with the assumption that
both HIV and a certain [level of] sexual promiscuity are
the necessary prerequisites for epidemics. We cannot pre-
vent HIV-infected individuals from continuing to transmit
the virus to the population, but we can remove the social
base for the spread of an epidemic.”

JPRS-TEP-90-001
18 JANUARY 1990

Bisexual Contact

Jens Misfeldt, the chief medical officer, said that tradi-
tional high risk groups such as drug users and hemo-
philiac patients do not exist in Greenland’s society.

“There is homosexuality. It is not organized, and it may
possibly occur rather in the form of bisexual behavior.
This probably explains the earlier transmission of HIV and
scarcely makes it probable that an epidemic will spread
quickly among the population in the immediate future.”

It needs to be expected that an epidemic among hetero-
sexuals will develop slowly—over a number of years,
and, in any event, the threat of an AIDS epidemic will be
something people will have to live with for several
generations to come.

“We believe that people’s level of information plays a
decisive role, especially in the long term. But we also
know that information alone is not enough. Infected
individuals will certainly come to Greenland on a regular
basis or infected individuals from one area of Greenland
will move to another area, but first and foremost, it is
important to be able to follow an epidemic as early in its
course as possible.”

Put Your Hat On

As the speed with which sexually transmitted diseases
[spread] has declined, the use of “Greenland” condoms
has been rising the past few years. The condoms, which
are obtainable in several colors, have been so popular
that the combined sales/distribution figure has reached
half a million. The former general reticence toward the
purchase of condoms is now disappearing.

In the course of | year—from 1987 to 1988—sales of the
expensive condoms doubled from 200,000 to 500,000,
while distribution from hospitals rose from 25,000 to
200,000 condoms.

“Fewer sexual partners, no anonymous sexual contacts,
and the use of a condom are all important messages which
can help remove the chances that this not easily transmit-
table virus will spread throughout the population. If you
want to protect yourself against HIV, you must use a
condom every time, even with your permanent sexual
partner, and this is far from being the case today,” said
Jens Misfeld, the country’s chief medical officer, who
added that “there is still a need for basic information, and
this need among the population is certainly greater than
among those groups we have studied,” he said.

FINLAND

HIV Self-Testing Kits Expected in Pharmacies

90WE0052B Helsinki HELSINGIN SANOMAT in
Finnish 7 Nov 89 p 5

[Article: “Quick HIV Test Not Yet Sold in Pharmacies”]



SJPRS-TEP-90-001
18 JANUARY 1990

CANADA
AIDS Incidence; Sentencing of Virus Spreader

3,208 Reported Cases

54200019 Vancouver THE WEEKEND SUN in English
2 Dec 89 p CIS

[Excerpts] Canada took advantage of World AIDS Day
Friday to announce a $2.4-million AIDS-prevention
program in Haiti.

External Relations Minister Monique Landry signed a
four-year agreement with Montreal’s McGill University
for the prevention program.

The project will support an AIDS-education program in
Haiti based on the results of a study assessing Haitians’
knowledge, attitudes and practices regarding AIDS. The
program stresses prevention and encourages changes in
sexual behavior.

In Canada, 3,208 AIDS cases have been reported,
including 1,873 deaths. As many as 50,000 Canadians
are believed to be infected with the virus that causes the
disease.

Bisexual Man Sentenced for Transmitting
Infection
54200019 Toronto THE GLOBE AND MAIL
in English 9 Dec 89 pp Al, A2

[Excerpts] A bisexual man who carries the AIDS virus
was sentenced yesterday to three years in prison for
knowingly infecting a pregnant woman.

Scott William Wentzell, 21, of Halifax, pleaded guilty to
criminal negligence causing bodily harm earlier this year
after his former girl friend tested positive for the deadly
virus.

“The public will not stand for the spread of this disease
by those who know they are infected,” said Judge Ian
Palmeter of County Court. “It is not hard to find
sympathy for those with this disease, but it is hard to find
sympathy for someone who acts in such a reckless and
wanton manner.”

Mr Wentzell, who occasionally worked as a male prosti-
tute, was identified as a carrier after two women with the
virus named him as a common sexual partner. Although
he was warned about the dangers of the disease and told
to wear a condom, Mr Wentzell became involved with a
third woman—who was already pregnant—in July of
1988.

In a pre-sentence report, a doctor said Mr Wentzell is
unlikely to live beyond 35.

Mr Wentzell and the woman, now 22, lived together for
nearly two months. By chance, the young woman’s

WEST EUROPE 27

godmother was the public health nurse who arranged Mr
Wentzell’s original AIDS test. She recognized the name
and alerted the woman.

The woman, whose name cannot be used, had her baby
about a year ago. But doctors say it may be two more
years before it is determined whether the child is infected
with the virus,

It’s the first time that section of the Criminal Code has
been used in a case involving AIDS.

Last August a Calgary AIDS carrier was sent to jail fora
year on a charge of common nuisance, after having
unprotected sex with two women. Neither of the women
contracted the virus.

In another case, an Ottawa man was sentenced to 15
months in jail for knowingly donating blood infected
with the AIDS virus to the Red Cross. The blood was
detected before it was given to anyone.

AIDS Incidence in British Columbia Reported

54200016 Vancouver THE SUN in English
27 Nov 89 p BI

[Article by Harold Munro: “B.C. Teens Virus Surges”’]

[Excerpts] Eighty-eight B.C. teenagers tested positive for
the AIDS virus so far this year, almost twice as many as
in all 1988, delegates at the third annual AIDS Confer-
ence in Vancouver learned Sunday.

The province’s teens are following a deadly trend set by
their counterparts in U.S. cities, warned Dr. Mike
Rekart, a member of the provincial advisory board on
AIDS.

“I think the infection rates in the U.S. are much higher
among teens but ours still indicates an alarming trend,”
said Rekart.

Three teenagers in the province have so far developed
the AIDS disease in 1989, compared to only one case a
year ago.

“We have a serious situation with respect to the spread
of AIDS amongst the adolescent population,” agreed
B.C. deputy health minister Stan Dubas. “It reinforces
the need for some dramatic educational moves
addressing lifestyle choices.”

The total number of people who have tested positive for
AIDS virus in the general B.C. population has increased
by 228 this year to 637.

The new total includes about half the province’s 200
hemophiliacs. Most contracted the virus through blood
transfusions prior to 1987, before a new clotting agent
was developed.

The number of AIDS-related deaths in B.C. this year
ranks the disease as one of the 12 leading causes of death



In addition, planning should consider the care to be
given to AIDS patients and a reduction in the impact of
HIV infection upon individuals, their families, and their
communities. Since the plans for health workers,
training, health promotion, and evaluation require more
than one strategy, these are normally handled in separate
sections of the National Plan. A complete description of
the GPA is provided in “Guidelines for the Develop-
ment of a National AIDS Prevention and Control Pro-
gram (WHO/GPA).”

On behalf of this planning process, the WHO GPA
provided assistance in the preparation of 75 short-term
and 21 medium-term plans. Immediate help was given to
71 countries involving agreements for services or other
types of technical or financial assistance.

AIDS Vigilance: Report
As of 10 February 1988, the worldwide total for reported

AIDS cases was 77,984 in 162 countries. AIDS was
reported in all parts of the world.

Continents Number of Cases | Countries or Territo-
ries Reporting Cases

Africa 8,752 48

Americas 59,217 44

Asia 225 28

Europe 9,004 28

Oceania 78614

Total 77,984 162

The lack of reporting and the widespread inadequacy in
recognizing and diagnosing AIDS mean that the number of
cases reported is a very small estimate of the true incidence
of AIDS. The WHO estimates that, by the end of 1987,
there were approximately 150,000 AIDS cases throughout
the entire world. Even this estimate does not adequately
reflect the current clinical dimensions created by HIV,
because AIDS cases represent only the final phase of
serious, irreversible damage due to HIV infection.

Support for the National Program

The GPA’s support for the national programs is pro-
vided as follows:

—The member state contacts the GPA (preliminary
discussion).

Initial visit to the country. Immediate assistance for
emergency action (short-term plan).

—Development of the National Plan (medium-term
plan).

—Technical and/or financial assistance for implementa-
tion of the National Plan.

SUB-SAHARAN AFRICA

JPRS-TEP-90-001
18 JANUARY 1990

NIGERIA

16 Deaths, Increase in AIDS Cases Reported

53000014 Lagos DAILY TIMES in English
22 Oct 89 pp 1, 3

{Article by Ranti Famuyibo]

{Text] Sixteen Nigerians have died of the dreaded
Acquired Immune Deficiency Syndrome (AIDS), the
Sunday Times investigations have revealed. The
deceased were from 35 sufferers put under intensive
medical care throughout the country.

So far 49,839 Nigerians have been tested to determine if
they have the AIDS virus. Of this number, 181 were
considered ‘positive and 35 developed the disease,
leading to the 16 deaths.

The Director of Disease Control and International
Health at the Federal Ministry of Health, Dr Gabi
Williams, confirmed the findings, but refused to give the
breakdown of AIDS cases state by state.

Sources close to the ministry said that at least four cases
of AIDS victims have been identified at the University
College Hospital (UCH) Ibadan, out of which one out-
patient was claimed to be an employee of one of the
country’s television houses.

Dr Williams said the ministry was yet to adopt the
World Health Organization’s medium-term plan for
AIDS prevention and control in Nigeria.

But he said that the ministry had already sent a draft of
the proposal which was prepared in March, to the world
body, adding that Nigeria’s AIDS programme coordi-
nator, Dr E.A. Abebe, was already in Geneva to discuss
the final draft.

The medium term plan was a WHO’s device to involve
governments in developing medical research centers and
establishing effective communication strategies and
public enlightenment on the disease with a view to
checking its spread.

Dr Williams agreed that not much was being done
locally, adding: “The curative research is beyond what
we can do here. What we are doing is to concentrate on
Knowledge’ Aptitude and Practice (KAP) studies”.

He debunked the earlier reports that WHO had given
Nigeria eight million dollars to prosecute anti-AIDS
programme, saying that the total sum made available to
Nigeria so far was 303,000 American dollars.

Armed Forces Warned of AIDS Spread
54000110B Lagos DAILY TIMES in English
29 Nov 89 p 14

[Text] Defence Minister Lt.-General Domkat Bali has
warned members of the armed forces and the police to


18 EAST ASIA

drug users, prostitutes, blood donors and recipients,
sailors, repatriated refugees, prisoners, patients of liver
cancer, and MPC.

Faced with an epidemic of AIDS on the world scale, the
Health Ministry of Vietnam decided to set up the
National AIDS Committee in June 1987 headed by
Professor Hoang Thuy Nguyen. To answer your ques-
tions on what has been done so far by this committee, we
invited Professor Hoang Thuy Nguyen to our studio to
talk with you. Here is what he said:

(Begin recording in Vietnamese fading into English
translation] In this connection, the Vietnam National
AIDS Committee has carried out the following mea-
sures:

—Set up in Hanoi in April last year a standard national
laboratory to screen for HIV infections with assistance
from the Pasteur Paris Institute. In April this year, the
committee set up a similar laboratory in Ho Chi Minh
City to service southern provinces. They organized
training courses for scientific workers in Hanoi,
Haiphong, and Ho Chi Minh City to diagnose HIV.

—Coordinated with the mass media to provide people
with basic knowledge about AIDS and preventive
measures;

JPRS-TEP-90-001
18 JANUARY 1990

—Cooperated with specialists of WHO global AIDS
program to set up a short-term plan for the prevention
and control of AIDS in Vietnam from mid-1989 to
mid-1990; and

—Joined efforts with WHO to organize two national
workshops on the prevention and control of AIDS.

From now to the end of the year, they continue to
organize three city workshops for Hanoi, Danang, and
Ho Chi Minh City“ [end recording]

According to Professor Nguyen, the introduction of
AIDS into Vietnam could be a reality in the future. So
right now, preventive measures must be taken and health
education is the best alternative, particularly for the
high-risk people such as foreigners in Vietnam or Viet-
namese back from abroad. The growing numbers of
prostitutes and drug users are also potential sources of
HIV infections.

World AIDS Day, 1 December 1989, is dedicated to the
world’s youth, so he said: The Vietnam Ho Chi Minh
Communist Youth Union should be assigned with the
task of being in the vanguard of the struggle against the
killer AIDS.



JPRS-TEP-90-001
18 JANUARY 1990

The following is the method that each of the health-care
centers taking part in the study used. When during
pregnancy or at childbirth a woman said that she
belonged to a high-risk group (those with multiple sexual
partners, drug addicts, or those who had hepatitis at
some point in their lives), she was told that she and her
newborn ought to be tested for AIDS.

Once permission was obtained, the usual diagnostic
procedures were employed: Elisa, Western blot, and
antigen tests, which provide a high level of assurance
that the virus will be detected.

When the infant was found to have antibodies from the
mother, periodic checkups by pediatricians at the center
were proposed to her. Hemophiliac patients were not
included in this study.

Since a patient had to volunteer the information that she
belonged to a high-risk group and had to give permission
for the tests and the follow-ups on the development of
the disease, the numbers are not accurate. Many women
concealed their drug addiction or sexual promiscuity,
while others who acknowledged as much did not give
permission to investigate further, and thus the case was
not included in the final tally.

Cases of AIDS Among Children in Spain

Community Number Percent
Madrid 303 35.49
Catalonia 234 16.48
Valencia 224 15.79
Basque Country 165 11.63
Andalusia 84 5.90
Balearic Islands 43 3.03
Galicia 43 3.03
Castile-Leon 42 2.95
‘Aragon 27 1.90
Asturias ai 1.47
Castile-La Mancha 9 0.63
Extremadura 6 0.42
‘Canary Islands 5 0.35
Cantabria 4 0.28
Murcia 4 0.28
Rioja 2 0.15
Total 1,416

AIDS Figures, Growth Rate Reported
90WE0073A Madrid DIARIO 16 in Spanish
1 Dec 89 pp 14, 15

[First paragraph is DIARIO 16 introduction]

[Text] According to the World Health Organization’s
[WHO] latest estimates, within 3 years Spain will be the
European country with the largest number of AIDS

WEST EUROPE 35

cases. This report may help to call attention to the
International Day To Combat AIDS, taking place all
over the world today, to be marked in our country with
a function scheduled for the Madrid Atheneum, with
some 50 famous figures, including intellectuals and
politicians, participating. In Spain, nearly 120,000 car-
riers of the virus have been counted, and 3,000 victims
of the disease have been officially acknowledged.

Specialists from all over the world are devoting their
activity today, decreed by the World Health Organiza-
tion as the International Day To Combat AIDS, to the
updating and exchange of information on AIDS, the
strange, fatal disease that has revolutionized the epide-
miological picture for the final stage of the 20th century
and changed the sexual behavior of citizines in most
countries.

AIDS has drastically terminated an era of permissive-
ness that began after it was discovered that sexually
transmitted diseases could be cured easily. The barriers
that no moral code could effectively raise have been
imposed with authority by what some have termed the
“modern plague.” AIDS has transcended the traditional
risk groups and its influence is invading the society as a
whole. The beginning of the epidemic is occurring in
Spain just when the establishment of a democratic
system is facilitating a long awaited liberalization of the
strict moral code that prevailed during the 40 years of
dictatorship.

This “liberalizing explosion” and the attention given by
politicians to a transition without confrontations will
foster the emergence and development of serious social
problems, such as drug trafficking and consumption.

Disturbing Figures

The latter will become the principal means of spreading
AIDS, which will also be concealed in the sharp increase
in sexually transmitted diseases, the incidence of which
has tripled during the first 3 years of this period.

As one infers from the latest estimates made by experts
from the World Health Organization, within 3 years
Spain will be the country with the largest number of
AIDS cases in Europe.

Specialists queried by D-16 agree on accepting figures
that are already very disturbing.

According to these estimates, our country currently has
over 120,000 carriers (that is, individuals who have not
developed the disease but could infect others with it);
and the number of real cases is nearly 5,000, compared
with the approximately 3,000 already officially
admitted. The meticulousness and slowness of the offi-
cial counts is causing a considerable distortion of the real
situation.

Spain shows the worst prospects in Europe for control-
ling AIDS, owing to its high degree of incidence among
the drug addict population. This situation has created an



36 WEST EUROPE

additional gravity, namely, the fact that the majority of
young female heroin addicts infected intravenously are
of child-bearing age. Hence, our country, besides having
a rate of infected young people that is double the
international average, shows the highest number of
AIDS cases in children.

According to the experts, a drug addict with antibodies is
even more dangerous than a patient who has developed
the disease. This risk group is also typified by an extraor-
dinary mobility; hence, its control is virtually impos-
sible.

As if this were not enough, the Spanish police lack
suitable regulations to prevent the sporadic forays made
by drug addicts into the world of prostitution: forays that
have contributed decisively to the spread of the disease,
exceeding the incidence among the traditional groups.

The latest samplings taken in our country have con-
firmed that it is precisely the cities with a higher rate of
floating populations (Madrid, Barcelona, and Bilbao)
that also show a higher number of infected persons. The
specialists consider this a direct result of the impossi-
bility of exercising effective control.

Effective Measures

In contrast to the gloomy picture evinced by Spain with
regard to AIDS as a result of the “explosion” of the
disease among the drug addict population and the con-
tagion spread by this risk group, the control measures
applied to homosexuals and hemophiliacs have proven
tremendously effective. Except for the case of the Bel-
Ivitge institution, no contagion has been determined
from transfusions, and the incidence among the Spanish
homosexual population has been clearly reduced, in
contrast to the advancement occurring among drug
addicts.

The Spanish health authorities have been constantly
caught between the need to establish severe control
measures to prevent the spread of AIDS and the unques-
tionable fact that the information on the dreadful con-
sequences of the disease is creating a “psychological
terror” among a sizable part of the population, which
could also entail serious consequences.

In fact, the first preventive campaigns have generated a
disturbing flow of people, panic-stricken over con-
tracting a disease whose overly disseminated symptom-
atology coincides with that of such common ailments as
influenza and slight gastritis, to the Social Security
out-patient facilities.

The oddity is that most of these individuals have had no
occasion to contract a disease requiring sexual or blood
contact, the degree of infectiousness of which is 100
times lower than that of type B hepatitis, for example.
Because of AIDS there has been an outbreak of much

JPRS-TEP-90-001
18 JANUARY 1990

remorse, with the recollection of extra-marital adven-
tures, that has converted general physicians into real
confessors, prompting a pathological inspection of any
anomaly on the skin.

This continuous self-monitoring of health is causing
states of constant stress, which actually reduce the level
of the body’s defenses and heighten the risk of con-
tracting other infections. It is estimated that panic over
AIDS is responsible for at least 2 percent of the cases of
depression currently besetting 15 percent of the Spanish
population.

30 New AIDS Cases Every Week

Spain has the most rapid rate of AIDS progression in
Europe, according to the latest estimates made by the
experts. It has been estimated that an average of 30 new
cases crop up weekly.

AIDS shows a very irregular distribution in Spain.
Whereas the Basque Country posts the highest rate of
incidence in Europe (132.7), both Castillas have the
lowest percentage in the EC [European Community],
namely, 23.5 and 23.7.

The Spanish research on AIDS has provided interesting
conclusions, acknowledged internationally. The tests
have been concentrated mainly among the terminal
adult population and pediatric infections.

The programs developed at the El Rey Hospital in
Madrid, the Clinic Hospital in Barcelona, and the
Basurto Hospital in Bilbao have demonstrated that treat-
ment with azitodimine (AZT) has contributed decisively
to an improvement in the patients’ quality of life.

This drug has considerably fewer side effects than what
had been attributed to it and, moreover, there is a
reversible type benefit, whereby the treatment may be
given based on the advantages accrued, and may be
stopped or reduced when the patient’s condition so
advises.

The clinical research on children stricken with AIDS has
been done at the Basurto and Cruces Hospitals in Bilbao,
Our Lady of Aranzazu Hospital in San Sebastian, Chig-
orruchu Hospital in Vitoria, and Virgin of the Road
Hospital in Pamplona, under the coordination of Pro-
fessor Alfonso Delgado Rubio.

The application of azitodimine to the pediatric segment
has revealed that the anemia processes associated with
the administration of this substance cannot be consid-
ered widespread, and may be corrected by blood trans-
fusions.

The Spanish Pediatric Association, for its part, has
decided to open a registration log on children affected by
AIDS, like those existing on classic pathologies.

The follow-up of 170 children associated with the virus
warrants the claim that about 30 percent of the children
of infected mothers end up contracting the disease,


INDIA

WHO Official: AIDS Epidemic Worsening

54500036 Madras THE HINDU in English
1 Dec 89 p3

[Article: “AIDS Epidemic Has Worsened’]

[Text] December 1 is the World AIDS Day and in a
statement to mark the occasion, Dr. U Ko Ko, Regional
Director of the South-East Asia Region (SEAR) of the
World Health Organisation (WHO), said “‘since the first
World AIDS Day was observed last year, the epidemic
has worsened in all regions of the world”.

Though many countries in the SEAR are still free from
the infection of the Human Immuno Deficiency Virus
(HIV) and the Acquired Immuno Deficiency Syndrome
(AIDS) disease, it is a matter of serious concern in a
couple of countries of the region, he added. The state-
ment was read out at the World AIDS Day meeting held
at the Regional WHO Office here today.

As of October 1, 1989, over 180,000 cases of AIDS have
been officially reported to the WHO from over 150
countries. The WHO estimate on the actual number of
AIDS cases to date, allowing a factor for unreported
cases, is about 600,000, with between 5 and 10 million
infected with the HIV. About half of these infections are
among people under 30. For this reason, the focus of this
year’s World AIDS Day is on youth—“for young people
tun greater risks of getting infected and yet they can play
a vital role in helping to stop AIDS from spreading,” was
Dr. U Ko Ko’s message.

Infection patterns: Speaking specifically on the situation
in the South-East Asian Region, Dr. N. K. Shah of the
WHO said that, as of October 31, 1989, the total number
of AIDS cases in the region had risen to 76 from 11
countries. However, five countries had not reported any
cases of HIV infection or AIDS disease. The two coun-
tries which had the largest number of cases in the region
were India and Thailand but the patterns of infection
and disease prevalence were drastically different in the
two—in the former it is the intravenous drug users while
in the latter the sexually promiscuous and blood donors
who constitute the high risk groups.

Giving information on the Indian picture Dr. Shiv Lal of
the Ministry of Health said that the HIV seropositivity
rate (per thousand) had increased from a value of 3.8 in
January 1989 to 4.5. Of a total of 379,470 persons
screened for HIV infection from high risk groups at the
41 serosurveillance centres approved by the ICMR (since
1985 when the national surveillance programme began),
1,784 had been found to be positive.

This, it must be observed, marks a stepped up screening
programme because since June 1989 as many as 134,659
additional persons have been screened giving an addi-
tional 864 HIV positives. This itself could be reason for

NEAR EAST & SOUTH ASIA

JPRS-TEP-90-001
18 JANUARY 1990

the noticeable jump in the seropositivity rate. The total
number of AIDS cases now reads 40, which is 11 more
than what had been reported earlier. Of this 28 are
Indians and 12 foreigners, which means 10 more indig-
enous AIDS cases since June. Among the 28 Indian cases
21 are males.

Increased surveillance: What is prominent in the data of
HIV positives is that the prevalence is highest among the
heterosexually promiscuous and blood donors. The
former account for 932 (of which 568 are females) and
the latter for 401 (of which 386 are males) and this is
indicative of female prostitutes and professional blood
donors being the worrisome high risk groups in the
country. The numbers also show an increased surveil
lance in blood collection centres which had been ii
ated early this year.

There is also an increase in the number of HIV positive
blood and blood product recipients in the last six months
by 25. The current figure is 44. In this context it may be
pointed out here that none of the nine indigenous blood
product manufacturers, who had been asked by the Drug
Controller of India to suspend operations till the com-
panies instituted mechanisms to adhere to the Health
Ministry Regulations with regard to manufacturing prac-
tices, has resumed operations. It is learnt that, so far,
only one company has imported a certain virucidal
technique approved by the Ministry and this unit should
commence operations soon.

At present the blood product requirements are being met
through imports with testing facilities established to
screen the imported products for HIV. Similarly
screening of every unit of blood collected in the 720
blood banks is also being initiated, although the process
has been rather tardy given the logistical problems, with
a network of 28 zonal centres linked to the four nodal
centres in Pune, Vellore, New Delhi and Delhi.

Lower rate: The seropositivity rate in India, it should be
remembered, reflects the prevalence in the high risk
groups and not the general population. This rate is much
lower compared to levels in the Western world and
therefore offers a distinct possibility of control and
prevention through a well laid out strategy of surveil-
lance, epidemiology, counseling, medicare and informa-
tion dissemination and education.

Statistics on AIDS in Karnataka Discussed

54500027 Bombay THE TIMES OF INDIA in English
27 Oct 89 p 11

[Text] Three persons diagnosed to be positive cases of
the acquired immune deficiency syndrome (AIDS) in
Karnataka have so far eluded all government efforts to
trace them.

Of them, one is a foreigner from Sharjah, another who
hails from Tamil Nadu suffers from a venereal disease
and the third is a professional blood donor, according to
the director of medical education, Dr Rajeeva Shetty.



SJPRS-TEP-90-001
18 JANUARY 1990 3

WEST EUROPE
CANADA

AIDS Incidence; Sentencing of Virus Spreader .....
3,208 Reported Cases [Vancouver THE WEEKEND SUN, 2 Dec 89]
Bisexual Man Sentenced for Transmitting Infection
[Toronto THE GLOBE AND MAIL, 9 Dec 89}
AIDS Incidence in British Columbia Reported
[Harold Munro; Vancouver THE SUN, 27 Nov 89)
DENMARK
Greenland Official Warns of AIDS Threat /Nuuk GRONLANDSPOSTEN, 24 Nov 89] ....
FINLAND

HIV Self-Testing Kits Expected in Pharmacies [Helsinki HELSINGIN SANOMAT, 7 Nov 89]
HIV-Positive Drug Users Demand Methadone [Helsinki HELSINGIN SANOMAT, 7 Nov 89]

GREECE
AIDS Spread, Public Ignorance Discussed [Athens TO VIMA TIS KIRIAKIS, 26 Nov 89]
Poll on Knowledge of, Attitudes on AIDS
[Sonia Zakharatou; Athens KIRIAKATIKI ELEVTHEROTIPIA, 3 Dec 89]
IRELAND

AIDS Problem in Ireland Said at Record Growth

. 27

[Alan O'Keeffe; Dublin IRISH INDEPENDENT, 24 Oct 89] . . 32
SPAIN
Figures Showing Spread of AIDS Published 33
30 New Cases a Week [Arturo Cenzai (adrid DIARIO 16, 19 Nov 89] 33
Highest European Figure for Newborns
[F. Jimenez Santos; Madrid DIARIO 16, 24 Nov 89] . 34
AIDS Figures, Growth Rate Reported [Madrid DIARIO 16, 1 Dec 89] . 35
AIDS Campaign Urged; Vatican Posture Scored [Madrid DIARIO 16, Nov 89] . 37
Discrimination Against HIV Positive Carriers
[Amparo G. de la Gama; Madrid DIARIO 16, 24 Sep 89] . 38
Poll Shows Doctors, Nurses Fear AIDS [Madrid YA, 23 Nov 89] . 39
AIDS Situation in Country’s Prisons Viewed [Madrid DIARIO 16, 40
First Doctors Tried for Negligence Involving AIDS Infections
[Madrid EL INDEPENDIENTE, 14 Nov 89] _...... 40
Subsidized Syringes as Anti-AIDS Measure [Madrid DIARIO 16, 19 Oct 42
SWEDEN
AIDS Spread Less Than Forecast
42

[Micke Jaresand: Stockholm DAGENS N- YHETER, 22 Nov 89] .....



IPRS-TEP-90-001
18 JANUARY 1990

“We might be struck with a new wave of HIV-infected
persons within 10 or 15 years. Then we cannot be caught
unaware.”

Johan Giesecke, an infection specialist in Stockholm,
has a similar view.

“It is probably more dangerous to bicycle without a
helmet in the streets of Stockholm, than it is to have
intercourse with your neighbor without using a condom.
On the other hand, if we are not careful today, we might
risk an epidemic in the future. That means that we have
to beat the drum now for something that actually does
not threaten us until maybe 20 years from now.”

Even if Sweden so far has managed to avoid an AIDS
epidemic, other parts of the world are hard hit.

WEST EUROPE 43

A whole generation of people are threatened in several
countries in Africa, where the infection is spread most
rapidly among heterosexuals. HIV is still a considerable
threat to homosexual men and intravenous drug users in
the United States. Furthermore, the virus is beginning to
spread in earnest in Southeast Asia, in Thailand, for
instance.

According to the latest statistics from the World Health
Organization, WHO, there are 600,000 known cases of
AIDS in the world. A total of 6 million people have been
infected with HIV.

“During the year 2000 alone, one-half million people are
expected to develop AIDS. In 1988 the same number was
100,000,” says Jonathan Mann, head of the AIDS pro-
gram at the World Health Organization.



JPRS-TEP-90-001
18 JANUARY 1990

Health Council issued an order on 10 October 1986
stipulating that all blood banks must subject donations
to antibody detection. Nevertheless, since that regula-
tion went into effect and up until 26 February 1987,
6,226 donations were received in the Bellvitge hospital
without the required test; and 2,284 transfusions were
given during that period.

Officially, “only” one person has died, although it is
believed that six others who succumbed because of
having contracted this disease may be associated with
the case. Two patients at the center, aged 61 and 39
(whose names remain concealed at the wish of the
plaintiffs themselves), were infected after having
received transfusions carrying antibodies.

According to the special prosecutor in the case, Jose
Maria Mena, both are now asymptomatic carriers of
AIDS antibodies. Included among those summoned to
make statements are council members Josep Laporte
(now on the Education Council) and Xavier Trias,
currently on the Health Council. At the time of the
incidents, the former served on the Health Council and
the latter was general director of the Institut Catala de la
Salut [Catalonian Institute of Health], an oversight
agency to the Bellvtige hospital. Nevertheless, both have
appealed to their status as privileged persons to avoid
having to appear in court personally; hence, they will
respond in writing to the interrogation already prepared.

Suspense

In addition to being the first trial in Europe to decide on
this issue through a criminal process, this case has
evoked enormous suspense because, for the first time, a
court will have to decide whether or not blood is a
medication, and also whether a person with AIDS anti-
bodies, even when the disease is not developed, can be
considered a sick person.

Still in the process is a criminal charge brought by
Apolonia Pasamontes, a 43-year-old housewife, against
the Vall d’Hebro hospital, also in Barcelona. On 14 May
1986, when it was not yet compulsory to make the AIDS
test, she received a transfusion with contaminated blood.
On 3 October of last year she filed the complaint, but her
case it still being held up in the No 20 Trial Court of
Barcelona.

The Association for User Health Integration (ALSU) has
charged that, a year before the Generalitat issued the
order requiring blood banks to make the tests to detect
antibodies, the Vall d’Hebro hospital already had an
internal protocol requiring such analyses.

Lack of Information

Apolonia Pasamontes Rubio refused to remain anony-
mous, and decided to file the complaint. Now she is
charging the lack of information to which the affected
citizens are subjected. She has even reported that, “In
the hospital they did not inform me of the means of
infection; telling me only to be careful with toothbrushes

WEST EUROPE 41

and to use condoms.” However, the doctors treating her
were especially “kind” to her: They advised her not to
say anything to her relatives, so that they would not
avoid her; or to her fellow workers, so that they would
not eject her.

She said no, that she rejected silence, despite the bad
experience that she was having and still has. “The
individuals responsible for all this should perhaps
receive a little of my blood and find out what it’s like to
undergo what I’m undergoing,” she remarked. For the
present, she does not yet know whether she has con-
tracted the disease, because the doctors visiting her
regularly (now from the Barcelona Clinic Hospital) only
tell her that she is “‘a carrier of the virus in an advanced
stage.”

Her situation is such that, at present, her body might not
resist pneumonia. A person with a normal degree of
health has a proportion of between 900 and 1,000
lymphocytes; she has only 70.

AIDS Test in Hospitals

During the past 2 years Spanish hospitals have been
subjecting to the AIDS test all material capable of
containing the virus, whether it be blood plasma, used on
a mass scale in surgical operations, or other blood-
derived products, for example, those injected into hemo-
philiacs every time they sustain a wound.

Nevertheless, this has not prevented a total of 136
hemophiliacs from dying during recent years in our
country as a result of AIDS infection, according to the
figures released by the National Federation of Hemo-
philiacs. This institution, which includes a total of 2,500
Spaniards suffering from this congenital disease, claims
that most of those in this group infected with AIDS
before 1986 received it from contaminated blood trans-
fusions.

In that year international laboratories created the HIV
(human immunodeficiency virus, the cause of AIDS)
detection test, the use of which was made compulsory in
all Spanish hospitals. It was the delay of several months
in implementing the test in a Barcelona hospital that
prompted the judicial proceedings in October 1986
against those in charge of the center, whose public
hearing is taking place now.

Therefore, according to the experts, there does not exist
the risk of contagion that was present during the 8-year
period from 1978, when AIDS broke out in the West,
until the test was generalized. The “test,” known by the
initials ELISA, offers a total margin of safety, because it
detects the presence of HIV antibodies; except in the
case of carriers of the virus who have not developed
antibodies: a “statistically negligible” risk, according to
the experts.



JPRS-TEP-90-001
18 JANUARY 1990

“Set to double”

“Many medical doctors are claiming that the number of
AIDS carriers will double every six months from now
making it essential that every child and every adult in the
country is aware of the dangers and in particular how the
disease is spread and how it can be prevented.”

South Africa has also been criticised for being one of the
few civilised states in the world that is not funding the
treatment of people affected by AIDS.

The treatment is expensive and way beyond the means of
most people.

* The Argus Foreign Service reports from London that
the spread of AIDS among heterosexuals has
increased dramatically.

According to the Department of Health’s latest figures,
nearly five people a day are being infected in Britain.

Altogether 11,218 péople have been reported as infected
up to the end of September.

The figures show an increase of 424 since the end of
June. In the same three-month period there was a 16
percent rise among heterosexuals compared with an
overall increase among homosexuals of just 4 percent.

Survey: AIDS No Greater Risk to Miners

54000017A Johannesburg BUSINESS DAY in English
30 Nov 89 p I

[Text] There was no evidence to suggest miners were at
greater risk of contracting AIDS than other male black
workers, a Chamber of Mines survey has found.

The survey results were published in the chamber’s
newsletter. Figures available from other medical studies
indicated the prevalence of HIV-positive persons among
miners attending sexually transmitted diseases (STD)
clinics at mines was lower than among blacks attending
STD clinics in Johannesburg.

The survey was conducted on a sample of 429 miners
from four gold mines—two in the Transvaal and two in
the Free State.

The report states: “The promiscuity of black miners, so
often alluded to in discussions about AIDS in SA, is not
borne out by this survey. A prevalent understanding of
the dangers of promiscuity in the spread of STDs and
AIDS was shown in this study.”

Although awareness of AIDS was high, the feeling of
personal susceptibility was low. Almost 95 percent of the
men interviewed had heard about AIDS, but only 20.3
percent believed they could contract the disease.

Because of the predominantly sexual transmission of
AIDS, knowledge of STDs was considered important.
Some 27 percent of the men had had an STD, while 7.7
percent could not remember. Single men showed double

SUB-SAHARAN AFRICA il

the incidence of STDs compared with married men,
while the 18-25 age group reported three times more
STDs than the over-45 age group. About 36 percent of
those who had had an STD were from SA townships,
while 25 percent were from Transkei and 18 percent
from Lesotho.

The report said it was noticeable that peer teaching was
the most important source of information to the miners.

Mine media were another necessary source of informa-
tion. Combining these two information channels and
using individual health education messages directed at
“at risk” groups (young, single, poorly-educated miners
and those having most contact with women), appeared
the most sensible strategy to combat the possibility of an
AIDS epidemic among mineworkers.

The newsletter also carried a synopsis of a paper deliv-
ered by chamber medical adviser Dr Oluf Martiny who
said another survey had identified Malawian employees
as being the most seriously infected, with an incidence of
3.76 percent compared with 0.02 percent in SA
employees, equivalent to 175 times more infection than
SA miners.

“By 1987 the situation had escalated to 10 percent of
Malawians, or 2,000 employees, testing HIV positive. By
1989, the prevalence in Malawian employees had
increased to 21 percent. A most interesting finding was
the discovery that 21 percent of Malawian employees
had become HIV positive on testing in 1989 compared
to 10 percent in 1987/88. The significance of this finding
is of major importance.”

The increase took place while the employees worked in
SA and did not return to Malawi on leave. They were
therefore not exposed to infection in Malawi during this
period and most could not have been infected in SA, as
the prevalence of infection in SA miners was probably
less than 0.2 percent during 1987-89.

UGANDA

District Health Official On AIDS Problem

90WE0047A Helsinki HU8FVUDSTADSBLADET in
Swedish 25 Oct 89 p 22

[Article by Sture Gadd: “At Least 1 Million Ugandans In
Death’s Waiting Room”]

{Text] In Uganda, in the heart of Africa, at least 1 million
people have been infected with the HIV virus and
consequently will contract AIDS. So far there are about
8,000 registered AIDS cases, but that number is consid-
ered far too low. The authorities admit that the number
of cases doubles every 6 months but base their statistics
on figures that are too low.

There are no reliable statistics in a dirt-poor country that
is in the process of recuperating from a devastating civil
war. However, UNICEF and a number of international



IJPRS-TEP-90-001
18 JANUARY 1990

Health Official Discusses Newly Discovered
AIDS Case

0W0211012089 Beijing Television Service in Mandarin
1100 GMT 31 Oct 89

[From “National News Hookup” program]

[Text] [Video shows a closeup shot of Cao Qing, deputy
director of the Department of Health and AIDS Epi-
demic Prevention under the Ministry of Public Health
and director of the National AIDS Prevention Group
being interviewed by a reporter}

[Text] Recently the first Chinese AIDS patient was
found among venereal disease [VD] patients on the
Chinese mainland. Last night, our station reporter called
on Cao Qing, director of the National AIDS Prevention
Group in this connection.

[Begin recording]

Beijing TV: Director Cao, it has been reported that a
certain hospital in Beijing Municipality has discovered
an AIDS patient from the blood samples of veneral
disease patients. Is that true?

Cao: Yes, that is true. The patient is male. He is a
salesman working for the Beijing Municipal Nonstaple
Food Store. He was seeing a doctor in the hospital who
had diagnosed his illness as second-stage syphilis. The
hospital checked the patient’s blood for AIDS. Later it
was discovered that his blood showed a positive AIDS
reaction. He is the first Chinese AIDS patient found
among VD patients.

Beijing TV: What measures have our AIDS prevention
and public health departments taken after finding him to
be an AIDS victim?

CHINA 13

Cao: After receiving the report, the relevant departments
immediately made some investigations. Since he used an
alias in the hospital, we encountered difficulties in
locating him, and later found that he had already gone
abroad. We checked his close relatives and acquain-
tances for AIDS, but none of them had been infected.

Beijing TV: What is the relationship between AIDS and
venereal disease?

Cao: Venereal disease is closely related to AIDS. In our
country, the rate of venereal disease infection is rising
sharply. AIDS infection occurs mainly in three ways.
First, infection’ may occur by sexual contact. Second,
infection may occur through blood transfusion. Third,
infection may occur through birth. That is, a child may
obtain AIDS from his or her mother. We found that our
patient had sexual relations with many people. He also
had homosexual contact with foreigners. This is the first
case of AIDS infection on the Chinese mainland discov-
ered among VD patients. It is possible that a second or
third case, or even more cases, of AIDS infection will be
found. Those who have been infected with AIDS may
spread the disease to others. Therefore, it is a dangerous
disease.

Beijing TV: How many AIDS patients are there on the
Chinese mainland?

Cao: China has so far discovered 30 AIDS victims,
including 25 who got the disease in other countries or
regions. Twenty-four of them are foreigners while one of
them is a Hong Kong compatriot. In addition, four
victims in China got the AIDS virus from U.S. biological
products which they had used. There are now a total of
30 AIDS patients if we add the AIDS victim we have just
discovered.



JPRS-TEP-90-001
18 JANUARY 1990 2

Warning as Four New Cases of AIDS Detected

[Mary Ann Benitez; SOUTH CHINA MORNING POST, 1 Nov 89) .. 14
Council on AIDS To Be Set Up Soon
[Mary Ann Benitez; Hong Kong SOUTH CHINA MORNING POST, 11 Nov 89] ..... 15
Experts Propose Testing Pregnant Women for AIDS
15

[Mary Ann Benitez; Hong Kong SOUTH CHINA MORNING POST 27 Oct 89

THAILAND

Senior Army Medical Officers Discuss AIDS .
Gen Arun on Mandatory Testing /Bangl 7 Nov 89]
Gen Panya on Budgetary Considerations {Bangkok NAEO NA, 26 O
Budget Provided for Testing /Bangkok MATICHON, 18 Oct 89].
Supreme Command Officer Comments [Bangkok SIAM RAT, 18 Oct 89]

VIETNAM
AIDS Prevention, Control Campaign Reported Hanoi International Service, 29 Nov 89]... 17
LATIN AMERICA

CUBA

Danish Journalist Visits AIDS Sanatorium
[Trine Jacobsen; Copenhagen LAND OG FOLK, 28 Oct 89]...

DOMINICAN REPUBLIC
21

Health Minister Cites AIDS Increase /Santo Domongo LISTIN DIARIO, 7 Sep 89] ....

HONDURAS

Reportage on AIDS Cases
374 Victims [Tegucigalpa (A, 3 Oct 89] ..
‘Alarming’ Local Increase {Tegucigalpa LA TRIBUNA,

MEXICO

National, State Aspects of AIDS Cases. ...
3,116 Cases Nationwide /Miquel Barba Cardenas; Mexico City EXCELSIOR, 4 Nov 89]
Mexico, Queretaro State Data

[J. Antonio G. Huicoechea; Mexico City EXCELSIOR, 10 Nov 89] ..
Blood Bank Threat Cited Eduardo Chimely; Mexico City EXCELSIOR, 11 Nov 89]
Veracruz Statistics Gustavo Cadena Mathey; Mexico City EXCELSIOR, 14 Nov 89]

NEAR EAST & SOUTH ASIA
INDIA

WHO Offficial: AIDS Epidemic Worsening /Madras THE HINDU[ 1 Dec 89] ..
Statistics on AIDS in Karnataka Discussed /Bombay THE TIMES OF INDIA, 27 Oct 89]

ISRAEL

First AIDS Case Reported Among Israeli Arabs
[Dvora Namir; YEDI'OT AHARONOT, 5 Sep 89] ....

AIDS Cases Reported Among IDF Soldiers /Yosi Verter;



34 WEST EUROPE

Highest European Figure for Newborns

90WE0055B Madrid DIARIO 16 in Spanish
24 Nov 89 p 12

[Report by F. Jimenez Santos]

Spain is the European country in which the most new-
borns have antibodies to AIDS, according to a report
drafted by the Spanish Pediatric Association (AEP).
From April to October 1,416 carriers were born, 277 of
whom contracted the disease and 71 died. These are
incomplete data, as the survey to determine the number
was limited to 71.5 percent of the centers.

There are 233 cases at Gregorio Maranon Hospital in
Madrid; this is more than in the entire United Kingdom.
By the end of this year about 2,000 children will have the
disease, which is caused by the HIV virus, at various
stages of development. These cases of mother-to-fetus
transmission are found almost exclusively (95 percent)
among drug-addicted mothers. Their sociocultural and
economic level tends to be low.

Of every 100 infants who are born with the antibodies,
25 will develop the disease over an undetermined period
of time. This infection rate is similar to that in the other
EEC countries. According to the AEP, the clinical follow-
ups have so far been very inadequate, mainly owing to
shortcomings and limitations in health-care infrastruc-
ture.

The association, which comprises some 6,000 physi-
cians, has asked that the test to determine the presence of
the virus be conducted on all pregnant women, and is
also calling for strict measures to prevent its spread.
These requests, as well as the data gathered, will be
presented at the next world congress of mother-infant
AIDS.

The average age of the mothers at childbirth was 23.
Only half of them were married, and 84.1 percent were
asymptomatic. Some 8.4 percent of them have died of
AIDS.

The average weight of the infected newborns was 2,762
grams; normal weight is 3,342 grams. Almost one-fifth of
them were born premature, at 37 weeks. One of four
infants was suffering withdrawal symptoms a few hours
after birth. +

Concentration of Cases

The highest concentrations of cases are in Madrid,
Catalonia, the Valencian Community, and the Basque
Country, in that order. These communities account for
80 percent of the total cases.

The association recommends that special family follow-
up units be created for these cases and that an advisory
technical group for government be set up to supervise
assistance and research programs for pediatric AIDS. It
is also calling for strict controls on the availability of
drugs for consumption.

JPRS-TEP-90-001
18 JANUARY 1990

The president of the AEP, Jose Pena Guitian, indicated
that “‘a vaccine is not expected until 1995. As of now we
can try to extend the life of the patient as much as
possible, but the problem that is plaguing Spain in
particular is the large number of women addicted to
intravenous drugs who have the virus and are in their
childbearing years.”

Dr Canosa, from the La Fe Pediatrics Department in
Valencia, underscored that newborns who have anti-
bodies “do not necessarily have to be the children of
mothers with the disease,” and he acknowledged that in
many cases the mothers find out that they are suffering
from the disease when they give birth.

In these cases the mothers do not suspect that they have
AIDS because they have not consumed drugs of late. In
this regard, Canosa underscored the surge in drug addic-
tion at the start of this decade, before the alarm over
AIDS spread; thus, some mothers who are carriers could
have stopped shooting up years ago and are only now
manifesting the disease.

Jose Pena highlighted the fact that the fathers of infants
who have the virus have formed no association whatso-
ever, in contrast to the case with other diseases. “They
cannot form pressure groups,” he said, “because they
would be socially ostracized right away. Such discrimi-
nation is working against us in compiling complete
statistics.”

The president of the AEP deplored the scant preventive
measures that were taken when the syndrome first
appeared 9 years ago. He said that pediatricians were
interested in the perinatal transmission of the disease
and recalled that the WHO’s priority was epidemiolog-
ical research.

Clinical Follow-Up

“Today, with just the standard techniques that we have,
we can do little more than wait and see what happens
during the first 18 months of an infected infant’s life, and
afterwards, over the next 5 years, through rigorous
clinical, analytical, and psychosocial follow-ups,” Pena
stated.

Nevertheless, such follow-ups cannot be conducted to
the extent that would be desirable owing to the insuffi-
ciency of personnel and equipment. “Rather than
bureaucracy, we need resources adapted to the propor-
tions and peculiarities of pediatric AIDS,” indicated the
president of the association, who also underscored that
health-care centers for children are collapsing under the
weight of the demand for services, which makes it
impossible to treat patients properly.

More Patients Than Statistics Indicate

The findings of this survey have been reported to the
government so that it becomes aware of the magnitude of
the problem, representatives of the Spanish Pediatric
Association said. The association financed the study.


‘Alarming’ Local Increase

90WE0022 Tegucigalpa LA TRIBUNA in Spanish
3 Oct 89 p 48

[Text] In recent months, the number of cases of AIDS in
this city has increased alarmingly, according to reports.
The data provided by the Department of Epidemiology
in Health Region No 4 indicate that there are 14 infected
individuals.

It has been determined that four of the patients are
individuals who are apparently healthy and are currently
leading normal lives, but are the principal agents of
transmission.

This has made it necessary to organize to prevent the
advance of AIDS.

Recently, the Choluteca City Interinstitutional Com-
mittee for Combating AIDS was established. It is made
up of state, private, and military institutions, as well as
other active groups, with Mayor Pedro Montanola as its
coordinator.

At a meeting held at the premises of the 101st Military
Brigade, Dr Soriano Pizzaty gave a clear explanation
about the proven cases of AIDS. He said that for every
known case, there are another 100 infected persons.

MEXICO

National, State Aspects of AIDS Cases

3,116 Cases Nationwide

90WE0050A Mexico City EXCELSIOR in Spanish
4 Nov 89 pp 5-A, 38-A

[Report by Miguel Barba Cardenas]

[Text] As of 1 October of this year 3,116 cases of AIDS
have been reported; 179 are new cases that were reported
in August, and most of them are patients who began
having symptoms in the second half of 1987 and the first
half of 1988. This was revealed by the Health Secretariat
in a nationwide survey.

The secretariat reports that the General Directorate of
Epidemiology is currently conducting a complete review
of AIDS cases and to this end is visiting the various
states and comparing the data in state files with its own.
The purpose of all this is to reduce to a minimum the
underreporting of AIDS cases.

The secretariat indicates that the states with the highest
rates are the Federal District, Jalisco, Morelos, Yucatan,
Colima, and Coahuila. Sexual transmission is the pre-
dominant mode in most states, except in Hidalgo, where
the disease is found mainly in bisexual and homosexual
men. [as published] In Baja California and Veracruz, in
contrast, the transmission rate of this group is 1.2 times
higher than the national average.

LATIN AMERICA

JPRS-TEP-90-001
18 JANUARY 1990

The Health Secretariat adds in its report that as far as
heterosexual transmission is concerned, the states of
Mexico and Puebla are in the lead, as the proportion of
heterosexual cases there is 1.8 times the national
average. As for cases among intravenous drug users, 54.4
percent of the total have been reported by Jalisco.

The secretariat added that the 39 cases associated with
perinatal transmission have been reported by 11 states;
the Federal District, Jalisco, and the State of Mexico
account for 61.5 percent of them.

It also revealed that 390 cases of AIDS have been
reported among women, accounting for 12.5 percent of
the total. The ratio of men to women with AIDS now
stands at 7 to 1, and among both sexes the hardest hit age
group is 25 to 44.

The highest risk group is men between the ages of 25 and
44, with 1.9 cases per 10,000; this represents a risk 2.8
times greater than for the total male population. The risk
for women is one-seventh as great as for men, the rate
being 0.1 per 10,000.

As for the reporting institutions, the IMSS [Mexican
Social Security Institute] has reported 42.7 percent of the
cases (1,330); the SSA [Secretariat of Health and Assis-
tance], 34.3 percent (1,070); the ISSSTE [Institute of
Social Security and Services for Government Workers],
10.9 percent (341), and other institutions, 12 percent
(375).

In conclusion, the Health Secretariat reported that as for
the current condition of the patients, 61.7 percent (1,922
cases) are still alive and 34.2 percent (1,066) have died.
The current condition of the remaining 128 sufferers is
not known.

Mexico, Queretaro State Data

90WE0050B Mexico City EXCELSIOR in Spanish
10 Nov 89 STATES section p 3

[Report by J. Antonio G. Huicoechea]

[Text] Of the 330 cases of AIDS that have been detected
in this state since 1985, 79 are in Nezahualcoyotl, 53 in
Toluca, 46 in Tlalnepantla, and the rest in other com-
munities, the director of the AIDS Prevention and
Control Committee here, Maria del Carmen Gutierrez,
reported today, adding that 158 of the patients have
died.

Of the total number of patients with the syndrome, she
indicated, 42 belong to the so-called serum-positive
group. Even though they may not show symptoms of the
disease, they have been infected and have the virus in
their bodies.

She emphasized that the figures for AIDS in this state are
not all that alarming. She felt, however, that “a greater
awareness had to be created among the citizenry about
how to avoid infection.”

|



Epidemiology

JPRS-TEP-90-001 CONTENTS 18 JANUARY 1990

SUB-SAHARAN AFRICA
ANGOLA
AIDS Leads to 28 Deaths, 156 Cases [Lisbon DIARIO DE NOTICIAS, 27 Nov 89]

KENYA

Country Named AIDS Research Center /Emman Omari; Nairobi DAILY NATION, 8 Nov 89] .....
MAURITIUS,

AIDS Information Campaign; Four Cases /Port Louis LE MAURICIEN, 27 Nov 89] ..
MOZAMBIQUE

Nationwide Anti-AIDS Campaign Reviewed [Maputo NOTICIAS, 6 Nov 89] .....
NIGERIA

16 Deaths, Increase in AIDS Cases Reported

[Ranti Famuyibo; Lagos DAILY TIMES, 22 Oct 89] ....
Armed Forces Warned of AIDS Spread {Lagos DAILY TIMES, 29 Nov 89]
Medical Experts Baffled by AIDS Rate [Laide Shokunbi; Lagos DAILY TIMES, 28 Nov 89]
Women Urged To Wage Total War on AIDS [Lagos DAILY TIMES 30 Nov 89]

SOUTH AFRICA

Baas

Rising AIDS Figures Released {Johannesburg THE CITIZEN, 7 Nov 89] ....
Efforts To Halt Spread of AIDS Viewed

[John Perlman; Johannesburg THE WEEKLY MAIL, 29 Sep-5 Oct 89] _. . 6
Experts Give Predictions on AIDS Jenny McMahon; Johannesburg THE STAR, 30 Nov 89] .
AZT Drug Soon Available at Academic Hospitals /Durban THE DAILY NEWS, 6 Oct 89]
More Blacks Reportedly Test AIDS Positive [Johannesburg THE CITIZEN, 20 Oct 89] ...
Government, Private Sector To Fight AIDS

[Bruce Cameron; Cape Town THE ARGUS, 12 Oct 89) ....
Survey: AIDS No Greater Risk to Miners (Johannesburg BUSINESS DAY, 30 Nov 89]

UGANDA

District Health Official On AIDS Problem
[Sture Gadd; Helsinki HUFVUDSTADSBLADET, 25 Oct 89] ...

CHINA

Health Official Discusses Newly Discovered AIDS Case
[Beijing Television Service, 1100 GMT 31 Oct 89] ....

EAST ASIA
HONG KONG

Concern Shown at Late AIDS Diagnosis
[Mary Ann Benitez; Hong Kong SOUTH CHINA MORNING POST, 15 Nov 89] ....



30 WEST EUROPE

12.1 percent of the physicians and nurses in Athens and
37.1 percent in Salonica wear rubber gloves when they
inject a patient and only 64 percent of the physicians in
Athens and 63 percent in Salonica know about the
Ministry of Health’s booklet with instructions for pro-
tection from the virus.

It should also be noted that the second AIDS virus
(HIV2), which was discovered more recently and is
endemic in Western Africa, has made its appearance in
Greece and, more specifically, in Crete. “Until now we
have located four HIV2 carriers, three men and one
woman, and we are about to report it in an authoritative
scientific journal,” Mr V. Georgoulias, assistant pro-
fessor in charge of the Center for AIDS Control in Crete,
told VIMA. “We believe that a search for this virus
should be made all over Greece so that a few years hence
we will not find ourselves in a worrisome situation.”

In addition, a new element in the history of AIDS in
Greece is the newly founded —two for the time being—
associations (in addition to the scientific societies on
AIDS) that offer support, on a voluntary basis, to the
carriers and the sick and protect their rights.

While the specialists the world-over believe that the peak
of the epidemic has not yet been reached (despite the fact
that the number of sick is estimated to be 500,000
worldwide) and Greece has fully joined this “deadly
game,” the lack of public information has been particu-
larly noticeable during the past few months. There is a
complacency even in the work of the National Com-
mittee on AIDS. “When the committee’s proposals are
not implemented, we see no reason to proceed with
further planning,” explains pediatrics professor and
member of the National Committee on AIDS, Dr N.
Matsaniotis. “Although | and ‘4 years ago we prepared,
in cooperation with the Advertisers Union, the new
information campaign, it has not yet been implemented
by the administration.”

What Do the Young Believe?

Internationally, but more so in Greece, a complacency
about AIDS and its consequences has recently been
observed. “The young believe that the danger does‘not
affect them, that it is to be found in other populations, in
other individuals,” a professor of preventive medicine.
and member of the National Committee on AIDS, Dr.G.
Papaevangelou, stresses. “For this reason the scientific
information should not only have been available, but
continued and intensified as well as updated in order to
hold the public’s interest.”

During this year’s World Day on AIDS there are to take
place—according to the circular of the Ministry of Edu-
cation and after the intervention of the Greek Society for
Research and the Fight Against AIDS—talks based on
the instructions of the WHO in all the high schools in
Greece. Simultaneously, there will be, on a voluntary
basis, an essay contest for high school students and an art
contest for junior high school students on the subject of
AIDS. The best essays will be published in an album and

JPRS-TEP-90-001
18 JANUARY 1990

the best art will be exhibited. At the same time, a concert
will be organized to perform at the Olympic Stadium, the
proceeds of the concert will be earmarked for research
and the fight against AIDS in Greece.

Poll on Knowledge of, Attitudes on AIDS

90WE0070A Athens KIRIAKATIKI
ELEVTHEROTIPIA in Greek 3 Dec 89 pp 30-31

[Article by Sonia Zakharatou: “AIDS Is Here’ and Few
See It”]

[Excerpts] A year and a half ago, Professor N. Matsani-
Otis, in his speech on AIDS at the Athens Academy,
reported: “We have the privilege of being, epidemiolog-
ically, where the United States was six to seven years ago,
or where,the northern European countries, but also the
large Mediterranean countries, were three to four years
ago, while we have for our defense the knowledge and
‘experience about AIDS today. It would be a mistake if
we did not avail ourselves of, if we did not exploit, this
great privilege. I have the strong impression that we are
not exploiting it sufficiently.”

A year and a half has passed since then. And it appears
that, yes, we are exploiting medical knowledge, but not
the experience which, condensed, can help in preven-
tion. And, as always in the health sector, what mainly
counts and is determinative is the clear and general
knowledge which leads every citizen to precaution, self-
protection and preventative measures. What is the
knowledge today? What is the behavior? .

What 1,100 of Us Believe

Five months ago, the First Pediatric Clinic and the
Athens University Hygienics and Epidemiology Labora-
tory, financed by the World Health Organization, con-
ducted a public opinion poll on AIDS among a represen-
tative sample of the Greek population, specifically,
among 1,100 people, aged 18 to 55, 70 percent of whom
were men and 30 percent women, from all socioeco-
nomic classes, in Athens, Salonica, and other urban areas
as well as in semi-urban and rural areas. The grounds for
conducting the poll state that “on the level of knowledge,
it is not enough, for example, for young people to know
how AIDS is transmitted, they must also know how it is
not transmitted. Otherwise, the multitude of alleged,
fictitious threats downgrades the significance of the
dangers where they really are to be found.” The poll
brought to the surface examples of such fictitious threats.

One example: 75 percent of those questioned correctly
disagree with the opinion, “If someone is not a homo-
sexual and does not use drugs he runs no risk of being
harmed by AIDS.” However, 36 percent believe that the
virus was created in laboratories and 73 percent think
that AIDS is transmitted while giving blood. And also
that sometimes it can be picked up from very dirty toilets
(59.5 percent).



IPRS-TEP-90-001
18 JANUARY 1990

Gloria is studying philology and hopes to complete her
education. At the university no one knows of her illness.
“If you say you have AIDS people look at you as if you
were some sort of freak, and nobody wants to have
anything to do with you. I had the bad luck of getting
caught, but now I want to get the most out of my life I
can.”

Her sex life hasn’t changed much since she contracted
the disease. “We AIDS patients aren’t running around
the world like kamikazes. If I go to bed with someone, I
do it from love; I’m not deliberately trying to infect him
with AIDS,” she asserted.

AIDS Continues to Spread Throughout Spain

Province Number of Cases Rates (per Million

Persons)
Andalusia 321 47.51
Aragon 55 44.86
Asturias 66 55.90
Balearic Islands 106 141.99
Basque Country, 367 157.14
Canary Islands 38 35.55,
Cantabria 42 77.40
Castilla-La Mancha 43 26.87
Castilla y Leon 2 28.31
Catalonia 969 147.71
Estremadura 34 33.84
Galicia 118 40.61
La Rioja 7 63.56
Madrid 699 130.03
Murcia 36 34.56
Navarra 42 78.16
Valencia 276 68.04
Totals 3,353 83.52
Children With AIDS

Carlos wants to put an end to the cliche that AIDS is
spread through sexual contact and he takes his friend
Rosa to committee meetings every time he goes. “Look,”
he says, pointing to her, “I’ve been making love with her
for 2 years, and she couldn’t be healthier. Sometimes
we've even talked about having a baby.”

At the present time the number of children born with
AIDS antibodies is growing at a considerable rate.
“Many women,” explains the mother of 4-month-old
child who is hospitalized, “don’t know where to get
abortions, and we know that if we have the virus, our
children will also be born with it.”

The child stirs in his crib while we are talking. He looks
at his mother and smiles at her. “If I had known this, I
would never have taken heroin,” laments Pilar. “This
child is going to be wretched.”

WEST EUROPE 39

Other babies are abandoned in the hospital when they
are born, and it is difficult to find people willing to adopt
children with AIDS antibodies. “These children are
condemned to death,” says one social worker, “and
nobody wants to grow attached to them because they are
going to have a miserable ending.”

Drug addicts, prostitutes and young street people are the
major groups of women who are being overwhelmed by
unwanted motherhood. “It would be good,” continued
the social worker, “if these women could get therapeutic
abortions, so the children would not have to suffer.”

Poll Shows Doctors, Nurses Fear AIDS
90WE0054B Madrid YA in Spanish 23 Nov 89 p 20

[Text] According to a poll taken by the Valencian Health
Service at Valencia’s primary care centers and hospitals,
37 percent of Valencian doctors and 40 percent of the
nursing personnel fear AIDS contagion from treating
patients with antibodies (HIV) [human immunodefi-
ciency virus}.

The poll reveals that the health workers show a medical
knowledge of AIDS far superior to that of the general
population, although nearly 40 percent erroneously asso-
ciate infection from the human immunodeficiency virus
with the act of drawing blood, and another 20 percent
believe that transmission can occur through saliva.

The Valencian Health Service’s Office of Studies took a
poll among over 1,300 doctors and nurses. That poll
discloses that there is among health personnel a medium
to high degree of acceptance for patients with AIDS
antibodies, but that they confuse the transmission mech-
anisms that can pass the disease with others that cannot.

As was explained by the poll’s technical official, Fran-
cisca Almena, over a third of those polled and 40 percent
of the nursing personnel cited in the poll “fear of AIDS
infection despite the precautions taken.” They also
expressed approval of the right of health workers to
refuse to care for such patients.

AIDS has created fear and anxiety among 32 percent of
doctors, who consider the disease infectious, incurable,
and fatal. Seventy percent of doctors and nearly 80
percent of nurses believe that those infected with HIV
should be treated in special rooms.

Rejection of Drug Addicts

The person in charge of the poll noted that health
personnel are more likely to reject infected drug addicts
and homosexuals than hemophiliac AIDS patients or
those infected by a blood transfusion.

Generally speaking, doctors and ATS [health technical
assistants] regard AIDS as infections (although not so
much as diseases transmitted by air). However, 15
percent of the doctors and 25 percent of the nurses
thought that mouth-to-mouth resuscitation could be a
means of transmitting AIDS.



SIPRS-TEP-90-001
18 JANUARY 1990

Speaking to reporters at a workshop on AIDS sponsored
by the World Health Organisation (WHO) and the
Bangalore medical college here. Dr Shetty said that the
three had not turned up at the AIDS surveillance centres
after they were diagnosed and all efforts were being made
to find them.

So far 20 positive cases of AIDS had been found in
Karnataka, among them 9 were professional blood
donors, 5 were prostitutes, 3 were persons suffering from
sexually transmitted diseases, 2 were foreigners and !
was a voluntary blood donor. Interestingly, not one of
the 20 drug addicts examined had the disease. Altogether
2,467 persons suffering from sexually transmitted dis-
eases were examined in Karnataka for AIDS between
1987 and 1989, 10,287 professional blood donors and
1,287 foreigners were examined during the same period
for AIDS, Dr Shetty revealed.

Only 5 homosexuals have been examined for the disease.
Voluntary blood donors, numbering 4,813 have been
examined only in 1989,.and not during the previous
years.

Under a “miscellaneous” heading, 361 persons have
been tested for the disease so far.

Dr Shetty said that steps were being taken to equip the 7
AIDS surveillance centres in Karnataka with the neces-
sary staff and equipment. The Indian Council for Med-
ical Research (ICMR) has found that two types of kits
were suitable for conducting the AIDS diagnostic tests.
Karnataka hopes to acquire the kits once the government
of India began manufacturing them.

The medium term plan for AIDS surveillance and con-
trol in Karnataka costing about Rs 75 lakhs, which had
been submitted to the Union government for its
approval in January this year, has still not been
approved, he revealed.

A sum of Rs 1 lakh has been allocated by the state
government for the AIDS programme and it was pro-
posed to sanction two posts of lab technicians for the
AIDS surveillance centres.

Dr Shetty pointed out that a committee headed by the
health secretary has been set up in the state to advise the
government.

Karnataka has 19 district level AIDS committees,
headed by the district surgeon.
ISRAEL

First AIDS Case Reported Among Israeli Arabs
54004501A Tel Aviv YEDI'OT AHARONOT in Hebrew
5 Sep 89 p 12

[Article by Dvora Namir: “First Case of AIDS in the
Arab Sector”]

[Text] AIDS antibodies were found in a young Arab
woman, age 28, who gave birth to a baby girl at Poria

‘AR EAST & SOUTH ASIA 25

Hospital. This is the first case of AIDS reported among
Israeli Arabs.

The woman, who comes from one of the villages in Emeq
Yizre’el, did not know she was infected. After the birth,
she told the physicians that her husband has AIDS. “He
contracted it several years ago after receiving blood
transfusions from the United States. Only later was it
discovered that the blood was contaminated with the
virus,” she explained.

Immediately after the birth, the doctors began testing the
infant to see if it was carrying the antibodies. Infants are
infected through the bloodstream in the mother’s womb.
The results of the tests done on the infant will arrive at
the hospital today.

Until now, two babies in Israel have been born carrying
the AIDS virus. One, the daughter of a drug addict, has
the disease. The other is a boy whose mother got the
virus from her husband who is a hemophiliac. The
mother and baby girl have returned to their home:

AIDS Cases Reported Among IDF Soldiers

54004503A Tel Aviv HADASHOT in Hebrew
12 Sep 89 p 15

{Article by Yosi Verter: “Fifteen AIDS Cases Revealed
So Far in IDF”]

[Text] So far, the disease AIDS or AIDS antibodies have
been found in five regular IDF [Israel Defense Forces]
soldiers and 10 reservists. All 15 were immediately
discharged from service after the screening. So said IDF
Deputy Chief Medical Officer Colonel Shuqi Shemer to
members of the joint committee of the foreign and
security committee and the education committee.

The committee, which concerns itself with educational
matters in the IDF, met to discuss the subject of AIDS.
Col Shemer explained that the blood test that every new
recruit undergoes is the only way to know if someone is
infected. “This still doesn’t free us from a proper pro-
gram of information,” he said and presented to the
Knesset Members the full IDF educational program,
including slides. According to him, they are considering
selling condoms in the canteen along with medical infor-
mation.

Chairman of the subcommittee, MK [Knesset Member]
Hagay Mirom (Alignment), suggested that condoms not
be sold to the soldiers but be provided free of charge
jointly by the IDF. MK Rafael Eitan (Tzomet) added: “It
is known that the Sheqem [canteen], which was estab-
lished during the Independence War, stands for choco-
late, condoms, and chewing gum.”

Prof Avraham Moreg, the top AIDS expert in Israel, told
the committee that, so far, there are known to be about
100 AIDS cases and about 500 carriers of the virus.
“This is actually an epidemic,” said Moreg. “We are



SJPRS-TEP-90-001
18 JANUARY 1990

In a best case scenario, 13.5 percent of the black popu-
lation will be dead or dying by the year 2000. In the
worst case scenario, that figure changes to 45 percent by
1996.

The truth, he says, probably lies somewhere in between.
So what is South Africa doing about this?

It is widely agreed that education about AIDS is neces-
sary to stop the spread of the disease. In South Africa
education is “a major problem” says Dr Ruben Sher of
the South African Institute for Medical Research.

“It is difficult to have a programme that will suit
everyone in the country,” he says.

To date, official education programmes in South Africa
have involved two awareness campaigns and the setting
up of AIDS Training and Information Centres (ATICS)
in Cape Town, Port Elizabeth, Bloemfontein and Dur-
ban.

A similar centre has been in operation at the Institute for
Medical Research in Johannesburg since January 1988.

The ATICS have been set up to “increase local aware-
ness, apply factual information, train health advisers and
counsellors and arrange workshops” as well as carry out
counselling and operate local AIDS surveillance projects,
says a Department of Health spokesman.

The first awareness campaign in 1988 involved televi-
sion and radio commercials and press advertisements.
The objective was to “impart information, raise aware-
ness of the causes of AIDS and direct people to sources of
more in-depth information”, said Mr Tim Bester, vice-
chairman of McCann Advertising.

A post-campaign survey done by Market Research Africa
indicated that the campaign succeeded in this, but
claimed that there was still a need for more information.
This, it said, would be tackled by future advertising.

Following this in 1989, the second awareness campaign
was launched. Three million brochures in nine languages
were distributed to clinics, pharmacies, health centres
and other outlets.

Dr Dennis Sifris, head of the Johannesburg Hospital
HIV Clinic, was sceptical about the campaign. He
pointed out that in a country with a population of over
30 million, only 3 million brochures were printed.

Many experts agree that the only way to stop the spread
of AIDS is by “education in prevention” as Dr Sher has
often said.

Dr Stan Schoeman of the Africa Institute says that
merely raising awareness of the causes of the disease will
not do this.

Dr Schoeman believes that the social, religious and
economic aspects of each group need to be looked at
before an educational campaign could change behaviour.

SUB-SAHARAN AFRICA 9

AFSA believes in involving industry, business, trade
unions, churches, doctors and concerned individuals and
groups in an effort to change social and sexual behav-
jour.

Another private enterprise initiative, The AIDS Policy
Research Centre, has been in existence since 1987.
Unlike the AIDS Foundation, it “provides practical
advice, audits and hands-on corporate policy planning
for the entire sub-continent”, says Dr van Niftrik of the
Centre.

AZT Drug Soon Available at Academic Hospitals

54000013A Durban THE DAILY NEWS in English
6 Oct 89 p6

[Text] Health authorities in South Africa may soon make
available the drug AZT—used for the treatment of AIDS
patients—at academic hospitals.

A spokesman for the Department of National Health and
Population Development said the extremely high cost of.
AZT and the risk involved in treating AIDS patients had
been taken into account.

“The head of the Department of Internal Medicine of the
relevant hospital should accept co-responsibility for the
selection of patients for this treatment,” he said.

The availability of resources and the patient’s condition
would have to be considered. ‘

The spokesman said that by the end of March this year,
47 patients in South Africa had been treated with AZT.

Seven died during treatment, treatment of another seven
was stopped, and four had left the country.

“A total of 29 therefore remained on treatment. From
the middle of August—when the drug was registered by
the Medicines Control Council—data was no longer
available from the firm that supplies AZT.”

He said according to the Department of Hospital Ser-
vices, on September 20, only one patient was being
treated with AZT at a Natal provincial hospital.

In the Transvaal, eight patients were being treated; four
in the Free State and seven in the Cape.

Statistics of patients in private hospitals could not be
obtained.

AZT is registered by the Medicines Control Council as
an antiviral agent under schedule four.

It is not a cure for AIDS, but can prolong life or improve
quality of life.



12 SUB-SAHARAN AFRICA

organizations have cooperated in mapping the situation.
In the villages out in the countryside, HUFVUDSTADS-
BLADET (Hb)) is told of the tragic future prospects.

“Between 10 and 20 percent of the pregnant women we
tested, are HIV-positive,” says Peter Kusolo, head of the
Mbale healthcare district in eastern Uganda.

“The government campaigns have made people aware
that AIDS is dangerous, but they really do not know how
you get AIDS and they are not sure of how to protect
themselves.”

Witch Doctor the Remedy

Lillian Lubega is a nurse and works for UNICEF in
Kampala. She says that many Ugandans still feel that
you get AIDS because some evil person has placed a hex
on you. Instead of going to the hospital, people contact a
quack or a medicine man, who will remove the hex
through invocations, herbs, or strange injections. Even
in the capital, Kampala, it is not unusual for people to
spend all their money on a medicine man in an effort to
escape their disease.

“It is difficult to explain to people why some are infected
and some are not. Since AIDS does not consistently
afflict everyone in a family, people do not believe the
official explanations of how the virus is spread. Instead
they ask themselves which of their neighbors is out for
revenge,” says Lillian Lubega.

Peter Kusolo relates that people are not eager to be
tested:

“Some of them believe that you can get AIDS from the
tests. That is why we are not sure of the disease situation
in the villages. On the other hand, we test as many as we
can at the hospital.”

Truck Drivers Lived Dangerously

The HIV infection is not spread evenly throughout the
entire country. It is most prevalent in Kampala and
along the coast of Lake Victoria. From the beginning the
infection was spread along the roads where truck drivers
and other travelers left behind a network of HIV-
infected people.

At this point there are so many, that it is estimated that
in a few years no villages will have escaped.

In a couple of villages near the Tanzanian border the
situation is catastrophic. In every family someone has
died of AIDS and here and there only old women are left
to try to care for the orphaned children. All the sexually
active parents in the family are dead.

The children survive by cultivating bananas or other
edible things in the fertile earth, while grandmother cares
for the youngest as well as she can. The government in
Uganda has hardly any income and consequently can do

JPRS-TEP-90-001
18 JANUARY 1990

nothing at all for the AIDS victims. The only consolation
is that the climate is ideal and that is why no one is
actually starving to death.

Carriers of Infection Sent Home

The few hospitals in Uganda cannot offer any help
either. They concentrate on diseases that might be cured.
The HIV cases and the AIDS patients are sent home and
in many cases continue to spread their disease there until
the symptoms become too repellent.

The government campaign has been effective in so far as
most people are aware that AIDS is a major problem.
The campaign emphasizes the importance of being
faithful and having only one partner, of not going to
medicine men, and of seeing to it that blood tranfusions
are only made in the hospital and that all syringes are
sterile.

However, in a country where people cannot afford to
spend more than at the most 50 kronor per year on
healthcare, condoms are not an alternative. Since they
are so expensive, relatively speaking, there is no demand
and they are not easy to find.

No Birth Control

Furthermore, Pete Kusolo says that people do not know
how to use condoms and that they do not like the idea of
limiting the number of children. Since the largest reli-
gious group in Uganda consists of Catholics, this is not
hard to understand.

At the worst, people believe that you get AIDS through
the use of condoms, because the Europeans have put
something evil into the condoms to make you sick.

In this situation, the government has chosen to empha-
size the importance of personal discipline and fidelity.

“Never have more than one partner,” is stated in one of
the brochures that quite a few are able to read.

However, within the Muslim minority in Uganda, there
are men with several wives. That is why, on the next page
in the brochure, it is explained that even a larger family,
ive., a man and four wives, can avoid the infection. It is
only a question of everyone being faithful.

Dangerous Brothers

In certain areas of Uganda, it is an accepted custom that
the men sometimes visit their brother’s wives at night—
wives, whom they often “inherit” together with other
property: when their brother dies.

An active brother, who is HIV-infected, has ample time
to pass on the virus to quite a few before he himself
succumbs.

Before the government campaigns can change such cus-
toms, another | million Ugandans risk infection.