IJPRS-TEP-93-008
23 April 1993

Official Views AIDS, HIV Cases in Country

BK1004123693 Jakarta THE INDONESIA TIMES
in English 2 Apr 93 p &

[Excerpts] Jayapura, Irian Jaya—The findings of persons
infected with HIV (Human Immuno-deficiency Virus),
the virus that causes AIDS (Acquired Immune Defi-
ciency Syndrome), in Irian Jaya Province turned out to
be the highest among 27 provinces in Indonesia, an
official said here Wednesday.

Head of Research Division on Epidemics of the Health
Ministry Suryadi Gunawan in a seminar of AIDS erad-
ication said that 36 out of 127 persons infected with
AIDS in the country are found in Merauke City in
southern Irian Jaya. [passage omitted]

Other cases were also found in East Java with 12 cases,
Bali with 17 cases, West Java with two cases, and
respectively one case in North Sumatera, West
Nusatenggara, and Central Java, while 54 cases were
found in Jakarta.

The increasing AIDS cases in Indonesia have been
expected as it is adjacent to some neighboring countries
noted with the high AIDS cases. [passage omitted]

New AIDS Cases Found in Outlying Areas

93WE0255a Jakarta KOMPAS in Indonesian
5 Feb 93 p8

[Text] Within the last month, i.e. up to the beginning of
February 1993, ten new AIDS cases have been found in
Indonesia; this increases the number reported to the
World Health Organization (WHO) by the Department
of Health from 83 cases at the end of December 1992 to
93 cases. Of the 10 new AIDS cases, six are in Irian Jaya,
two in West Sumatra, one in Bali, and one other in West
Nusa Tenggara.

These figures are based on reliable sources at the AIDS
National Working Conference (RAKERNAS), which
was held for 3 days (2-4 February) at the Pertamina
Cottages Hotel in Denpasar, Bali. Based on information
provided at that conference, there are now eight prov-
inces in which AIDS has been found in Indonesia—Bali,
Metropolitan Jakarta, West Java, East Java, North
Sumatra, Irian Jaya, West Nusa Tenggara, and West
Sumatra.

According to these sources, four of the six AIDS cases in
Irian Jaya are citizens of Thailand who are working as
seamen in the area and the other two are prostitutes. One
of the two AIDS cases in West Sumatra is a prostitute
and the other was infected by a blood transfusion. The
AIDS case in West Nusa Tenggara is an Australian
citizen who has since returned to Australia, and the case
in Bali is a clerk in a store who was infected by a blood
transfusion.

KOMPAS’s source said that the Department of Health
had asked the Immigration Service not to extend the

EAST ASIA 13

visas of the four Thai seamen infected by the AIDS virus.
Those affected were also urged to have safe sex.

When asked for confirmation, Dr. Jumhana Sumantri,
Head of the Directorate for the Elimination of Infec-
tious Diseases of the Department of Health, who was
also present at the AIDS RAKERNAS, declined to
comment. He said that the development and increase
in the number of AIDS cases in Indonesia would be
reported by the Department of Health once every 3
months. “Let’s wait for the Department of Health’s
March report,” he said.

Based on KOMPAS’s notes, the Department of Health’s
report said that there had been 83 cases of AIDS-infected
people up to the end of December 1992; and 21 of the 26
who had AIDS had died. Another 57 people were HIV
positive. In 1987 and 1988 there were six cases each
year, seven cases in 1989, ten cases in 1990, 18 cases in
1991 and 36 cases in 1992.

Cross-Sectoral

As Chairman of the AIDS RAKERNAS Guidance Com-
mittee, Jumhana explained that the conference, which
was looking into the strategic steps needed to fight AIDS,
had reached agreement on increasing cross-sectoral
cooperation. Programs such as training information
staff, increasing screening of blood, especially from
blood donors, overseeing and protecting high-risk
groups, such as HIV-positive people and prostitutes,
have been set up at the provincial level.

There were 97 participants at the conference, consisting
of elements of the Department of Justice, the Defense
and Security Organization, Public Relations, Social,
Association of Women Civil Servants, the AIDS Infor-
mation Center (PIA) and a number of LSMs [Commu-
nity Self-Help Institutes]. These efforts were partly
funded by the WHO under its AIDS program.

When he was contacted, Dr. A. A. Gede Muninjaya,
MPH [Master of Public Health], Head of the PIA,
regretted that the Department of Tourism, Post and
Telecommunications had not sent a delegation because
that department is closely involved with fighting AIDS.
“It’s true that AIDS is the direct responsibility of the
Department of Health. But the Department of Tourism,
Post and Telecommunications should also feel involved
because fighting AIDS will be closely tied in with the
presence of foreigners living in Indonesia,” said Munin-
jaya, who is also the Head of the Research and Training
Unit of Community Epidemiology (UPLEK) at
Udayana University.

On the other hand, Muninjaya is happy that at least there
exists a forum which considers the fight against AIDS as
a movement to be stepped up. Funding for the fight
against AIDS could be put into the APBD [Provincial
Budget] at the provincial level through the involvement
of the government agencies concerned.



34 EAST EUROPE

An active method of work will be introduced on all levels
with a view to educating and familiarizing with the
disease not only the health, education, and other cadres,
but also the entire population and, especially, the high-
risk groups. The target is for every individual to become
involved in protecting himself, his relatives, and his
surroundings, for there is neither a cure nor a vaccine
against that disease, and those infected with it are
infected for life; 50 percent of those infected become sick
and die within a period ranging from several months to
3 years.

Those infected with the disease and the carriers of the
HIV virus, as well as the sick, must be identified actively
and at an early stage; the former must be kept under
epidemiological supervision, while the latter must be
hospitalized and treated.

A. Steps and Activities for the Implementation of the
Program

1. Basic Health Protection and Hygiene-
Epidemiological Activities on Republic Territory

In accordance with the recommendations of the WHO
and the Yugoslav Plan for the Prevention and Control of
AIDS in Yugoslavia, and our practical experience in the
implementation of Republic programs, this program will
include the following measures and activities:

—A system of programmed epidemiological testing and
monitoring;

—Laboratory testing;
—Educating and informing health workers;

—Engaging in preventive efforts among the general
public and, especially, the high-risk population
groups, and providing health education.

System of Programmed Epidemiological Testing and
onitoring

Monitoring the epidemiological situation throughout the

world and in our country, as well as global and domestic

achievements in that area;

Monitoring the implementation of pertinent legal stipu-
lations and expert instructions;

Organizing the epidemiological testing and prompt iden-
tification of AIDS patients and individuals infected with
the AIDS virus, primarily among high-risk population
categories;

Organizing the health supervision of patients and
people infected with the AIDS virus, and epidemiolog-
ical research that must include monitoring their state
of health, testing people around them and their con-
tacts (sexual partners; closer family members, espe-
cially children; drug abusers), taking blood samples for
laboratory testing, and respecting the confidentiality of
the measures;

JPRS-TEP-93-008
23 April 1993

Testing hospitalized patients on the basis of epidemio-
logical indications;

Organizing the treatment of the sick in proper medical
facilities;

Identifying and publicizing the names of individuals
who have become infected or are sick or have died from
AIDS, and keeping a special identification record of said
individuals. Individual public announcement will be
based on the manifestation of the disease: dying from
AIDS—in three copies, confidential, in a sealed enve-
lope, which will be supplied by the medical institution
that will ratify carriers of antibodies of the AIDS virus,
illness or death caused by AIDS, addressed to the
Republic Health Protection Institute, with the initials of
the individual and the status code.

The Republic Health Protection Institute in Skopje will
submit the information to the Union Health Protection
Institute and will draft proper notifications concerning
those infected, the sick, and those who have died of
AIDS, in accordance with the requirements of the WHO,
directed to the Union Institute and the Republic’s
authorities.

Laboratory Testing

Blood tests for determining the presence of antibodies of
the AIDS virus will be made in the medical facilities
indicated by the Republic authority in charge of health
protection;

The testing will be done with the ELISA [Enzyme-Linked
Immunosorbent Assay] and other successful methods,
use of immunofluorescent tests, and others; if the results
are positive, the test will be repeated. Should the second
test also prove to be positive, the Western blot test will
be used for confirmation purposes;

A mandatory blood test will be made for the presence
of antibodies of the AIDS virus separately for each
dose of blood for transfusion and for organ and tissue
transplants.

Informing and Training of Health Workers

Broadcasts, expert meetings, and seminars will be orga-
nized to instruct and inform health workers in the
Republic. The health personnel will be regularly
informed of the epidemiological condition throughout
the country and the world and of the medical achieve-
ments in the struggle against AIDS, as well as of expert
conclusions.

Special instruction and information activities will be
carried out among health workers engaged in diag-
nosing and in prevention work and treatment provided
by various groups of involved individuals (neuropsy-
chiatrists, dermatology and venereal-disease special-
ists, infection disease specialists, laboratory workers,
and others).


30 EAST EUROPE

type have now appeared as disguised brothels. After the
collapse of communism, it became possible to advertise
sexual services in the home country’s press.

Prostitution has served as a means of moving up socially
in some of the former East-bloc states, at least for girls
who do not fall victim to drugs, crime, venereal disease,
and mental illness (a common fate for prostitutes). With
the money they save, they create a new social position for
themselves. Girls who prostitute themselves very often
also develop gynecological complications involving,
among other things, chronic abdominal pain and sterility
brought on by infections, with the resulting personal
tragedies.

Girls in the Eastern countries who become prostitutes
are often young. The average age of the girls involved in
our survey of Romanian prostitutes who had left their
country was 21 years. About 40 percent had been unem-
ployed when they left home. Half had been living at
home with their parents before leaving. The families in
such cases had an average monthly income of less than
$13. The average age at which the girls had had their first
sexual experience was 17.5 years, and about one-third of
them had simultaneously become active sexually and
begun their lives as prostitutes when they arrived
abroad.

About one-fourth said they had gone abroad to work, but
not as prostitutes. Three-fourths of the girls had been
enticed into going abroad by acquaintances who had
already been abroad, and in 12 percent of the cases, the
family itself had encouraged the departure. About half
stated that they wanted to stay abroad and get married.

Besides the group that lives by prostitution on a perma-
nent basis west of the former Iron Curtain, there is also
a kind of short-term prostitution in which the prostitute
arrives on Friday evening and returns home to her
Eastern country before Monday morning! That type of
prostitution enables her to live a kind of double life in
which her social roots in the environment of the former
East-bloc country are maintained. With money in the
form of hard currency in one’s pocket, one can live a
luxurious life in one’s homeland. The exchange rate
between the countries’ currencies depends to a great
extent on the prostitution traffic.

This also means that infection with STDs is spread in
both directions across the former Iron Curtain. Some of
the East European women who prostitute themselves in
the West also work as prostitutes with Western cus-
tomers in their homelands, and this further contributes
to the spread of venereal disease.

Another important mechanism for the spread of STD’s
involves long-haul truckers. For example, viruses are
transported from the Middle East to West Germany by
way of the Czech Republic, where prostitutes work along
the highways and “serve” the drivers. This example
shows that even the customers are mobile.

IPRS-TEP-93-008
23 April 1993

Hotel prostitution has been very obvious to any traveler
visiting the Eastern countries (at hotels where rooms are
booked for Westerners). The clients also travel across the
borders between Western and Eastern countries. Prosti-
tution in the border areas is growing more and more,
especially along Germany’s eastern borders.

An important concept in the epidemiology of STDs is
that of the “hard core’—that is, the fact that a small
number of individuals spread infection to a large
number of people. This means that the pattern of sexual
contacts among those in the hard core is important.
Besides prostitutes, the beach lotharios at tourist resorts,
who are usually local residents or come from other parts
of the same country, effectively spread venereal infec-
tions because of the large number of partners they have.
When autumn approaches and female tourists begin to
grow scarce, those men often turn to prostitutes.

Visiting prostitutes is not infrequently an accepted social
pattern in several of the countries visited by prostitutes
from the Eastern countries. That is how an exchange of
venereal infections occurs between those two groups of
people—that is, prostitutes and beach lotharios. The
result is that tourists, both women and men, are exposed
to infection from both groups.

How extensive is mobile prostitution in Europe? For
obvious reasons, it is hard to estimate exactly. Prosti-
tutes are usually not registered. One-third of the regis-
tered prostitutes in Vienna are immigrant women, and
the percentage of unregistered foreign prostitutes is
higher if short-term prostitutes are included, especially
during the tourist season. About 90 percent of the girls
who work as prostitutes in that city’s bars and nightclubs
are of foreign origin.

There are a total of about 4,000 prostitutes in Vienna,
but the individuals change frequently. If every girl is
visited by 10 customers a day, that means nearly 40,000
visits to prostitutes in that city in every 24-hour period.

The prostitutes often work under very primitive sanitary
conditions (with no possibility of tending to hygiene)
and without requiring the use of condoms by their
customers. Language difficulties between the prostitutes
and their customers do not promote hygiene. The same
is true, obviously, of prostitution in the street and in cars
or wherever it takes place.

In the Czech Republic, 10,000 young girls have turned
up missing since the borders were opened. It is believed
that many of them have become prostitutes. It is esti-
mated that between 10,000 and 20,000 prostitutes are
now working in Prague.

A large number of prostitutes from East Europe go to
Turkey—perhaps more than 100,000 per year.

Bulgarian girls go straight to Istanbul, while Russian girls
arrive by way of Georgia and move west, where they
undercut the local prostitutes by charging less. The
Russian girls often began as “bag-traffic girls” [preceding



JPRS-TEP-93-008
23 April 1993

In charge: The Bardovci Nervous and Mental Diseases
Hospital, Skopje

Expert instructions will be issued regulating the work of
the consultation centers, especially in preventing the
spreading of AIDS among and by drug addicts, as well as
promotional publications aimed at drug addicts and
encouraging health education activities by health and
educational personnel.

In charge: the Bardovci Nervous and Mental Diseases
Hospital, Skopje

Regional seminars and consultations will be held in
cooperation with consultations about drug addicts for
the health personnel in the individual areas, as well as for
anyone involved in preventing and eliminating drug
addiction, with emphasis on taking all the necessary
steps to prevent the spreading of AIDS through drug
addiction (4).

In charge: the Bardovci Hospital for Nervous and Mental
Diseases and the health institutions in the Republic

Expert supervision will be provided in taking the steps
included in the program and the stipulations of the
health regulations in the Republic. Information will be
provided on expert supervision and submitted to the
Republic Sanitation and Health Inspectorate and the
health establishment in charge of supervision.

In charge: the Bardovci Hospital for Nervous and Mental
Diseases, Skopje

The organization and responsibility for the regular and
systematic testing of all drug addicts in the Republic for
the HIV virus no less than four times annually or more
frequently on the basis of epidemiological indications. In
the case of persons who have tested positive, steps will be
taken to ensure definitive proof. Said individuals will be
kept under permanent health supervision and given
health instruction. Furthermore, steps will be taken to
test all individuals with epidemiological indication of
positive HIV.

In charge: the Bardovci Hospital for Nervous and Mental
Diseases, Skopje

Use will be made of the daily press, and the radio and
television, to promote health education related to pre-
venting the spreading of drug addiction and of AIDS
through drug addiction.

In charge: the Bardovci Hospital for Nervous and Mental
Diseases, Skopje

8. Activities of the Macedonian Red Cross Organization

Several times each year regional seminars will be orga-
nized to train cadres to teach health education, related to
the elimination and the spreading of AIDS.

Intensive health education activities involving the young
generation will be promoted (broadcasts, showing of the

EAST EUROPE 39

“AIDS in Young People” motion picture and distribu-
tion of propaganda materials) in all Republic opstinas.

Brochures, leaflets, and posters on AIDS will be pro-
duced and printed. Films on AIDS will be procured and
issued to the Red Cross organizations in all Republic
units and health institutions.

9. Activities of the Republic Expert Commission on the
Organization and Suggestion of Steps for Protection
From Aids

Formulate draft programs and plans for the protection of
the Republic’s population from AIDS;

Monitor the situation and, in the outbreak of AIDS cases
in the Republic, coordinate activities and steps among
organizations involved through their own activities and
steps in preventing the spreading the disease;

Submit proposals to the Minister of Health on steps and
activities should an outbreak or danger of outbreak of
AIDS appear in the Republic.

B. Funds for the Implementation of the Program

In order to implement the Program for the Protection of
the Population in the Republic of Macedonia from the
AIDS Syndrome for the current 1992, funds totaling
47,550,000 denars will be needed. The funds have been
estimated on the basis of December 1991 prices.

1. In-hospital treatment: 15 million denars.

In-hospital treatment is mandatory in all cases in which
an AIDS patient suffers from a specific infection, until it
has been treated, after which the individual may con-
tinue his treatment at home. Repeated hospitalization
will be provided for a period of 2 to 3 years until the
lethal outcome, so that, on an average, in-hospital treat-
ment per individual will cost about 5 million; for three
patients at 5 million each, 15 million.

2. The basic health protection (outpatient-polyclinical
treatment and testing) and hygiene-epidemiological
activities on Republic territory: 11,200,000 denars.

The outpatient-polyclinical testing and treatment of
patients after their release from the hospital will con-
tinue along with taking all the necessary hygiene-
epidemiological and antiepidemiological steps until the
next hospitalization for a specific infection. Further-
more, it is anticipated that all HIV-positive individuals
will be monitored and all the necessary hygiene-
epidemiological and antiepidemiological steps will be
taken, as well as all epidemiological studies will be made
to identify undetected carriers of the HIV virus,
including:

Monitoring all individuals temporarily discharged after
hospital treatment;

Monitoring anyone who is HIV-positive, as well as early
detection of new carriers;



IPRS-TEP-93-008
23 April 1993

to power in January 1986 that about 2,000 soldiers in
his National Resistance Army (NRA) die of AIDS
every year.

ZAMBIA

More Than 6,000 AIDS Cases Reported

93WE0289D Lusaka TIMES OF ZAMBIA in English
17 Jan 93 p5

[Text] The Zambia Information Service (ZIS) and coun-
cils have been urged to help educate people about the
dangers of AIDS, Copperbelt Province permanent secre-
tary Mr Duncan Kaona has said.

Ina speech read for him yesterday by Assistant Secretary
Mr Cephas Sikana at the opening of the second Copper-
belt doctors’ seminar on AIDS held at Ndola’s Nazin-
nina hotel, Mr Kaona said it was pertinent that ZIS and
the councils throughout Zambia draw up a programme
which would mount a deliberate campaign and be in the
forefront to educate residents about AIDS.

The impact of AIDS in Zambia is the increased mortality
and morbidity in the productive people aged 15 to 50
years.

“Demand for treatment and hospitalisation has
increased proportionally to the extent that Government
with its already overstretched resources cannot be able to
cope with the consequences of AIDS epidemic,” Mr
Kaona said.

The first case of AIDS was officially identified in
Zambia in 1985 and by September 1992, Zambia had
reported over 6,000 AIDS cases and over 20,000 AIDS
related illnesses.

Because of underreporting, the scale of AIDS and HIV
infection in Zambia has not been realised by many
people. Some people still deny AIDS is a real problem in
Zambia.

Mr Kaona said some areas which needed urgent atten-
tion were:

—Assessment of the current status and monitoring of the
progress of the epidemic;

—To reduce the number of AIDS cases through health
education and control of sexually transmitted dis-
eases;

—To reduce the number of new cases acquiring HIV via
blood transfusions through careful donor selection,
screening blood for HIV antibodies and reducing the
number of transfusions;

—To reduce the AIDS virus transmission via injections
and other skin piercing activities;

—To reduce mother to child transmission;

AFRICA 7

—To improve diagnostic capabilities and ensure optimal
quality of life to AIDS patients and their families and;

—To promote research on HIV/AIDS related issues and
problems.

The seminar was sponsored by Copperbelt Health Edu-
cation Project, Tropical Disease Research Centre and
the Ministry of Health.

ZIMBABWE

17 Percent of Population Reportedly Carry AIDS
Virus

MB1801133993 Johannesburg Channel Africa Radio
in English 1100 GMT 18 Jan 93

[Text] A survey published in Harare shows that at least
1.5 million Zimbabweans, that is about 17 percent of the
population, have contracted the AIDS virus.

The survey, commissioned by the Commercial Farmers’
Union, says the Zimbabwean economy could face
serious skilled labor shortages if infection rates continue
at present levels. Officially, Zimbabwe has 40,000 con-
firmed AIDS cases in a population of just over 10
million, that is, less than .5 percent.

At Least 1.5 Million Infected With AIDS

93WE0290A Harare THE HERALD in English
18 Jan 93 p 1

[Text] Bulawayo—At least 1.5 million people in Zim-
babwe are infected with the AIDS virus and if the rate
of infection continues unabated, this could have disas-
trous effects on the country’s agro-based economy, a
recent survey by the Commercial Farmers’ Union
[CFU] shows.

According to the survey, between 800 and 1,000 people
are being infected with the virus every 24 hours. The
CFU, which represents commercial farmers, employs
over 127,000 workers, about 17 percent of whom are
believed to be infected with the AIDS virus.

CFU AIDS programmes co-ordinator Mr John Frazer-
Mackenzie said in an interview at the weekend that the
agricultural sector could face a serious skills crisis if the
AIDS epidemic was not stemmed.

With that in mind the farming organisation had
embarked on a vigorous nationwide campaign to educate
farm workers and their families about AIDS.

“We are going to lose skills and experience in such
sectors as transport, finance, marketing and this will
compound a serious problem which needs to be
addressed urgently,” said Mr Frazier-Mackenzie.

The CFU AIDS awareness programme was slowly
spreading throughout the rural side where understanding
of the epidemic was clouded by myth and ignorance.



SJPRS-TEP-93-008
23 April 1993

When working on the Ukrainian law “On AIDS Preven-
tion and Social Protection of the Population,” we
accounted for the basic principles of anti-AIDS legisla-
tion of Western countries. This law went into effect as of
January 1992, and it received a positive evaluation from
our and foreign experts. It standardizes a wide range of
relations—from protection of the rights of HIV-infected
and professional risk groups and social assistance for
them, to administrative and criminal punishment for
violating them.

The second criterion determines the correspondence of
existing state institutes to national needs and how they
fit in with international structures. Unfortunately state
policy has been pursued thus far in Ukraine without due
coordination between the Ukrainian Ministry of Health
and other ministries and departments. Ukraine still lacks
a guaranteed system of diagnosing HIV infection. We
have no diagnosticums that would meet the require-
ments of the World Health Organization, and legal
regulation of the diagnostic process is imperfect. More-
over preventive educational programs directed at
changing risky forms of human behavior continue to be
the sole means of influence upon the epidemic process.
But once again except for a few video clips and pam-
phlets of little informative value, we have nothing of this
sort.

There is one other problem—the low level to which
medical workers are informed on AIDS problems.
Absence of the necessary medical training of doctors in
matters of HIV infection is creating a situation where
medical personnel are becoming a professional risk
group, and without wishing to do so, are assisting the
spread of the AIDS virus. And the incompetency of
medical workers in legal matters is consolidating the
epidemic process in Ukraine in its latent state.

Considering all of this, the need has arisen for estab-
lishing a state institution endowed with emergency
powers. In correspondence with the Ukrainian law, a 27
May 1992 edict of the president established the National
Committee for the Control of the Incidence of AIDS
under the Ukrainian president.

This committee must coordinate the actions of all min-
istries, departments, state institutions and public orga-
nizations, and direct them at fulfilling Ukrainian AIDS
legislation.

The national committee must coordinate and direct
Ukrainian science toward solution of the problems of
preventing and treating AIDS, and concurrently review
scientific programs with regard for the real economic
situation in Ukraine.

Meeting with Western colleagues, and with WHO
experts in particular, we hear them ask: Who is directly
responsible for protecting the health of citizens from
HIV infection? Now the responsibility before society for
the state of affairs in the fight against AIDS wiil lie
primarily with the national committee.

CENTRAL EURASIA 67

Such that if we look at the hierarchy of responsibility, it
would appear as follows: president of the Ukraine,
chairman of the national committee and all of its mem-
bers, and then all bodies of state administration in
Ukraine, beginning with the Ministry of Health.

If we can say that the legal foundations of anti-AIDS
policy and the corresponding state institutions provide
sufficient conditions for the fight against AIDS, then the
existence of a national program called upon to direct this
fight is a necessary prerequisite. The global strategy
requires development of a broad, all-encompassing pro-
gram in all countries of the world. The greatest attention
should be devoted to its creation. Therefore the third
criterion determines the correspondence of the goal and
strategy of the national program with the principles of
the WHO.

Of course, in drafting a national program we need to
account for the unique features of the spread of HIV
infection in Ukraine. But the programs must be based on
principles that are universally recognized and binding
upon all countries.

What are these conceptual requirements of the World
Health Organization? First of all we must find a place in
the global program that is adequate to the possibilities
and needs of Ukraine. Moreover we need to determine in
the national program who in the state must do what,
when, how and to what degree of responsibility in order
to stop and then neutralize the spread of AIDS. In the
event that such requirements are fulfilled, Ukraine as a
state experiencing great financial difficulties may count
on significant practical methodological, informational
and financial assistance from world anti-AIDS institu-
tions. Up until today, those who are called upon to fight
AIDS in Ukraine—that’s chiefly the Ministry of
Health—are ignoring such a possibility for joining the
world community. Our inferiority complex continues to
bind us to the “Moscow Center.” In its time this became
the cause of adventuristic introduction of a poor-quality
system for diagnosing HIV infection into Ukraine, and
as a consequence, formation of an introverted public
health system as regards the fight against AIDS.

The presently existing national program, which was
drawn up by the Ministry of Health and adopted by the
government, requires immediate and extensive revision
of all of its sections, and chiefly in regard to the use of
finances.

The fourth criterion is the degree to which the popula-
tion is informed. As was noted earlier, scientifically
substantiated preventive and educational programs
directed at changing human behavior are creating a real
obstacle to development of the AIDS pandemic. It is
difficult to overstate the effectiveness of precisely this
factor in the fight against AIDS. In the early 1980s the
tisk group was limited to just certain social groups. The
attitude of people toward representatives of these groups
was blatantly negative. The civilized world shut AIDS
patients out of its life, and doctors employed epidemic



SJPRS-TEP-93-008
23 April 1993

ALGERIA
Review of AIDS Cases; Figures, Research

Total Cases Detailed

93WE0292A Algiers EL WATAN in French 18 Jan 93
pp 13-14

[Article by Amel Boumediene: “The AIDS Threat”—
first two paragraphs are EL WATAN introduction; fig-
ures as published]

[Text] Algerians have long realized that they are not
immune from the ills that afflict others, including AIDS,
which is now present in Algeria. How many in our
country have contracted this still incurable disease? Here
are a few cases, figures, and accounts. While the infor-
mation may not be precise and the statistics unreliable, it
is certain that this quietly spreading disease will claim
more Algerian victims in the future. Unless...

The first AIDS case in Algeria was diagnosed in
December 1985 and some time later, three individuals
were reported to be HIV positive. After sparing the
country for several years, the AIDS-causing virus had
reached our shores. Doctors and professors had pre-
dicted that it would. Algeria, they said, could not escape
the disease given the country’s location wedged between
Europe to the north and sub-Saharan Africa to the south.

How many cases of AIDS have been reported in Algeria
to date? In September 1992, a health ministry report
officially announced that 88 men and 33 women had
been diagnosed as having AIDS, for a total of 121 cases.
Since then, seven new cases have been reported, bringing
the total to 128. Of that number, however, 70 have
already died of the disease.

The health ministry’s report placed the number of HIV-
positive individuals at 334, but that figure was called
into question when Professor Bouguermouh, chairman
of the National Committee To Combat AIDS in Algeria,
stated that as many as 30,000 individuals may be HIV
positive in Algeria. That estimate, he explained, is based
on a guideline developed by the World Health Organi-
zation (WHO), which states that for every diagnosed
case of AIDS, there are 99 undiagnosed cases. Where did
these individuals contract the virus? According to esti-
mates made in September 1992 by doctors and profes-
sors knowledgeable of the subject, 35 of the 121 diag-
nosed AIDS patients were drug users; 29 of them
contracted the virus while abroad; two cases were con-
tracted in Algeria; and in two other cases, the location
could not be determined. The information we have been
able to obtain indicates that a large number of these
patients have already died of AIDS.

Transfusions, the second leading cause of infection,
accounted for 27 cases; 17 of these patients were infected
abroad, seven in Algeria, and three others in unspecified
locations. In 27 other cases that were diagnosed toward
the end of the 1990s [as published], the cause of infection

NEAR EAST/SOUTH ASIA 49

has not been determined. Two such cases were con-
tracted abroad, five in Algeria, and 20 in an undeter-
mined location.

There are 18 cases of heterosexually transmitted AIDS,
according to a report by the health ministry. Four of
these patients were infected abroad, 11 in Algeria, and
three in an unspecified location. In last position, there
are nine homosexual drug users, four of whom were
infected abroad, 11 in Algeria, and three in an undeter-
mined location. These figures, despite their weaknesses,
show that most of the individuals diagnosed with AIDS
were infected abroad (60 out of 121 cases); 27 were
infected in Algeria, and 34 in an undetermined location.
The patients range in age from 20 to 80 years old. As for
the number of HIV-positive individuals, doctors and
professors knowledgeable of the subject state that
“recent data on the incidence of HIV in Algeria are too
incomplete and fragmentary.” They go on to state that it
is difficult to determine the future trend of the AIDS
epidemic in Algeria, but that all studies point to mod-
erate growth.

According to information made available by the health
ministry, a plan to combat AIDS in Algeria was drawn
up in 1988 by a mission from the WHO world program
against AIDS, with Algerian specialist groups. To cover
the activities planned under this collaborative effort, a
funding package of 97,700 dollars spanning the period
from 1 August 1988 to 31 July 1989 was made available.
However, conditions in Algeria in 1992 caused a delay in
setting up a network to monitor sexually transmitted
diseases and HIV. With regard to prevention, particu-
larly in terms of transfusion risks, an inquiry into oper-
ating conditions at transfusion centers is reportedly
under way. The data to be collected will be used in
assessing the overall system of administering blood
transfusions and the difficulties of applying regulations
designed to ensure systematic screening of blood dona-
tions. In addition, in a ministerial directive, the Pasteur
Institute of Algiers has been designated a national labo-
ratory of reference for HIV diagnosis.

Number of AIDS Cases in Algeria

Year Men Women Total
1985 1 0 1
1986 3 0 3
1987 5 1 6
1988 7 6 13
1989 15 2 17
1990 20 6 26
1991 22 10 32
1992 15 8 23
Total 88 33 121

To date, seven new AIDS cases have been diagnosed.



IJPRS-TEP-93-008
23 April 1993

actualmente :
i} do 6 mil a 10 mil |:

Increase in HIV Carriers in Nicaragua
Key: 1.10,000 carriers; 2. An estimated 6,000 to 10,000
persons are currently infected

MINSA officials noted that “we can still halt the progress
of the virus, but the responsibility belongs to all of
society. The most important thing is to halt the plague”
through a campaign of education, information, and
prevention.

For his part, Dr. Carlos Linger, representing the Pan
American Health Organization (PAHO), said the cost of
medical care for those clinically ill with AIDS could
destroy the health system financially and that the
problem can only be attacked through “education and
more education.”

Lack of Coordination

Rita Arauz, from the Nimehuatzin Foundation, one of
the nongovernmental organizations working to prevent
AIDS, said “there is no coordination with MINSA and
there never has been any.”

Nevertheless, Munoz reported that “efforts are moving
forward with the Ministry of Education to put together a

LATIN AMERICA 47

real plan offering students accessible, easily understood
technical information.” The campaign will begin in
March.

While Munoz emphasized “faithfulness between part-
ners” as the most effective means of prevention, “inas-
much as the use of condoms has its problems,” Arauz
noted that this is a “long-range proposal because it
implies changing sexual habits. Right now, we must
promote the use of contraceptive sheaths or condoms.”

Aviles said “there is no intention of reducing the distri-
bution of condoms. The problem is technical: We bought
a million condoms last year, but that was not enough.
This year we will buy 4 or 5 million. The SILAIS
[expansion not given] are in charge of distributing
them.”

Aviles said that “95 percent of all blood used in trans-
fusions is checked to prevent the spread of disease but
the possibility of human error always exists. Conse-
quently, in all cases of transfusion, testing is required.”

Free Test

MINSA officials emphasized that the Elisa test for
detecting the presence of the virus in blood is free and
that confidentiality and the privacy of results are guar-
anteed. “To date, no patient has complained,” Munoz
said.

Rita Arauz disagreed. “The tests are not confidential.
Many people learn the results. The information is given
out. There is no followup or psychosocial support for
those infected and ill.

“There is discrimination and there are cases of sick
people who are rejected because no one wants to take
care of them. Hospital gowns have a label that says HIV.
This encourages the secrecy of those infected,” Arauz
said.

She concluded by saying that “the most important thing
is that one never knows whether or not one is carrying
the AIDS virus. That is why prevention is vital in terms
of sexual habits and blood transfusions. Doctors must
take all preventive measures with all patients in order to
avoid applying them to infected persons in a discrimi-
natory manner.”

ST CHRISTOPHER AND NEVIS

Chief Medical Officer on Number of AIDS Cases

FL0212155592 Bridgetown CANA in English
1506 GMT 2 Dec 92

{Text] Basseterre, St. Kitts, Dec 2, CANA—Thirty-seven
AIDS cases have been brought to the attention of St.
Kitts-Nevis health authorities in the seven years since
the country started keeping records of the fatal disease,
Chief Medical Officer Thomas Jones reported. Dr.
Jones, in an address broadcast Tuesday on radio and



IPRS-TEP-93-008
23 April 1993

Continuing Fight Against AIDS Reported

Alarm Justified

93WE0140A Bombay THE SUNDAY TIMES OF
INDIA in English 22 Nov 92 p 21

{Article by Subhash Kirpekar]

[Text] NEW DELHI, November 21. When a small
north-eastern state like Manipur shows HIV incidence of
155 per 1,000 population as against the national average
of 7.10 per 1,000, officialdom has every reason to feel
alarmed.

Neighbouring Nagaland also has a high figure of 111.16
per 1,000 and even the Mizoram figure is above the
national average though it is nowhere near that of
Manipur and Nagaland.

These September-end figures lend credence to the latest
World Health Organisation (WHO) estimate that India
has one million HIV cases.

The health ministry’s figures for HIV are based on a
screening of more than 1.5 million people in the high-
risk sexual behaviour group. Of this sample screened by
October-end, 10,586 people were found to be HIV-
positive. While 18,293 were ELISA-positive (a prelimi-
nary test), 10,730 were found positive by the confirma-
tory Western Blot test. The wide gap between the WHO
figure of one million and the health ministry figure of
10,730 is too big to be glossed over.

The infection appears concentrated in Maharashtra in
the west, Tamil Nadu in the south and Manipur in the
north-east. The virus is spreading in Maharashtra and
Tamil Nadu through heterosexual promiscuity, and in
Manipur through syringe sharing.

In the proximity of the golden triangle where drug
smuggling is lucrative business, the youth of Manipur
and Nagaland engaged in drug pushing is using heroin
and other drugs which are injected intravenously,
leading to syringe sharing. Generally, disposable syringes
are also repeatedly used.

After the first full-blown AIDS case was reported in
India in May, 1987, the figure has grown to 242 by
October-end. Of these, 228 are Indians and 14 for-
eigners. Of the 242, 175 are Indian men and 10 for-
eigners and 49 Indian women and four foreign women.
The probable source of infection is multiple sex partners
in as many as 170 cases, blood transfusion in 29, blood
product infusion in seven, homosexual contact in one,
and intravenous drug addiction in nine cases.

The prospects are frightening. One of the biggest prob-
lems in tackling HIV/AIDS is that almost the entire
population seems to be at risk. What heightens the
concern of those actively engaged in fighting the deadly
syndrome is that the group which is sexually active is
also the backbone of the nation’s work force including
defence. Once AIDS strikes in a big way there can be a

NEAR EAST/SOUTH ASIA 53

dramatic decimation of the work force, with tragic
consequences for the whole country.

There is no preventive vaccine. An individual who has
contracted HIV may not show any outward symptoms
for a full decade. AIDS then manifests itself with a
shattering effect.

The sexually active population in the 15-45 age group is
most at risk. The recent report of a 13-year-old girl in
Madras found infected with HIV illustrates the vulnera-
bility of teenagers to this dreaded disease.

Even within this group, a particular section is at a much
higher risk. They are highway truck drivers, migrant
labourers, construction workers and others whose occu-
pations make them move from place to place very
frequently. The single common factor linking these high-
mobility people is that their jobs keep them away from
their families. That makes them more prone to high-risk
sexual behaviour which lays them open to HIV infection
and subsequently AIDS.

Obviously, no section of the population is entirely free
from this danger as even an innocuous blood transfusion
can transmit the lethal virus. It is known that private
blood banks in all major cities and towns do not test
blood donors for HIV. Nursing homes buy blood from
these blood banks and use it on unwary patients. Unless
every blood donor is screened for HIV, the multiplier
effect from this seemingly innocuous source can be
deadly in the long run.

Very often, private blood banks buy blood from donors
who are hooked on drugs and are regular visitors to
brothels. There is a persistent reluctance on the part of
the public to donating blood, making it difficult to
reduce dependence on professional donors.

But incentives can be offered. For example, genuine
blood donors could be given flash cards which would
entitle them to the use of blood, if needed, for themselves
and immediate family members. Another incentive
could be to give such cards to a whole family of blood
donors entitling them to easy admission into govern-
ment hospitals in case of need.

Yet another source of infection is blood products (used
for treatment of bleeding disorders like haemophilia)
imported from different countries. There were media
reports some time ago that an infected consignment of
French blood products was exported to many countries.
Efficient and alert “gate-keepers” would be required to
stop such imports.

The absence of a reliable baseline data for Sexually
Transmitted Diseases (STD) is also coming in the way of
establishing an inter-connection between STD and
AIDS. While efforts are afoot to identify and appoint a
national consultant on STD through WHO, one piece of
encouraging news is that a community-based survey,
possibly the first of its kind in India, has been complete
in Calcutta. Based on this survey, intervention among



JPRS-TEP-93-008
23 April 1993

The reasons behind this suspicion are that until now
there were no facilities to carry out periodic tests and to
maintain records of those suspected of carrying the
dreaded virus or being actually inflicted by the disease.

The Principal Secretary, Public Health and Family Wel-
fare, Mr G.S. Shukla, said: “These 59 cases were
detected in just the three regional centres in Bhopal,
Jabalpur and Gwalior. But we feel that there are a great
many more carriers in the tribal belt as well as in the
labour camps in adjoining project sites. Another factor
that is bound to increase the number of AIDS cases in
the State is the increase in highway prostitution, spe-
cially in the Indore, Ratlam and Mandsaur belt in the
north-western part of the State.”

More than Rs 50 lakhs have been allotted to the State by
the Centre to initiate the project. In addition, sophisti-
cated equipment will be provided to all the blood-testing
centres and the STD clinics, free of charge. Five more
regional centres and seven additional zonal blood-testing
centres—each covering about five to six districts—will
be set up.

Hence, almost all the 45 districts will have access to a
blood-testing centre exclusively for the detection of
AIDS. Each such zonal centre will have two trained
technical officers from the district.

A unique feature of the project, according to the Director
of Medical Education, Dr Bose, is the setting up of an
AIDS centre in every district of the State, primarily for
educating the people and creating mass awareness.
Termed IEC (Information, Education and Communica-
tion) centres, these will focus on high-risk groups such as
prostitutes, truck drivers and labourers.

“The staff for these centres will be drawn from the
districts and given on-the-job training. The main task of
these centres is to carry out surveillance of the target
group and to give it counselling. If this is a success we
will go to the universities and colleges,” says Dr Bose.

In another major decision, it has become mandatory for
all STD clinics in the State to test the blood of patients.
Besides, a special watch will be kept on regular blood
donors and blood samples will be sent to the zonal
blood-testing centres.

One indication of the seriousness with which the project
has been taken up in the State is the fact that the Chief
Secretary, himself, has decided to take charge of it. He
will oversee the entire programme management and will
be guided by a specially-constituted “State AIDS Cell.”
In addition, a technical advisory committee has been
constituted.

A seven-point detailed action plan has been drawn up to
streamline the whole project. This includes:

NEAR EAST/SOUTH ASIA 57

—Programme management
—Surveillance and research

—Creation of social awareness

—Control of sexually transmitted diseases
—Condom distribution

—Blood safety

—Prevention aimed at reducing the impact of the dis-
ease.

In addition, the Health Department has been asked to
take steps to reduce infections in hospitals since prelim-
inary treatment for AIDS patients will be carried out in
Government hospitals.

“Our aim is to see that the AIDS programme is inte-
grated with the overall plan to improve health conditions
in the State. As such, AIDS treatment cannot be isolated
as the patient frequently needs to consult the general
health departments,” says Mr Shukla.

But the success or failure of this programme, health
officials feel, will depend largely on the participation of
the people. Says Mr Shukla: “We have to try and get rid
of age-old taboos and stigmas and also impress upon the
people that simple contact with a patient need not lead to
the disease. Hence, the IEC component of the project
will be the most crucial.”

The biggest challenge facing the Health Department is its
proposed operations in the predominantly tribal area of
Bastar, where the literacy rate is very low and awareness
of the disease almost minimal. Keeping this in mind,
about 20 percent of the initial project cost has been
reserved for IEC alone.

On the technical side, the major emphasis has been given
to blood testing and safety. All zonal blood centres will
send quarterly reports of blood tests and detailed records
of those tested positive. Blood samples that are initially
tested positive will be sent to Delhi or Pune for a
confirmation test after which treatment will begin.

The State Government has also informed that foreigners
who test positive will be deported immediately to their
respective countries,

As far as the financing is concerned the Health Depart-
ment has agreed to the decision that Central funds will
be provided until 1997, after which the entire responsi-
bility will lie with the State Government.



SJPRS-TEP-93-008
23 April 1993

Son of a poor family and raised in the Jabaquara
neighborhood in Sao Paulo’s southern zone, the boy also
had an older brother—Edson Fernando Candido de
Almeida—in whose footsteps he may have been fol-
lowing. Edson had been at FEBEM and, like Candido,
contracted AIDS because of his use of intravenous drugs.
His first stay at FEBEM occurred when he was 15, and
he left for the last time in 1989, at 17. Edson was one of
the few to escape the mass testing done by FEBEM. But
shortly afterward he was shot during a robbery. Unlike
Candido, he did not die: he lost one of his kidneys and,
while being treated, his blood was tested and he found
out from the doctors that he had AIDS. He died of the
virus in May 1991, at the age of 19.

The story repeats itself with boys like Claudinei Apare-
cido Palhare and Luciano Moraes, whose names we also
found in the FEBEM files, Claudinei died of AIDS in
September 1990, at 18. “FEBEM knew that Claudinei
had AIDS, but it took almost six months for them to tell
me about it,” said Remigio Palhare, 64, the boy’s father.
“The boy was always very sick, having crises, and was
never hospitalized. He was kept in the same room as
other boys. That is why they end up getting infected
inside that place,” Palhare added. It was also AIDS that
killed Luciano Moraes, in May 1992 at age 20. “To this
day, I remember the tragic day when I was called by the
FEBEM social worker to be told that Luciano had
AIDS,” recalls his father, Roberto Moraes, 45. When
Luciano turned 18, FEBEM sent him home. His father, a
devout Protestant, accepted him under two conditions:
that he change his lifestyle and that he take every
precaution not to infect the others in the family. “J have
always watched a lot of TV and so I am well-informed. I
know how AIDS is transmitted. In fact, Luciano had a
girlfriend and I would buy condoms for him to use,”
Moraes said. After 2 years, Luciano was hospitalized at
the Vila Nova Cachoeirinha hospital in the northern
zone of Sao Paulo, where he died. The words the devout
father said over his son’s body were the same ones he had
been repeating to him in the final months of life, like one
who is trying to console himself about the hell the boy
experienced: “No one is responsible for your mistakes.
AIDS is the trophy life awarded you.”

CUBA

Health Minister Dedicates Camaguey AIDS
Sanatorium

FL2912133892 Havana Tele Rebelde and Cuba Vision
Networks in Spanish 0100 GMT 29 Dec 92

[Text] An AIDS sanatorium has been dedicated by the
public health minister in Camaguey, where he toured
several projects in the health sector.

With the dedication of the AIDS sanatorium in
Camaguey and the completion of the civil construction
part of the Western Polyclinic, Camaguey Province is
keeping up its rate of construction and repair of medical

LATIN AMERICA 45

facilities. The sanatorium for AIDS patients has 16
cabins, consulting rooms, admissions offices, occupa-
tional therapy, a recreation area, and other facilities that
are needed by AIDS patients.

Public Health Minister Dr. Julio Teja visited several of
the centers that are being expanded. He praised the care
and dedication with which the work is being carried out.
Furthermore, Teja stressed that it is important to main-
tain the facilities and provide quality care.

DOMINICAN REPUBLIC

Health Official Gives AIDS Virus Carrier Figures

FL0312232792 Santo Domingo Radio-Television
Dominicana Radio Network in Spanish
1600 GMT 3 Dec 92

[Text] The director of the Dominican Social Security
Institute has stated that the only weapon to prevent
AIDS is a change in sexual habits, since the health
sciences still have no medication that will cure this
terrible disease. Dr. (Ley Arias Rueda) spoke in these
terms at a ceremony held by the institution he heads on
the occasion of International AIDS Day. He explained
that there are currently some 50,000 to 70,000 Domini-
cans in the Dominican Republic carrying the virus, and
that these people infect others without realizing they are
ill. He said that at present, the publicity by governmental
and para-governmental agencies has not been enough to
educate the community regarding the havoc wreaked by
AIDS.

Health Official Notes Tuberculosis Increase,
AIDS Linkage

FL3012191092 Santo Domingo Cadena de Noticias
in Spanish 1030 GMT 30 Dec 92

[Text] The secretary of public health has stated that the
number of tuberculosis cases has increased considerably
in the last few months. Surgeon General Miguel Angel
Estefan said that approximately 30 percent of all AIDS
patients have become infected with tuberculosis as well.
Estefan pointed out that last year 2,000 cases of tuber-
culosis were detected nationally. He added that they did
not count the cases detected under the social security
program. Furthermore, Estefan said that so far 500
people have died from tuberculosis. The secretary of
public health pointed out that they are trying to reduce to
a minimum the number of tuberculosis cases that occur
in the country.



JPRS-TEP-93-008
23 April 1993

“Do men have a high incidence?” I asked because they
were apt to infect themselves with disease.

“Promiscuous men who have come to hospitals of the
Ministry of Public Health have been found to have the
following incidence of AIDS: Phayao 36 percent, Chiang
Rai 31 percent, Rayong 30 percent, Ranong 17 percent,
Pathum Thani 16 percent, and Bangkok 30 percent,” Dr
Thephanom explained. He also said that:

“There are two strains of AIDS in Thailand. There is the
Bangkok strain and the Chiang Mai strain. The Bangkok
strain is similar to that in America while the Chiang Mai
strain is similar to that in Africa.”

When I heard this, I became curious - “Why is the
Chiang Mai strain similar to the one in Africa?”

“It is thought that many Africans visited Chiang Mai
and brought the strain there while the strain in Bangkok
and the South is like that in America. Both the Bangkok
and the Chiang Mai strains are equally serious,” Dr.
Thephanom said. He added that:

“After one contracts the AIDS virus, one has no symp-
toms for 5 years. Then the symptoms begin: there is daily
diarrhea and weight loss. One is sick an average of 3
years and then one dies. From the time when one
contracts the AIDS virus until death is 8 years. Ameri-
cans die more slowly - it takes 10 years there from the
time when the virus is contracted until death. It is still
not known why it takes them longer.”

“Are prostitutes contracting the AIDS virus more and
more?” I asked.

“Much more. In Phet Buri 64 percent have it, in Pathum
Thani 49 percent, in Chiang Rai 58 percent, in Nakhon
Pathom 50 percent, in Samut Sakhon 49 percent, and in
Kothomo 30 percent have it. In particular 90 percent of
the women in the tea houses in Kothomo have the AIDS
virus because they are inexpensive and people patronize
them a great deal,” Dr. Thephanom reported. He was
concerned that:

“Now there about 400,000 to 500,000 people throughout
the country with the AIDS virus. Each year about 7
percent will become sick. At this time Thailand has
90,000 beds for patients. In 5 years these beds will not be
enough.”

I asked: “Do you mean the beds in state hospitals and
private hospitals?”

“Yes. The 90,000 beds would not take care of just the
AIDS patients. And what will we do with the many other
patients? Those in medical circles are very concerned
about this. If we reach that point we will have to have the
sick people stay home and have the doctors go to care for
them. At this point the figures for AIDS are not
decreasing, just increasing. Most are contracting AIDS
from prostitutes. Unfortunately we cannot forbid people
from visiting prostitutes,” Dr. Thephanom said wearily.

EAST ASIA 17

WHO Approves Plan for HIV/AIDS Vaccine
Development

BK1612030392 Bangkok BANGKOK POST in English
16 Dec 92 p 6

[Text] The World Health Organisation has formally
approved Thailand’s national plan for HIV/AIDS vac-
cine development and evaluation. WHO's Global Pro-
gramme on AIDS is expected to give Thailand US$1.25
million (roughly 31.25 million baht) in support of the
2-year plan for 1993-94.

The objectives of the plan are:

—to develop a comprehensive, well-coordinated, long-
term strategy for the evaluation of the safety, immu-
nogenicity and efficacy of preventive therapeutic and
perinatal HIV/AIDS vaccines in Thailand;

—to develop and explain the policies and procedures for
the planning, implementation oversight, administra-
tion and evaluation of HIV/AIDS vaccine-related
research activities in Thailand; and

—to facilitate the conduct of scientifically and ethically-
appropriate HIV/AIDS vaccine trials in Thailand.

Actual vaccine trials are not expected until the pro-
gramme is completed in 1994.

WHO's Steering Committee, at its annual meeting on
December 4, reviewed Thailand’s plan and recom-
mended endorsement.

The global programme’s director is expected to endorse
the plan this month, then WHO will send a vaccine
expert to Thailand early next year to help work out
details of the plan.

The steering committee also reviewed the latest results of
HIV/AIDS vaccine research at its annual meeting. So far,
there is still no candidate vaccine which WHO can
recommend for large scale trial in humans.

The national plan, drafted in part by the Public Mealth
Ministry, says “the Royal Thai Government is com-
mitted to active participation in the global effort to
develop and evaluate HIV/AIDS vaccines...”

It states that ‘‘a major goal of the national strategy is to
promote and support national and international collab-
orative research that will lead to the development and
evaluation of effective HIV/AIDS vaccines for potential
use in Thailand...”

Thailand’s initiative to participate in the development of
HIV/AIDS vaccine in part results from WHO identifying
it as a “vaccine trial site”, along with Rwanda, Uganda
and Brazil.

Experts from the Vaccine Development Unit of WHO
visited Thailand in April 1991 to meet with scientists
and Public Health officials.



IPRS-TEP-93-008
23 April 1993

Instructing and training paramedical personnel who, by
virtue of the nature of their work, are in contact with
infected individuals or are involved in informing the
population about AIDS.

On the basis of special AIDS programs, the Republic
health institutions will draft basic regulations regarding
laboratory activities, treatment, hospitalization, health
education, and other activities aimed at the prevention
of AIDS, in accordance with the respective achievements
and practical experience acquired in the rest of the
world. In this connection, timely information and expert
instructions will be issued to the health workers,
including leaflets, pamphlets, specific health education
broadcasts, and publications in the periodical NAR-
ODNO ZDRAVJE.

Health-Education Activities

Bearing in mind that the only efficient method for
preventing the spreading of the infection with the AIDS
virus is providing full information on the nature of this
infectious disease, the ways of its spreading, and the
ways of protection from it, health information and
education are mandatory steps that will be implemented
in all environments.

In addition to the health workers, who will provide
health education, other education workers will be given
special training. This will apply to Red Cross education
activists, media information personnel, and others.

The content and means of information will be adapted to
the environment in which health education work will be
done, and the age and degree of general and health
knowledge.

Health education will include primary education
schools, based on the Program for the Health Education
of Children in Eighth-Grade Schools for Preventing and
Stopping the Spreading of AIDS that will be included in
the respective instruction programs.

The following steps will be taken to provide the popula-
tion with the broadest possible information:

—Suitable broadcasts will be produced for worker and
other organizations and unions;

—There will be permanent sections in the daily press
that will provide information on the epidemiological
condition, advice, new developments in medical
advances, a variety of announcements, questions and
answers, and so on;

—Cooperation with the radio and television in devel-
oping information and health-education broadcasts,
including spot announcements;

—In work with particularly risky population groups,
special educational methods will be used, based on the
specific nature of these groups (drug addicts, delin-
quents, prostitutes, workers in high-risk infection
areas, and others);

EAST EUROPE 35

—Health education activities will be promoted, espe-
cially aimed at individuals infected with the AIDS
virus,

In cooperation with the Macedonian Red Cross, the
Republic medical institutions will coordinate health
education activities throughout the Republic through:

—Joint standardized leaflets providing basic informa-
tion on AIDS, means of its spreading, and preventive
measures,

—Posters;
—Standardized transmissions;

—Leaflets and promotional materials for Macedonians
employed abroad.

Scientific Research

—Monitoring scientific research in the Republic on
AIDS-related problems;

—Keeping records on studies and scientific research
within the Republic;

—Procuring specialized publications;

—Organizing the time study of all seropositive cases in
the Republic with a view to determining the duration
of the asymptomatic period of carrying the virus and
the factors that influence it;

—Organizing serological tests for high-risk population
groups and monitoring seropositive cases and the
factors which contribute to their growth.

2. Treatment of AIDS Patients

AIDS patients or those suspected of having AIDS will be
treated at the Communicable Diseases and Febrile Con-
ditions Clinic of Skopje’s School of Medicine.

The treatment of AIDS patients at the clinic will last for
the duration of the specific infection. Subsequent mon-
itoring of the state of health and extent of the treatment
will be assumed by the local health institution. The
patient will be hospitalized again in the respective com-
municable disease hospital for any other related infec-
tion (whether different or the reactivation of the pre-
vious one), and so on until the fatal outcome. The actual
treatment is not only extensive and repeated but is also
very expensive, for it involves specific infections which
attack an organism with a destroyed immunity system by
the HIV virus, and most of the drugs are imported,
difficult to procure, and very expensive.

3. Activities of the Republic Health Protection Institute

In order to implement the objectives and activities
approved with the 1992 program, the institute will
implement the following steps and activities:

Participate in drafting plans for the medical centers and
health homes to prevent the spreading of AIDS in 1992,



66 CENTRAL EURASIA

618 Cases of HIV-Infection Officially Registered
in Russia

OW1603235593 Moscow INTERFAX in English
1946 GMT 16 Mar 93

[Following item transmitted via KYODO]

[Text] As of today, 618 HIV-infected persons have
been officially registered in Russia, Mikhail
Narkevich, a Russian Health Ministry spokesman, told
a session of the Russian-American Information Center
in Moscow. It is 6 years this month since the first AIDS
case was detected in the USSR. According to official
statistics, by today 120 AIDS and HIV-infection
patients have died in Russia. On the other hand,
numerous independent public organizations, in partic-
ular You and We, an association of Russian AIDS
patients and their families, and American health char-
ities believe that the actual number is much higher and
can dramatically increase in the near future if the
problem is tackled purely administratively.

Mikhail Narkevich believes that the panic period over
this disease is over and balanced informational coverage
is needed now.

Shortage of Condoms in Moscow

93WE0259N Moscow MOSKOVSKIY
KOMSOMOLETS in Russian 3 Feb 93 p 1

{Text] In the very near future, Moscow could experience
a serious shortage of one of the most urgently needed
medical resources—condoms. MOSKOVSKIY
KOMSOMOLETS learned that the larger part of these
products are languishing in commercial stalls, and phar-
macies are getting only the meager leavings. People are
reluctant to buy condoms from stalls. The price is high,
and the quality is terrible. Cases are known where
merchants have dumped goods on customers that they
had formerly “used” themselves.

It was reported to us from Moscow’s Pharmaceutical
Chamber that some fraction of the condoms will prob-
ably be stored away so that the city will have a reserve. It
is interesting that security service agents suffer the
poorest supply of contraceptives: They are practically
never found in departmental pharmacies of the Ministry
of Security.

AIDS Committee Meets, Reports Nine AIDS
Deaths in Ukraine

LD2903202493 Kiev Radio Ukraine World Service
in Ukrainian 1900 GMT 29 Mar 93

[Text] Nine citizens, four of whom were children, have
so far died from AIDS in Ukraine. In addition, 118
incidents of HIV infection have been registered among
Ukraine’s residents and 191 among citizens of other
states. This was reported today at the first session of the

IPRS-TEP-93-008
23 April 1993

national committee for the battle against the AIDS
disease under the Ukraine president.

The session noted that Ukraine has a national program
of AIDS prevention. It envisages the creation of an
effective system of inspection for the spread of HIV
infections and the implementation of a range of preven-
tative measures to warn against the spread of AIDS. The
session stressed that more than 160 diagnostic laborato-
ries for examining blood samples for HIV are now
operating in Ukraine. A network of enterprises is being
created which will produce disposable syringes, needles,
and blood transfusion systems.

Ukrainian Official on AIDS Control

93WE0225C Kiev PRAVDA UKRAINY in Russian
15 Sep 92 p3

[Article by Ukrainian People’s Deputy Valeriy Ivasyuk:
“How to Save the Nation”)

[Text] At the request of the editor’s office, Candidate of
Medical Sciences Valeriy Ivasyuk, a deputy to the Ukrai-
nian Supreme Soviet, a member of the Supreme Soviet’s
commission on public health issues, and president of the
All-Ukrainian AIDS Fund, ponders the status and pros-
pects of the fight against AIDS in Ukraine.

AIDS is an extremely complex problem of all mankind,
solution of which requires immediate measures. Many
countries have found themselves in an unprecedented
situation in connection with this problem. They are
faced by the need for developing and introducing the
corresponding state AIDS control programs.

How do we evaluate the effectiveness of such programs,
developed in one country or another? What strategic
steps should our country take in this highly complex
situation? It should be noted that the World Health
Organization has already developed all of the necessary
provisions and recommendations on controlling and
preventing this dangerous disease.

By what criteria can we determine whether the national
AIDS control program corresponds with WHO’s global
strategy?

The first criterion is legal. It determines the correspon-
dence of national legislation pertaining to the individ-
ual’s and the state’s relationship to AIDS problems with
the rules of international law. Efforts to develop national
legislation in this aspect have only just begun in Ukraine.

All legal relations must be regulated by law. The drafting
of legal acts would be suitable only in extreme situations;
however, they should not go beyond the bounds of
legislation foreseeing them.

Otherwise a situation may arise where legal acts may
contradict the law, and this can result in violation of
human rights.


IJPRS-TEP-93-008
23 April 1993 4

LATIN AMERICA
ANTIGUA AND BARBUDA
Government To Review Health Laws, AIDS Program (Bridgetown CANA, I Dec 92] .....
BAHAMAS

Spread of AIDS Cases in Nassau Prison ‘Alarming’ [Bridgetown CANA, 11 Dec 92] .... . 41
BERMUDA

Drop in AIDS Cases, Deaths Reported Versus 1991 [Bridgetown CANA, I Dec 92] ..... . 41
BRAZIL

Life Style of Ex-Febem AIDS-Infected Residents

[V. Franca, A.C. Prado; Sao Paulo ISTOE, 13 Jan 93] . 42

CUBA

Health Minister Dedicates Camaguey AIDS Sanatorium /Havana tv, 29 Dec 92) ..... ~ 45
DOMINICAN REPUBLIC

Health Official Gives AIDS Virus Carrier Figures ‘/Santo Domingo radio, 3 Dec 92] .. . 45

Health Official Notes Tuberculosis Increase, AIDS Linkage /Santo Domingo radio, 30 Dec . 45
HAITI

AIDS Cases: 10,000; HIV Seropositivity: 200,000 Port-au-Prince radio, 1 Dec 92] ..... . 46

HONDURAS
AIDS: 635 Dead, 3,632 Infected Nationwide /San Pedro Sula TIEMPO, 6 Mar 93]
JAMAICA

AIDS Committee Seeks Greater Community Involvement /Bridgetown CANA, 3 Dec 92]
NICARAGUA

AIDS Figures Reported /Noel Irias; Managua BARRICADA, 13 Feb 93] .... . 46
ST CHRISTOPHER AND NEVIS
Chief Medical Officer on Number of AIDS Cases [Bridgetown CANA, 2 Dec 92] ..... . 47

ST LUCIA
Health Officials Report 5 New Cases of AIDS (Bridgetown CANA, 13 Apr 93]
ST VINCENT & THE GRENADINES
Incidence of AIDS ‘Increasing Rapidly’ /Bridgetown CANA, 1 Dec 92]
NEAR EAST/SOUTH ASIA
ALGERIA

Review of AIDS Cases; Figures, Research. ......



IPRS-TEP-93-008
23 April 1993

year their number increased by 11,000 to a sum total of
over 213,000 persons; Brazil is in second place, and
Colombia is next.

The rate at which the number of infected individuals and
patients is increasing in the world as a whole is very high,
and all of mankind is in the risk group today. The disease
presents a real threat to CIS countries as well, in which
1,276 HIV carriers and 72 patients have been registered
(65 percent of them were foreigners who were returned
to their own countries). Forty-seven of the total number
of patients have already died.

Ambartsumyan: How do things stand in Kazakhstan?

Devyatko: Our republic hasn’t yet suffered this fate,
which in no way gives us any grounds for understating
the possible outbreak of disease that can occur, because
the eight HIV carriers that are in our country (three
persons in Karaganda, one in Alma-Ata, two in Aktyu-
binsk, and one each in North Kazakhstan and Kzyl Orda
oblasts) could at any moment become the cause of
infection of healthy people.

Ambartsumyan: When it was part of the former Union,
Kazakhstan was isolated to some extent from the outside
world, which (there’s always bad news with the good
news) I believe played a certain positive role in estab-
lishing what could be called a favorable AIDS situation.
Now that the republic has become a sovereign state, the
number of foreigners visiting our country will increase
by several times, which could lead to significant growth
of the number of HIV carriers and AIDS patients. To
what extent has the system for revealing possible car-
Tiers, contained in the AIDS prevention plan, prepared?

Devyatko: In September of this year I signed the regula-
tions on medical certification of foreign citizens visiting
our country for over 3 months for work, study or other
Purposes, with the exception of those coming from
countries that issue AIDS virus testing certificates rec-
ognized by our republic.

Associates of international, intergovernment, nongov-
ernment and other organizations and institutions, as well
as foreign representatives accredited by the corre-
sponding ministries, departments and organizations are
subject to certification at the decision of these ministries,
departments and organizations on the basis of interna-
tional multilateral treaties and conventions and bilateral
agreements.

Ambartsumyan: What can you say specifically about the
work of the AIDS control service, so important to all of
us, in the republic as a whole?

Devyatko: It has already been 2 years since a specialized
republic AIDS prevention and control center was estab-
lished in Alma-Ata with its own subdivisions in 22 oblast
and city centers and its diagnostic laboratories. Over a
quarter of the republic’s population was tested anony-
mously in just the last 2 years.

CENTRAL EURASIA 69

Ambartsumyan: In distinction from many others, these
tests are anonymous, guaranteeing total confidentiality
of the information obtained. Nonetheless it seems that
people are still afraid or embarrassed to undergo AIDS
testing.

Devyatko: We guarantee anonymous testing to all who
come to us for assistance. Consequently there is nothing
to fear here. The mechanism is simple: A person who
places himself in our trust receives a number, which is
then attached to the sample sent to the laboratory, and
he can learn the results by telephoning us.

Taking this opportunity, I would like to say something
about the not very tactful statements made by some
representatives of the mass media in regard to such a
delicate issue. The sole case of an HIV carrier revealed in
Alma-Ata was so sensationalized that this very act prob-
ably caused the break in contact with this person, who
had come to us for assistance. But even this case once
again confirms the real anonymity of testing.

Ambartsumyan: What do you propose changing in the
sector itself so as to keep AIDS from spreading?

Devyatko: I think that the training of future specialists in
the republic’: ’s medical schools must be reexamined, and
modified in some part to provide room for the study of
the urgent problems of AIDS prevention and treatment.

Laboratories for immunoenzymatic and differential
diagnosis of immunodeficient states that can occur with
all diseases, especially ones like hepatitis, toxoplasmosis
and so on, have been established within the structure of
many therapeutic and preventive institutions—in poly-
clinics, dispensaries and hospitals—in order to keep HIV
infection from getting through, to reveal it promptly and
to provide emergency assistance. This work is pro-
ceeding successfully in Pavlodar, Karaganda, West
Kazakhstan and other oblasts.

The time has come to have a hospital for HIV carriers
with a capacity of 15-20 beds, thus concentrating them in
one place. With the opening of such a hospital, we also
need to think about acquiring Retrovir, an expensive
drug, and as yet the only one available. Its use makes it
possible to maintain the overall condition of HIV car-
Tiers at a certain level, holding back transition of infec-
tion into disease for many long years.

Ambartsumyan: Vasiliy Nikolayevich, has the the woeful
experience of Elista and Volgograd, where children were
infected with AIDS in the hospital, served as a lesson for
our medical personnel?

Devyatko: The weak material and technical base of most
therapeutic institutions raises little certainty in this
regard, of course. Understanding this, we have stiffened
our control over the strictest possible observance of
sterilization procedures in all therapeutic and preventive
institutions.

Production of disposable syringes in Pavlodar has
become a great help to medical personnel in this aspect.



68 CENTRAL EURASIA

resources that are harmful from a medical point of view.
Today the orientation and conception for determining
risk groups, carriers and social policy have changed
fundamentally in developed countries. This had an
immediate effect on the epidemic process. In particular,
this process first began to stabilize and then began
declining among social risk groups in these countries.
The developed countries came to understand that AIDS
knows no borders, and it can visit every family. First the
pragmatism and the altruism of people cause a change in
attitudes toward unfortunate HIV carriers—from rejec-
tion to benevolence.

Of course, changing the attitude of millions of people
toward the victims of AIDS from one of fear and hatred
to conscious behavior and humanitarian sympathy for
patients is a monumental task. But it is precisely through
such a spiritual, intellectual and scientific orientation of
the people that we see our road to salvation. This is the
road that Ukraine must travel together with civilized
countries.

AIDS Awareness Day in Baltic Republics

93WE0229A Riga THE BALTIC OBSERVER
in English 10-16 Dec 92 p 114

{Text] December 1 is International AIDS Day, and it did
not pass unnoticed in the Baltic states. As they develop
closer relations with Western countries, the Baltic states
are also beginning to experience Western problems.

The number of patients with the HIV virus, which is
believed to cause AIDS, continues to grow in all three
Baltic states. Recently the 16th HIV carrier was regis-
tered by the Lithuanian AIDS Prevention Center, which
provides anonymous testing for the HIV virus. The
Latvian AIDS center has registered 14 HIV positive
patients, two of whom already have AIDS. Twenty-nine
HIV patients have been registered in Estonia, but the
real figures may be quite different.

Representatives of all Baltic states recently took part in
an international symposium on HIV and AIDS problems
in the Scientists’ House in Lielupe, Latvia. The sympo-
sium was organized by the Latvian AIDS Center, which
is headed by Dr. Juris Zalcmanis, and by the Interna-
tional Center for Better Health in Los Angeles, headed
by Stewart Altschuler. The International Center was
founded in 1990 in order to improve health services in
the former Soviet countries.

In Zalcmanis’ opinion, the AIDS Center is only aware of
about one-third of all HIV positive Latvian residents.

However, Sahdna Kahlsa, the medical director of the
department for sexually transmitted diseases at the
International Center, believes that the tide of AIDS cases
can still be stemmed in Latvia, even if the number of
people found to be HIV-positive is ten times larger than
indicated by the Latvian AIDS Center.

SPRS-TEP-93-008
23 April 1993

This year in Lithuania, November 28 was Sargio Svente
(Condom Festival) Day. Lithuanian rock groups like
Tadas Padas, Foje, and Kolibri from St. Petersburg
participated in concerts dedicated to International AIDS
Day. The Lithuanians also had the education of the
younger generations in mind. A special concert was held
for children during the day.

Information provided by Diena

Tajikistan: Dushanbe on Measures To Combat
AIDS

LD0212140492 Dushanbe Radio Dushanbe Network
in Tajik 0100 2 Dec 92

[Excerpt] [passage omitted] A center for the prevention
of and fight against AIDS, under the Ministry of Health,
is in operation in our republic. Irrespective of the com-
plicated social and political situation in the republic the
center for the prevention of and fight against AIDS
continues its activity. At present 24 laboratories for the
diagnosis of AIDS are operating in the republic,
including four laboratories in oblast centers. They are
serving all those people interested. Beknazarov, acting
head physician of the center, said that people do not
reveal their names and addresses or their places of work
and education during the examination. Patients only
undergo an ordinary examination and they can get the
answer by telephone.

The unsettled situation in the republic had a negative
effect on implementing measures for protection against
AIDS and contagious diseases. Officials at the center for
the prevention of and fight agaist AIDS are making
efforts to ensure that this [word indistinct] plague does
not spread in our republic.

Kazakh Health Minister on AIDS

93WE0259G Alma-Ata KAZAKHSTANSKAYA
PRAVDA in Russian I Dec 92 p 3

[Interview with Kazakhstan Republic Minister of Health
Vasiliy Nikolayevich Devyatko by Mikhail Ambart-
sumyan on World AIDS Day; place of interview not
given: “AIDS: All Mankind Is in the Risk Zone”’]

[Text] Today is World AIDS Day. And so we publish
Mikhail Ambartsumyan’s interview on this topic with
Kazakhstan Republic Minister of Health Vasiliy Niko-
layevich Devyatko.

Ambartsumyan: Vasiliy Nikolayevich, AIDS has now
made its way to all continents of the globe. Is there any
hope that the epidemic of the “plague of the 20th
Century” will begin abating?

Devyatko: I don’t want to cause any greater anxiety in
these troubled times, but I think I need to cite some of
the basic figures published by the World Health Organi-
zation. At this moment the United States of America is
the absolute leader in the number of AIDS patients. Last


SJPRS-TEP-93-008
23 April 1993

BELGIUM

Record New HIV-Positives Registered

BR1803135993 Brussels DE MORGEN in Dutch
3 Mar 93 p 12

[Article: “Record Number of New HIV-positives in
Belgium—IHE: Two to Three New Cases Every Day”]

[Text] Last year, 1,029 new HIV-positives were regis-
tered in Belgium. An average of three new HIV-positives
were reported every day. According to the Hygiene and
Epidemiology Institute (IHE), the increase in the
number of HIV-positives in Belgium was by far the
greatest since record keeping of the disease began. The
THE attributes the increase to the higher relative propor-
tion of non-Belgian HIV-positives in 1992, On 31
December of last year, the number of HIV-positive cases
totaled 7,155.

Since the beginning of record keeping, the number of
AIDS cases registered has gone up to 1,297. On 31
December 1992, 580 of these patients already had died,
and the doctors had lost track of 136 other patients.
Among these 1,297 AIDS patients, 706 were Belgians. As
of 31 December 1992, 338 of them were still alive, while
doctors had lost track of 24 of them. All of this informa-
tion can be found in the statistics published by the IHE
yesterday.

Among adult Belgian AIDS patients, the overwhelming
majority are in the 35-39 age bracket (115 men and 21
women).

Homosexuality and bisexuality still appear to be the
main risk factors. This is true for seven out of 10 adult
men. Among adults, heterosexual transmission occurred
in 28 percent of the cases (23 percent for men and 61
percent for women). The mothers of two out of the 15
infected Belgian children are drug users, in seven other
cases the mother was infected through heterosexual
contact, while for the remaining six infected children the
cause of the mother’s infection is unknown, The IHE has
more detailed information about 2,939 HIV-positives
and their risk behavior, subdivided according to nation-
ality and sex.

Among Belgian HIV-positive men whose risk factor is
known, 68.2 percent had homosexual or bisexual con-
tacts (788 persons). Heterosexual contacts was the main
tisk factor for 402 Belgian HIV-positives (232 men and
170 women). Other risk factors are drugs, blood trans-
fusions, mother-child transmission, and hemophilia.
Among non-Belgian HIV-positives, heterosexual con-
tacts come first (1,138 persons, 543 of whom are men),
followed by homosexual contacts (128), drug needles
(126), transfusions (51), and mother-child transmission
(also 51).

According to the IHE, the non-Belgian HIV-positive
cases clearly are different from the Belgian cases, both in
terms of the subdivision according to age and sex, and in

WEST EUROPE 1

terms of transmission. Among adult non-Belgians, for
instance, transmission is due to heterosexual contact in
65 percent of the cases while among Belgians, it is only
28 percent.

Of the AIDS patients with a registered domicile in
Belgium, 50 percent live in the Brussels area. The
majority of the others reside in such cities as Antwerp,
Ghent, and Liege and their suburbs. According to the
THE, the geographic spread of the HIV-positives is
almost identical to that of AIDS patients: 47 percent in
Brussels (50 percent for AIDS), 28 percent in the Wal-
loon region (24 percent for AIDS), and 25 percent in
Flanders (26 percent for AIDS).

At the end of last year, 611,589 AIDS patients had been
reported officially to the World Health Organization’s
(WHO) World Aids Prevention Program. The WHO,
however, estimates the actual number of AIDS cases to
be 2.5 million. The number of HIV-positives is esti-
mated at 13 million, including 1 million children, an
increase by | million of HIV-positives since July 1992.

DENMARK

Number of HIV-Infected Rises by 369 in 1992

93WE0303A Copenhagen BERLINGSKE TIDENDE
in Danish 25 Feb 93 p 6

[Article by Henning Ziebe: “More Heterosexuals Than
Gays Infected With HIV”]

[Text] In 1992 at least 369 Danes were diagnosed as
HIV-positive.

For the first time in Denmark more heterosexuals than
homosexuals were diagnosed as HIV-positive in the last
half of 1992.

The Public Health Administration’s newsletter, AIDS-
NYT (AIDS News), also revealed that more people
tested HIV-positive in 1992 than in 1991. In 1991, 330
HIV diagnoses were reported in Denmark. The prelimi-
nary figure for 1992 is 369 new cases.

The head of the Health Administration’s AIDS office,
Niels Peter Rothgardt, said the figures are small, but they
show no sign of any slowing in the spread of the
infection.

Rothgardt said people should be cautious about inter-
preting the figures, which now show a majority of
heterosexual HIV-infected people.

“Among other things the figures are very unreliable
because they are based solely on reports from people who
have chosen to have themselves tested for HIV. In other
words this does not involve either a representative cross
section of the total population or people from well-
defined environments with especially high risk factors.”



28 EAST ASIA

Nguyen Khanh at Seminar on Implications of
HIV/AIDS

BK0712105392 Hanoi VNA in English
0537 GMT 7 Dec 92

[Text] Hanoi VNA Dec 7—A two-day national seminar
on the social and economic implications of HIV/AIDS in
Vietnam was inaugurated on Dec. 3 by a speech from the
Vice Premier Mr. Nguyen Khanh.

The semiar, which is being organized by the National
Aids Committee, with support from the United Nations
Development Programme’s (UNDP) regional project,
‘Development Implications of HIV/AIDS’ is the first
national seminar on HIV and AIDS. The seminar seeeks
to address the importance of HIV/AIDS as a factor
which could potentially impede Vietnam’s development
efforts.

The objectives of the seminar are:

1. to raise awareness of the development implications of
HIV/AIDS among government and non-government
organisations of Vietnam and,

2. to promote the development of HIV/AIDS education
and behavior change strategies within government min-
istries, provincial authority and non-governmental
organisations.

Mr. Roy Morey, resident representative, UNDP pledged
the support of the United Nations system in Vietnam to
provide coordinated support to the government in their
efforts to prevent the further spread of the virus and
provide care and support to those already affected.

Vo Van Kiet, Nguyen Khanh Urge More
Anti-AIDS Efforts

BK 1404133593 Hanoi VNA in English
1328 GMT 14 Apr 93

{Text] Hanoi VNA April 14—Prime Minister Vo Van
Kiet and Deputy Prime Minister Nguyen Khanh have
told medical officials to intensify the prevention [of] and
fight against AIDS.

In a working session with the responsible persons of the
Health Ministry on April 13, the prime minister called
for wider and deeper education about AIDS, tougher
measures to check drug addiction and prostitution.

According to a report of the Ministry of Public Health,
the number of HIV positive carriers in Vietnam has risen
to 216 including 141 Vietnamese, 75 foreigners, 67 Thai

IPRS-TEP-93-008
23 April 1993

fishermen, 3 Vietnamese of foreign nationalities, 4 for-
eigners married to Vietnamese citizens and one tourist.
Most of the cases are drug addicts and prostitutes. The
Health Ministry warns that the number of HIV-affected
people may run into the thousands among the drug
addicts in the very near future.

First AIDS Deaths Reported

BK2903123893 Hong Kong AFP in English 0908 GMT
29 Mar 93

[Text] Hanoi, March 29 (AFP)—Health officials have
reported the AIDS-related deaths of two drug addicts
who may be the first known victims of the deadly disease
in Vietnam, a newspaper reported Monday.

Do Hong Ngoc, a Ho Chi Minh City health official, told
the English-language VIETNAM NEWS that both
deceased carried the AIDS precursor, the human
immuno-deficiency virus (HIV).

“We suspect AIDS is responsible for their death,” he
said.

Ngoc estimated that the number of diagnosed HIV
carriers nationwide has jumped from 45 to 101, with
most cases reported in Ho Chi Minh City, formerly
Saigon.

29 New HIV Carriers Discovered in South

BK1404160093 Hanoi Voice of Vietnam in English
1000 GMT 13 Apr 93

[Text] Another 29 more HIV-carriers have been diag-
nosed in south Vietnam in the week ending last
Thursday. It brings the total of HIV-carriers in Vietnam
to 140. The Ho Chi Minh City Medical Service says the
newly discovered cases are drug users.

55 More Tested HIV Positive in Ho Chi Minh
City

BK2403081393 Hanoi VNA in English

0553 GMT 24 Mar 93

[Text] Hanoi VNA March 24—Another 55 Vietnamese
residents in Ho Chi Minh have tested HIV positive since
the beginning of March, bringing to 92 the total number
of carriers of this dreaded virus in the city. With this, the
number of Vietnamese HIV carriers has risen to 100,
including 87 drug addicts and nine prostitutes. Their
ages range from 10 to around 30. Fifty-eight cases are in
the 30-year-old group.


14 EAST ASIA

Touching on several factors in the spread of AIDS in
Indonesia, Muninjaya said that because the awareness of
AIDS and its spread is still very low in society at large,
the use of condoms, which is still obstructed by local
customs, could prevent the spread of AIDS.

JAPAN

Watanabe May Broach Joint Japan-U.S. Fight
Against AIDS

0W1002072893 Tokyo KYODO in English 0709 GMT
10 Feb 93

[Text] Tokyo, Feb 19 KYODO—Foreign Minister
Michio Watanabe may discuss what Japan and the
United States can do to fight the AIDS epidemic when he
visits Washington from Thursday, a Foreign Ministry
source said Wednesday [10 February].

The official said the issue could be broached in a general
manner by either side when Watanabe meets with mem-
bers of the new U.S. administration of President Bill
Clinton.

But the official said that Japan has no concrete proposals
under consideration at the present time.

He said any such bilateral cooperation would have to
take into account the differences in the severity of the
AIDS problem, perceptions of it, and depth of experi-
ence in tackling it.

At the end of 1992, Japan had 543 known AIDS patients,
298 of whom have died, and 2,551 carriers of the HIV
virus that causes AIDS.

Prime Minister Kiichi Miyazawa vowed in the Diet last
month to implement enhanced counseling, testing, and
treatment for AIDS patients, as well as greater research
into cures.

Last December, an influential report to the government
by the Council on Japan-U.S. Economic Relations urged
that the two countries develop a “common strategy of
coordination” to fight AIDS and other such transna-
tional issues.

A similar proposal was made in January in a published
article by Yukio Sato, chief of the Foreign Ministry’s
North American Affairs Bureau.

Research Team Produces Antibody Targeting HIV
Enzyme

0W0503131693 Tokyo KYODO in English 1301 GMT
5 Mar 93

[Text] Tokyo, March 5 KYODO—A research team said
Friday it has produced an antibody which targets an
enzyme responsible for the spread of the AIDS-causing
Human Immunodeficiency Virus (HIV) in the human
body.

IPRS-TEP-93-008
23 April 1993

The team, comprising professor Jo Chiba, an immunol-
ogist at the Science University of Tokyo, and researchers
from the National Institute of Health and Ube Industries
Ltd., announced its finding to a meeting at the Japan
Health Sciences Foundation’s Tokyo headquarters.

The team said it is still at the test tube stage, but the
discovery could prove a powerful weapon in the diag-
nosis of and development of a completely new medicine
for the treatment of AIDS.

It has already applied for a patent on the finding.

The enzyme works when the HIV virus attacks the
deoxyribonucleic acid (DNA) in a person’s lymphocyte.
The enzyme effectively allows the virus to spread
throughout the human body.

Drugs such as Azidotimidine (AZT), used in aids treat-
ment in Japan since its approval by the government in
June 1992, inhibits the spread of HIV by interfering with
the action of the enzyme.

But if treatment is prolonged, the virus develops a
tolerance to AZT and the drug loses its effectiveness.

AZT can also cause anemia and a decrease in the number
of white blood cells by undermining the blood-producing
capability of bone marrow.

As the newly developed antibody combines with the
enzyme at different parts of a DNA molecule than other
medicines, it can be used against the HIV virus when it
has developed a tolerance to AZT.

The antibody is monoclonal, a type used in the treatment
of illnesses because of its ability to target and combine
with specific antigens which are capable of stimulating
an immune response.

To develop the monoclonal antibody, the research team
infected a laboratory mouse with a virus produced by
inserting a gene from the enzyme into the substance used
in the production of raw vaccine,

They then produced several types of monoclonal anti-
bodies based on the cells from the mouse.

After mixing the antibodies with the enzyme extracted
from the HIV virus, one of the monoclonal antibodies
displayed an ability to virtually halt the action of the
enzyme.

When the team looked at what part of the enzyme with
which the antibody combines, they found the location
was different compared with the AZT.

Chiba said the antibody has a large number of molecules,
making it difficult to actually enter a cell and control the
HIV virus.

“Rather, there might be a shortcut whereby we could
attack the enzyme by attaching drugs to the antibody,”
he said.


20 EAST ASIA

The faculty planned to test the vaccine on about 20
people in the first stage, he said.

Drug Use, Second High Risk Factor for AIDS

93WE0113A Bangkok BAN MUANG in Thai
1 Nov 92 p3

[Excerpts] At 0845 hours on 29 October 1992 in the
Wiphawadi C Room at the Central Hotel in Bangkok,
Dr. Withun Saengsingkaeo, the director-general of the
Department of Medical Services, presided at the cere-
mony to open the conference of officials concerned. The
purpose of the conference was to look for ways to control
AIDS among intravenous [IV] drug addicts and come to
a conclusion about standard measures that can be used
by the hospitals and units concerned in dealing with this
problem. Dr. Thamrong Tatsananchali, the director of
the Drug Rehabilitation Activities Coordination Divi-
sion, gave a report. [passage omitted]

A report by the World Health Organization states that
Thailand now has approximately 300-500,000 drug
addicts. In 1990, only 58,327 addicts voluntarily came
for treatment. Of these, only 120 were IV (heroin) drug
addicts. IV drug use is the second highest risk factor in
the spread of AIDS. The most recent AIDS report issued
by the Epidemiology Department, Ministry of Public
Health, on 30 September 1992 states that there are 34
AIDS patients who contracted the disease from injecting
drugs intravenously. Another 35 people have AIDS-
related symptoms. There is only one woman in each of
these two groups of people. The rest are all men. [passage
omitted]

Campaign To Slow HIV Through Condoms Seen
Failing

93WE0281A Stockholm DAGENS NYHETER
in Swedish 23 Feb 93 p 11

[Article by Goran Leijonhufvud: “HIV Infection
Spreading Like Wildfire”]

[Text] Bangkok—Thailand is facing a catastrophe
spelled with four familiar letters: AIDS. The warning
signals are coming in with increased frequency. Ten
percent of the population could be stricken by the end of
the century. At that time AIDS will be the cause of one
death in three, according to former Health Minister
Mechai Viravaidya.

Independent Thai doctors at AIDS clinics estimate that
between 900,000 and 1.5 million of the country’s 57
million inhabitants are HIV-positive.

The Health Ministry has stopped publishing figures. The
AIDS doctors suspect that the authorities do not want to
alarm tourists.

Swedish men continue to take sex trips here. Of the
approximately 50,000 Swedish tourists who come each
year, 75 percent are men.

JPRS-TEP-93-008
23 April 1993

Thailand is the most serious example of the fact that the
biggest increase in HIV cases is now occurring in Asia.
By the year 2000 two-fifths of the infected people in the
world will be Asians, according to figures from Harvard’s
Global AIDS Policy Coalition.

The explosion could be even greater, a study from the
Asian Development Bank warned. It cited heroin
abusers in the Golden Triangle (Burma, Laos, Thailand)
as a big source of infection in addition to the sex trade.

Frequent Brothel Visits

On Bangkok’s brothel street, Patpong, the threat seems
remote. Just now the air seems to have gone out of the
condom campaign that was visible here earlier.

In spite of a good deal of information on TV, awareness
of the risk of frequenting brothels is low. And Thai men
have sex with prostitutes twice a month on the average,
according to a recent opinion poll. Patpong and Pataya,
with their foreign tourists, are only a small part of the
problem.

“Nice Thai girls are supposed to remain pure. But boys
are expected to be sexually experienced. Most of them
make their sexual debut with a prostitute,” Dr. Vichai
Vithayasai of the university hospital in Chiang Mai said
in a newspaper article.

Chiang Mai is one of the hardest hit areas when it comes
to the spread of HIV infection.

“We have a saying that a man has not been somewhere
unless he has had sex with the local girls,” the doctor
said.

There is a misconception among a good many men that
it is harder for young girls to become infected. This lends
support to child prostitution.

Another almost incredible figure comes from the Foun-
dation for Children: 2.8 million people are involved in
the sex industry, almost 5 percent of the population. Of
these 800,000 are children.

The official Health Ministry estimate is that there are
75,000 prostitutes, 13,000 of them children, a gross
underestimate according to most of the humanitarian
organizations that work with the problem.

How many ofall these prostitutes are infected with HIV?
About 70 percent of those who have been engaged in
prostitution for at least a year are infected, according to
hospital statistics.

If one puts two and two together, all these figures send a
message that is chillingly clear.

At the AIDS clinic at the hospital in northern Chiang
Rai, Dr. Wat Ytuthai sees mostly men between the ages
of 20 and 30. That is the major group of infected people.

“They are heterosexual and were infected in brothels.
The homosexual element in Thailand is small.”



16 EAST ASIA

addicts, but the fatal syndrome’s threat has since spread
dramatically to include heterosexuals.

Cooper said that in order to maintain necessary disci-
Pline, the defence chief should be able to dismiss per-
sonnel whose sexual behaviour was “incompatible with
the maintenance of good order within the NZDF or
brings the NZDF into disrepute.”

Cooper said this meant that homosexual behaviour by
service personnel would be treated for disciplinary and
administrative purposes in exactly the same way as
heterosexual behaviour.

“Inappropriate homosexual or heterosexual sexual
behaviour by service personnel will, if detected, result in
disciplinary action and/or administrative release.

“Inappropriate sexual behaviour will, in practice, be
behaviour which is incompatible with the maintenance
of discipline in a service or which is likely to bring a
service into disrepute,” he said.

The fact that someone was a practising homosexual
would not in itself lead to such action. A decision would
be made on the merits of each case, Cooper said.

THAILAND

Ministry of Public Health Updates AIDS
Information

BK1912050992 Bangkok BANGKOK POST in English
19 Dec 92 p2

[Text] The number of AIDS patients is now 1,105,
according to November’s report by the communicable
diseases department of the Ministry of Public Health.

The report says that up to November of this year 61
people acquired the disease, mostly as a result of sexual
intercourse.

According to the report, in 77.2 percent of cases the
disease is sexually transmitted, in 11 percent it is trans-
mitted to children by their mothers, in 9.1 percent it is
due to drug abuse, and in one percent it is the result of
blood transfusions.

The cause of 1.6 percent of cases is unknown.

From the time the first AIDS patient was traced in
Thailand in September 1984, most males infected have
been aged between 25 and 29, whereas most women with
AIDS have been 20-24.

The largest single occupational group of AIDS patients is
found to be labourers.

Up to November this year, 268 AIDS patients came
from Chiang Mai 167 from Chiang Rai an 157 from
Bangkok.

SJPRS-TEP-93-008
23 April 1993

The director general of the communicable diseases
department Prayun Kunasol, said one of the main ways
of helping to prevent the spread of the disease is to
publicize its causes and effects.

Dr Prayun said young people are a target group and need
to know more about the disease.

If the publicity is effective, officials will not need to close
brothels; they will close of their own accord when people
become aware of the dangers, he said.

“It is time for all work units involved to inform people
about the disease. The matter gets more and more
serious every day,” he said.

Doctor Projects AIDS Cases: 1 in 4

93WE0113B Bangkok DAILY NEWS in Thai
10 Nov 92 p 19

[Excerpts] Dr. Thani Siriyong, the president of the
Catholic Anti-AIDS Association, spoke at an interna-
tional conference on AIDS that was held at the YMCA.
He talked about the policy of suppressing brothels.
[passage omitted]

Ask for the AIDS situation in Thailand, it is thought that
in the next eight years, one in four Thai men will have
the AIDS virus. The data have shocked the Ministry of
Public Health. It is trying to dispute the validity of these
data by claiming that condoms are 100-percent reliable
in preventing AIDS. But he said that he does not believe
that condoms can control this disease. The best way to
control this terrible disease is to change people’s
behavior. [passage omitted]

Doctor Reports on AIDS Incidence
93WE0088A Bangkok NAEO NA in Thai 21 Oct 92 p 5

[Article by Long Likhit: “AIDS Invades the Bed”]

[Excerpt] [passage omitted] I met Dr. Thephanom
Muangmen, an old hand who is now Dean of the faculty
of Environmental and Resource Science at Mahidon
University in Salaya Subdistrict, Nakhon Pathom. He
spoke of his concern that:

“Now there are many people contracting AIDS. The
latest figures from the Ministry of Public Health indicate
that 10 percent of those supplying blood have the AIDS
virus. That means that 10 out of 100 have the AIDS
virus. Drug addicts have a high incidence of AIDS. Many
Pregnant women have been given the AIDS virus by
husbands who frequent brothels and bring it back.” He
said this was as it was in Africa.

“In the North, in Phrae 8.5 percent of the pregnant
women have the AIDS virus, in Mae Hong Son it is 4
percent, and in Chiang Rai it is 4 percent. In the East, in
Rayong it is 6.7 percent. In the South, in Phetburi it was
4 percent.



JPRS-TEP-93-008
23 April 1993

REGIONAL AFFAIRS

Eastern Europe Reportedly Facing HIV Epidemic

AU0804185093 Hamburg DIE WELT in German
8 Apr 93 p 12

[(“WELT-Nachrichtendienst” report: “Eastern Europe
Faced With HIV Epidemics”]

[Text] Berlin—According to the WHO, the East Euro-
pean countries are facing a devastating HIV epidemic.
All conditions for the spread of the immune-deficiency
syndrome exist there, Michael Mearson, director of the
Global AIDS Program of the WHO, said in Berlin on
Wednesday [7 April]. As a result of inceasing drug abuse
and rising prostitution, the risk factors for an epidemic
exist in Eastern Europe. The former Warsaw Pact coun-
tries must not make the same mistakes as the Asian
states. In Thailand, India, and Burma there were hardly
any AIDS cases 6 years ago. As a result of the inactivity
of the governments, up to 6 percent of adults are now
suffering from this disease, Mearson said. To prevent an
epidemic in Eastern Europe, one must, above all, work
against the discrimination and stigmatization of those
suffering from this sickness.

‘Mobile’ East European Prostitution Spreading
HIV

93WE0244A Stockholm DAGENS NYHETER
in Swedish 2 Feb 93 p 4

[Guest commentary by Prof. Per-Anders Mardh: “New
HIV Wave Threatens”)

[Text] A new form of prostitution is spreading through
Europe. It is mobile prostitution in which about 100,000
young women from East Europe travel around Europe
every year to earn money by prostituting themselves, sent
there by their families or organized pimps. A survey shows
that venereal disease is spreading alarmingly. That
uncontrolled prostitution is becoming a new and
extremely dangerous source of HIV infection. The spread
of HIV is threatening even Sweden, partly through
tourism. So writes Prof. Per-Anders Mardh.

The disappearance of the Iron Curtain has made it
possible for people in the East to travel to West Europe
(provided that they have access to a travel allowance).
People have started moving along the socioeconomic
gradient westward from poor East Europe to look for
work and create a more tolerable existence for them-
selves. In some sections of the population, poverty is so
great that hunger is just as imminent as it is in countries
we regard as underdeveloped.

Those conditions have become a breeding ground for
increasingly widespread prostitution—a traditional way
of improving one’s finances, especially for young women

EAST EUROPE 29

and in some cases their families as well as the girls’
pimps and not infrequently their “chiefs” in the criminal
element.

All that has now become an increasingly frightening
reality in Europe, which does not take second place to
the better-known prostitution situation in Thailand.

In both Thailand and East Europe—in Russia, Romania,
and Bulgaria, among other places—people send their
girls abroad so they can earn money for the family’s
support, precisely as happens in the northeastern prov-
inces of Thailand, from where girls arrive in great
numbers in Bangkok and the seaside resorts in the
southern part of the country.

Such travel has also taken a more organized form in
which the mafia that has developed in several of the
formerly communist countries plays a part. An example
of this is the busloads of girls who are transported from
Romania to Istanbul for prostitution and the male
“acquaintances” who accompany them.

The girls they “export” quickly become infected with
sexually transmitted diseases [STDs]. For instance, we
(Genc, Mardh, and colleagues) were able to diagnose
venereal disease in about 40 percent of the Romanian
prostitutes in Istanbul. Mobile prostitution introduces a
new and particularly serious factor in the intensified
spread of the HIV virus and AIDS within the European
population.

Besides working in big cities such as Vienna, Prague, and
so on, girls from East Europe also ply their trade at
charter destinations that are popular with tourists from
Central and Northern Europe and on the Black Sea and
Mediterranean coasts in Turkey. There the girls seek
contact with tourists and offer their services cheap.

Because of this partly new potential source of infection
for HIV and other STDs, preventive measures at the
national level in the countries where tourists originate,
among them Sweden, are becoming harder to imple-
ment. The fact that imported cases of venereal disease
have their own epidemiology distinct from the domestic
variety can be clearly seen, to take one example, in the
case of gonococci that do not respond to penicillin
preparations (so-called PPNG strains). In the case of
HIV, we in Sweden are now in danger of facing a faster
spread of the infection and one that we cannot control
because it is occurring abroad. In other words, while the
number of “domestic” cases is declining, the number of
imported cases is rising.

In another pattern, a pimp travels with a few girls to
pleasant and “lucrative” places and there offers his
“merchandise” for sale. Acts of violence are common,
since the pimps are often armed. Those “conducted
tours” also take place in the western parts of the former
communist empire.

Brothels did not exist in communist countries before the
collapse of communism. Massage parlors of the Western



JPRS-TEP-93-008
23 April 1993

REGIONAL AFFAIRS

ASEAN Countries To Establish AIDS Task Force

BKO0104123093 Hong Kong AFP in English 1217 GMT
1 Apr 93

[Text] Jakarta, April 1 (AFP)—Association of Southeast
Asian Nations (ASEAN) are to join efforts in a regional
task force to fight AIDS, an official said in Jakarta on
Thursday.

A 3-day ASEAN meeting on AIDS ends on Friday. The
association groups Brunei, Indonesia, Malaysia, Singa-
pore, Thailand and the Philippines.

A delegate at the meeting who declined to be named told
AFP that the task force would seek ways of cooperating
in medical and social research on AIDS, including mobi-
lizing United Nations non-govermental organizations in
the campaign against deadly Acquired Immune-
Deficiency Syndrome.

Health education was another task force goal, the dele-
gate said.

A source said registered alarm over [as received] World
Health Organisation (WHO) data which shows 25 per-
cent of the one million new carriers of AIDS precursor
Human Immunodeficiency Virus (HIV) were found in
Asia.

According to official figures supplied by delegates, 10
people infected with HIV in Brunei, five in Indonesia,
4,902 in Malaysia, 282 in the Philippines, 55 and 896 in
Singapore and Thailand, respectively.

The number of AIDS cases reported were two in Brunei,
49 in Indonesia, 69 in Malaysia, 86 in the Philippines, 18
in Singapore, and 869 in Thailand.

Data from Brunei and Indonesia were as of February,
while the other nations’ figures were as of the end of
1992.

The next annual task force meeting is to be held in
Malaysia in a year, the source said.

Japan’s Foreign Ministry Announces AIDS
Assistance to Thailand

‘Comprehensive’ Plan

OW 1803131993 Tokyo KYODO in English 1206 GMT
18 Mar 93

[Text] Tokyo, March 18 KYODO—Japan plans to grant
300 to 400 million yen in aid to Thailand to help it tackle
AIDS, a Foreign Ministry source said Thursday.

The source said the grant project assistance will be given
over 3 years from fiscal year 1993, which starts April 1.

EAST ASIA 11

Japan wants Thailand to use the funds to combat AIDS
in a comprehensive manner by providing testing equip-
ment, training of researchers and medical personnel, and
educating the public through anti-AIDS campaigns, the
source said.

The source said a Japanese survey team is now in
Bangkok consulting with the Thai government about
disbursement of the funds.

Informed sources said Japan may also join forces with
the United States in a project in Thailand to fight the
AIDS epidemic.

Foreign Minister Michio Watanabe made the proposal
during a visit to Washington last month.

Thailand’s experience of AIDS is the worst of any
country in Southeast Asia and it reportedly expects the
disease to cost the country 10 billion dollars in lost
productivity by the year 2000.

Thailand has about 1,400 registered AIDS cases, more
than double the number last year.

Unofficial estimates put the number of Thais infected
with the HIV virus that causes aids at more than
400,000.

Thai Radio Report

BK2403081493 Bangkok Voice of Free Asia in Thai
1030 GMT 23 Mar 93

[Text] An agreement was signed over the weekend on
Japan’s AIDS assistance to Thailand. Dr. Chamrun
Mikhanan, deputy permanent secretary of the Public
Health Ministry, represented Thailand, and Dr. (Akira
Oya), a senior member of Japan’s National Institute of
Public Health, represented Japan at the signing cere-
mony which took place at the Royal Princess Hotel.

The agreement provided for an assistance to Thailand’s
AIDS control and prevention program. Last year Thai-
land proposed to Japan the establishment of mobile
health education centers under the Health Education
Department, community rehabilitation centers for those
infected with HIV virus under the Communicable Dis-
ease Control Department, national institute for control
of AIDS under the Medical Science Department, and
laboratory study and research project on the virus under
the Medical Science Department.

The Japan International Cooperation Agency [JICA]
sent experts to survey the above-mentioned projects, and
finally decided to assist Thailand in studies on AIDS
epidemiology and improvement of medical service. It
also decided to help Thailand in collecting data on those
at risk for AIDS, and in study and research through
laboratory science. JICA approved a fund of 36 million
baht for the projects—the first allocation will be 12
million baht, to be followed up by a sum of 8 million
baht annually in the following years. All projects as
mentioned will get start in July 1993.



SIPRS-TEP-93-008
23 April 1993

caused it to be widely discussed, and a large store of
information to become available.

Andrada: Are you worried about the new cases without a
virus but with immunodeficiency?

Najera: It’s a complex topic that must be studied,
because in those 60 cases there may possibly be different
features that perhaps have nothing in common with it.
This is enormously important from a scientific stand-
point, because we must learn what it is. However, it
doesn’t seem to have epidemiological significance,
because in no case does it appear to resemble HIV. There
are different particles, which may possibly be far more
closely linked with another similar virus previously
described in an immune disease. We are working on it,
and are in contact with all the specialists in other
countries, so as to follow each case, initially. But, as was
noted at the Geneva meeting, it doesn’t appear to be a
communicable disease.

Andrada: AIDS didn’t seem so at first, either.

WEST EUROPE 83

Najera: For that reason, the contrary can’t be precluded
either.

Andrada: Death from AIDS is tragic.

Najera: When the AIDS patient reaches the point where
he begins to feel sick, he is fully aware of the progress of
his disease; and although, now, precautions are being
taken against incidental diseases, giving them a better
quality of life and a longer life, in any case, the patient
wastes away. He suffers, and his family and social
environment suffer. In particular, the fact that the dis-
ease affects young people makes it more tragic.

Andrada: Is the battle against AIDS the main purpose of
your life?

Najera: Yes, I’ve been working on the subject for many
years and, now that I’ve left the Carlos III administra-
tion, I’m completely devoted to the laboratory.



1 CENTRAL EURASIA

Ambartsumyan: The fate of the growing generation is
raising special concern in our difficult and contradictory
times.

Devyatko: The sooner we begin educational work among
children and adolescents, the more we will be able to
accomplish. With this purpose the Ministry of Health
has drawn up a program jointly with the Ministry of
Education on AIDS education for students of secondary
schools, vocational-technical schools, tekhnikums and
institutions of higher education, with regard for the age
and intellectual development of students at each level of
the education system.

Our hope is that these programs will be adopted every-
where in our republic in the next school year.

Ambartsumyan: Homosexuality is another problem that
we can’t seem to do anything with. Hounded into the
underground and persecuted by law, these people are
essentially one of the most sizable risk groups. They
require more of a loyal relationship and understanding.

Devyatko: I am certain that if these people were to sense
even just a tolerable attitude toward themselves, they
could help us in blocking the spread of this disease, at
least in their own milieu. We can persuade ourselve of

SJPRS-TEP-93-008
23 April 1993

this by looking at the cases of HIV infection among
homosexuals of Karaganda Oblast. Doctors from the
republic’s AIDS prevention and control center went
there. They established the necessary contact on a con-
fidential basis, making it possible to reveal and test over
40 sex partners. Contrary to circulating rumors, fortu-
nately no HIV carriers were found among them.

Concluding our interview, I would like to ask the direc-
tors of enterprises, institutions and commercial struc-
tures to make their charitable contribution, and support
the public “Anti-AIDS” movement headed by Academi-
cian M. Aliyev, a deputy to the Kazakhstan Republic
Supreme Soviet.

Seven HIV Cases in Dnepropetrovsk Oblast

93WE0226F Moscow KOMMERSANT-DAILY
in Russian No 43, 3 Dec 92 p 14

[Text]According to the data as of 1 December, seven
residents of Dnepropetrovsk Oblast, including two chil-
dren, are infected with the AIDS virus. According to the
information of the National Committee for AIDS Con-
trol under the president of the Ukraine, the actual
number of HIV carriers in the republic is 10 times higher
than officially recorded.



SJPRS-TEP-93-008
23 April 1993

Major components of the programme are generation of
awareness, programme management, condom mar-
keting, blood safety and control of sexually transmitted
diseases.

For the implementation of the national AIDS control
project, a separate National AIDS Control Organization
has been set up.

A national AIDS control committee headed by the
Union Health and Family Welfare Minister, with repre-
sentatives from various sectors, has been constituted,
besides a national AIDS control board and a technical
advisory committee.

Till now, 16 States have formed empowered committees
of their own and the remaining States and Union Terri-
tories are expected to follow suit soon, official sources
said.

Twenty-three States and Union Territories have set up
AIDS cells and sanctions have been issued releasing
grants totalling Rs 11 crores to them.

On the basis of recommendations made by the WHO,
the draft for amending the Drugs and Cosmetic Rules,
1945, has been finalized to revise the quality specifica-
tions of condoms and notified for receiving suggestions
or objections.

The final notification will be issued after the legal
formalities are completed by the end of March, the
sources said.

Thrust Area

The use of condoms is a major thrust area in the battle
against AIDS and, hence, the posters and hoardings one
comes across in towns and cities, highlighting the virtues
of safe sex.

A programme to generate community awareness through
the print and electronic media is already one. The mode
of transmission of HIV infection and the ways to avoid
it are being highlighted.

A policy document, relating to the area of collaboration
with non-governmental organizations is being finalized,
the sources say.

A study on the prevalence of high-risk behaviour in 65
cities, including State capitals and cities with a popula-
tion of 500,000, is being planned to facilitate advocacy
and planning.

The draft proposal is ready and the final report of the
study is expected by May or June, sources say.

Till now, no reliable baseline data are available for
sexually transmitted diseases.

NEAR EAST/SOUTH ASIA 55

The Centre and the WHO have jointly initiated action
for collection of the data in select urban and semi-urban
and rural areas of Madras and Jaipur.

Calcutta

A community-based survey, possibly the first in India,
has been completed in Calcutta. Based on the findings of
the survey, an intervention among commercial sex
workers of Calcutta is scheduled to start soon, the
sources say.

Under the Blood Safety Programme, a deputy director,
Blood Safety, has been posted at the national level as a
nodal officer and States have been asked to position the
staff for blood safety.

Disease Not Notifiable

93WE0304B Bombay THE TIMES OF INDIA
in English 17 Feb 93 p 10

{Article: “Notifying AIDS Ruled Out”]

[Text] New Delhi, February 16. The national AIDS
committee has ruled out making AIDS a notifiable
disease and promoting needle exchange programmes
among drug abusers. Such a move would force those
affected to go underground, it was feared.

The committee was also not in favour of providing
needles/syringes to drug abusers as practised by some
western countries to check the spread of AIDS. Any
suggestion of doing so may send wrong signals on the
government’s policy on drug abuse, the committee felt.

The meeting of the committee held yesterday and
chaired by the Union health and family welfare minister,
Mr. B. Shankaranand, was attended by 45 of the 52
members of the committee, including bureaucrats, jour-
nalists, social workers and MPs [Member of Parliament].
The two-hour meeting was largely devoted to suggestions
from members on what the national AIDS control organ-
isation (NACO) ought to do.

The minister set the ball rolling by stressing the need to
break communication barriers, prejudices, myths and
taboos about the disease. Efforts, he said, must be
concentrated towards removing the fear of stigma and
discrimination against an infected person.

Mr Shankaranand drew attention to the need to explore
the Indian system of medicine, including ayurveda and
homeopathy to find a cure for the disease. He urged the
members to give their continued support to the govern-
ment in tackling the disease.



IJPRS-TEP-93-008
23 April 1993

factors, the north was less affected by the war, which
made it possible to install laboratories there. “This is not
to say that we can single out the north as the only area in
the country where there are HIV carriers.”

Epidemic Disease Statistics for Luanda Revealed

92WE0677C Luanda JORNAL DE ANGOLA
in Portuguese 22 Aug 92 p 11

[Excerpt] [Passage omitted] Vita Vemba, the local public
health director for Luanda Province, stated that the
“high number of sexually transmitted diseases leads one
to believe that in the short term Luanda could be fertile
ground for new AIDS cases,” if we consider the six
deaths, out of the seven recorded, during the first half of
this year. Dr. Vemba announced this to Angop [Angolan
Press Agency] and did not provide comparative data
from previous years.

KENYA

Estimated Over 750,000 HIV Positive

93WE0254A Nairobi THE KENYA TIMES in English
3 Dec 92 p 13

[Excerpt] Over 1.7 million out of a population of 30
million Kenyans will be infected with the Human
Immune Deficiency Virus (HIV) by the year 1996 the
Minister for Health, Mr. Jeremiah Nyagah, has said.

Ina speech read on his behalf by the Director of Medical
Services, Prof. Gedion Okello, during the Sth Interna-
tional Aids Day ceremony at Ugunja in Siaya District on
Tuesday the minister said the cases of full-blown AIDS
in Kenya as of November this year stood at 30,764 while
HIV positive carriers were estimated at over 750,000.

He said that 300,000 adults and 115,000 children will
develop AIDS in Kenya in the next 5 years and asked
every one to take an active role in the prevention of the
spread of the disease.

Mr. Nyagah pledged that the Government would con-
tinue to provide safe blood for transfusion and sterile
medical equipment, but called on individuals to change
their sexual behaviour, saying that the culture of “ndogo
ndogo” and all forms of promiscuity should be aban-
doned. [passage omitted]

NIGERIA

In 3 Years 4 Million May Be AIDS Carriers
93WE0288A Lagos THE GUARDIAN in English
14 Jan 93 p4

[Article by Onajomo Orere and Ben Ukwuoma]

[Excerpt] With the current rate of infection, about four
million Nigerians may in the next 3 years have contacted
the Human Immunodeficiency Virus (HIV), according

AFRICA 3

to Dr. Abiola Tilly Gyado, the national co-ordinator of
the National AIDS Control Programme.

Mrs. Gyado told a seminar for health correspondents in
Tbadan on Tuesday that HIV infection had increased
from zero percent in 1986 to 1.2 percent in 1992.

Already the Health and Social Services Ministry claims
that the number of infected Nigerians stands between
450 and 800,000.

AIDS, according to Gyado, by nullifying the efforts and
gains from past healthcare survival strategies and
diverting funds from other meaningful developmental
and health programmes to itself, possessed a major
challenge.

“With AIDS neither having a cure nor a protective
vaccine against infection, the only weapon at our dis-
posal is educated information targetted through appro-
priate communication channels, to promote positive
sexual behaviour change, she added. [Passage omitted]

Federal Government Earmarks Fund To Fight
AIDS

ABO212153192 Lagos Radio Nigeria Network
in English 2100 GMT 1 Dec 92

[Text] The Federal Government has directed that the 1
million naira annual budgetary allocation by state
governments for AIDS control be deducted from the
federation accounts and paid directly into the AIDS
control special account. The directive also applies to
the 500,000 naira budgetary allocation by local govern-
ments for the same purpose. President Ibrahim
Babangida gave the directive in a message today on the
occasion of the World AIDS Day. He recalled that the
directive was given last year because the government
was convinced that the control of the epidemic was a
national emergency.

General Babangida, however, said reports from the
states indicated that the funds were not being released.
He described AIDS as the scourge of the century and said
that Africa seems to be hard hit. The president stated
that between 400,000 and 550,000 Nigerians were
already affected by the HIV virus. The figure is expected
to rise to 4 million in 1996 and 7 million by the year
2000 at the current rate of infection. Gen. Babangida
said the official reported cases of AIDS in the country
was 436,

The President said he would make AIDS education
accessible to all Nigerians by incorporating it into the
curricula of schools at all levels. He announced that the
decentralization of the management of AIDS victims
would be intensified at the grass root. The president
explained that government had realized that the coun-
try’s health institutions would not be able to cope with
the treatment of people affected. Gen. Babangida’s mes-
sage was read in a radio and television broadcast by the
vice president, Admiral Augustus Aikhomu.



26 EAST ASIA

“Seven percent of pregnant women alone have tested
HIV positive, and six percent for AIDS, so you can
imagine the number of males infected,” he said.

Dr Udomsin said it was surprising that not only the less
educated people were infected, but in Chiang Rai several
educated businessmen had died of AIDS. He said the
only way to stop the spread of this disease was to stop
having extramarital sex.

Many people are psychologically affected after their
spouses or children are found to be infected, he said,
adding that he felt sorry to see civil servants who have to
leave their jobs, just to take care of their HIV-infected
child, who lay helplessly in a hospital bed, waiting for
death. He praised the doctors and the nurses of the
province for their dedication in taking care of these
patients.

“Even though the doctors and nurses know that they are
at risk, they do their duty, for which they are respected
by their patients, particularly because most of them have
earlier undergone a Tham course,” said Dr Udomsin.

The PDP MP said one of the main problems with these
hospitals is that there are few staff able to counsel people
about the dangers of the disease and ways to prevent it.
The deputy minister said he would ask Public Health
officials to train local volunteers, who in turn would be
able to advise the villagers. He said he would also ask the
Public Health Minister to set aside a budget to provide
counselling to villagers in other parts of the country,
especially in the border areas.

Dr Udomsin said that it was found that over eight
percent of women have tested HIV-positive in Mae Sai
and suffer from diseases like skin cancer.

Poll on Attitudes Regarding Prostitution

93WE0268A Bangkok THE NATION in English
30 Jan 93 pel

[Article by Victoria Combe: “Child Sex Trade Forced
Underground”]

[Excerpt] [passage omitted] Dr Saisuree Chutikul,
adviser to the prime minister on women and children’s
affairs, says a breakdown in morals has led to commer-
cial sex becoming a social norm. “Going to a brothel is
considered as ordinary as having a cup of coffee,” she
said.

Her plan is to instil a sense of respect for human life in
the Thai education system. By teaching boys and girls
when they are still young and impressionable about the
suffering of sex workers, she hopes she can break the
vicious cycle.

She faces a huge challenge. In one survey 75 percent of
Thai men of all classes admitted to having used a
prostitute, despite the fact that prostitution is illegal.
This figure may not be surprising, but the results of a
Red Cross survey last year in primary schools are.

IJPRS-TEP-93-008
23 April 1993

In two schools in northern Thailand, 97 percent of the
10- to 12-year-old children thought prostitution was a
worthwhile profession, and 4 percent of 11-year-old girls
said they would probably enter the sex trade. [passage
omitted]

Law Would Increase Penalty for Selling
Daughters

93WE0281B Stockholm DAGENS NYHETER
in Swedish 23 Feb 93 p 11

[Press Wire Service, Inc. (TT)-AP report: “Stiffer Penal-
ties Proposed”]

[Text] Bangkok—Thais who sell their daughters into
prostitution will lose their parental rights and face fines
if a proposed law goes through.

Parents should be held accountable, a civil servant in
Bangkok said Monday [22 February]. Around 800,000
girls under age 18 work as prostitutes in Thailand.

The proposed law would make it possible for social
authorities to help women escape from prostitution. In
the past even parents who had sold their daughters had a
right to remove them from the custody of social author-
ities—and perhaps send them back to their old life,
according to Rangima Limpisawadhi, leader of a
women’s organization.

The scale of parental fines has not been established, but
those who organize the trade can be sentenced to a
maximum of 20 years in jail and fined as much as
100,000 kronor.

The text of the law shows that clients who have sex with
children or women forced into prostitution will also face
prison sentences and fines if the proposed law is
approved by the legislature.

The fact that Thai authorities are now beginning to react
against prostitution may be due in part to dread of what
an AIDS explosion could mean for the nation.

VIETNAM
AIDS Explosion Seen as ‘Inevitable’

Health Minister’s AIDS Day speech

BKO01 12093692 Hong Kong AFP in English 0923 GMT
1 Dec 92

{By Andrew Sherry]

[Text] Hanoi, Dec 1 (AFP)}—The popular Vietnamese
belief that you can only get AIDS from foreigners will
worsen the inevitable explosion of the disease in this
Southeast Asian country, experts warned here Tuesday.
Only 79 cases of HIV—the virus that causes aquired
immune deficiency syndrome (AIDS)—have been
detected in Vietnam, Vietnamese Health Minister



62 NEAR EAST/SOUTH ASIA

clinic in Calcutta’s largest red light district, for spreading
awareness about AIDS, she added.

Top Surgeons Said Contributing to Spread of
AIDS

BK1612094592 Delhi INDIAN EXPRESS in English
7 Dec 92 p3

[Text] Bombay—Top notch surgeons in State Govern-
ment hospitals are contributing to the spread of HIV
infection through transfusion of untested blood,
according to the additional director of health services,
Dr S.R. Salunke, at a symposium here on Sunday. He
was speaking at a symposium organised by the Haffkine
Institute. “They are professors of surgery but they insist
during emergencies that their patient be supplied blood
instantly; they do not even wait for the 4 hours it
takes-for HIV test results to be ready. And they bully any
junior staffer who dares to stand in their way,” he further
regretted.

Hospital Reportedly Supplying Blood Without
HIV Screening

BK2403053593 Delhi INDIAN EXPRESS in English
18 Mar 93 p 3

[Text] Dehra Dun—At a time when the world’s attention
is engaged in devising fool-proof technique to fight
AIDS, costly equipment worth lakhs, like the advance
reader machine and refrigerator, supplied to the Doon
Hospital under a USAID programme, are gathering dust
for the past one year for want of an Elisa Kit.

As there was no such centre this side of the State, it was
proposed to have one AIDS screening centre here to
cater to the districts of Uttarkashi, Tehri Garhwal Pauri
Garhwal, Chamoli, Dehra Dun and Saharanpur. The
necessary equipment arrived in April-June lact year and
subsequently, an AIDS centre was set up adjacent to the
existing blood bank.

After a long wait for the main equipment—Elisa Kit—
the hospital officials wrote to the health authorities at
Lucknow for taking up the case with the Centre and the
National Aids Control Organisation (NACO) at Delhi.
Hospital officials also visited NACO for the supply of
either the Elisa Kit or the Serodia Kit but the organisa-
tion has so far not supplied any of the two for reasons
best known to it.

But this is not the only grievance of the hospital. Dr S. S.
Aswal, pathologist and in charge of AID centre here, told
INDIAN EXPRESS that he had also sent an action plan
to the government. He has suggested recruitment of
trained staff for the centre as at present he is the only
person who is trained for carrying out HIV screening. He
said that he would himself visit NACO for supply of kits.

IJPRS-TEP-93-008
23 April 1993

As the screening of all blood samples, whether from
voluntary donors or professionals, has been made com-
pulsory. all blood samples are being sent to the Lucknow
AIDS Centre which obviously takes several days to
come.

The Government hospital sources admitted that in case
of emergency it may cost a patient a life as the report
cannot be ascertained from Lucknow immediately.
Moreover, inquiries revealed that for the past four
months samples of blood are not being sent to Lucknow
by the blood bank staff. And in violation of all norms,
blood is supplied to the patients without ensuring that it
is HIV free

Even the credibility of the blood test too is in question.
Recently, a professional donor was declared HIV posi-
tive by the Lucknow centre.

On its recommendation, the blood sample was sent to
Delhi where again it was confirmed that it was HIV
positive. However, the said donor obtained the third
report from Lucknow again that it was an “AIDS free
case”.

Dr Aswal said that he had also received a letter from
director, health services, asking him to personally take
up the case with NACO. The centre had also been
airconditioned sometime back but had not been able to
function for lack of Elisa Kit. One kit is sufficient to
screen 96 and 192 HIV cases depending upon its
capacity.

ISRAEL

Possible Discovery Preventing the Spread of
AIDS

TA02120943 Tel Aviv DAVAR in Hebrew 2 Dec 92 p 1

[Text] Initial findings of research studies by the Tel Aviv
University point towards the possiblity of preventing the
spread of AIDS into the blood cells. The discovery came
about within the framework of experiments in genetic
engineering, through the use of natural materials gath-
ered from the Gulf of Eilat. The research studies include
such experiments as the sending of proteins into space
aboard the “Columbia” space shuttle.

Professor Jonathan Gershoni of the Life-Sciences Fac-
ulty at Tel Aviv University explained yesterday that the
AIDS virus enters the body through a series of stages: In
the first stage it becomes attached to the receptor of the
cell; the cell then identifies the virus and allows it to
enter the cell. The experiments currently being carried
out are investigating the procedure through which the
receptors identify the virus and permit them to enter.

“Investigation into the procedure and the exposure of
the mechanism involved will enable the formulation of
synthetic products likely to prevent contact between the
receptor and the virus”, said Prof. Gershoni. These


64 NEAR EAST/SOUTH ASIA

population of the Frontier province, the northern terri-
tories and Hazara division is more than 10 million but
there are no AIDS diagnostic centers in these areas. It is
of the utmost urgency that AIDS screening centers be set
up in these areas without delay; mobile clinics can also
be utilized for diagnosing AIDS. By such means, it will
not only be possible to find out how many individuals
are suffering from AIDS but to treat them as well. It is
regrettable that the 250 patients identified as AIDS
sufferers by Pakistani doctors did not come to the
doctors voluntarily but were found to be carrying the
AIDS virus. As Dr. Sircles Broad has pointed out,
illiteracy and lack of family planning are largely respon-
sible for the spread of AIDS. As he has suggested, the
government should immediately establish AIDS
screening centers and family education centers to teach
AIDS prevention in the remote areas of the country. The
governments of Sindh, Baluchistan, Punjab, and Azad
Kashmir should also immediately set up AIDS screening
and family education centers in the remote areas of these
provinces so that the spread of AIDS may be prevented.

IPRS-TEP-93-008
23 April 1993

Minister Says AIDS ‘Fast Spreading in Country’

BK1312155492 Islamabad Radio Pakistan Network
in Urdu 1500 GMT 13 Dec 92

[Text] A 3-day international seminar about the dissem-
ination of the facts and information on AIDS began in
Islamabad today. Inaugurating the seminar, Punjab
Governor Mian Mohammad Azhar said what is needed
is that the people should be informed of the causes of this
fatal disease and its protective measures because the
deadly disease is spreading dangerously. The seminar
was told that the number of registered AIDS patients in
Pakistan until February this year was more than 100 and
its sudden spread indicates that the disease of AIDS is
fast spreading in the country. The seminar, organized by
the Pakistan Institute of Medical Sciences in cooperation
with the World Health Organization, is being attended
by representatives of the four provinces, Azad Kashmir,
international bodies, and nongovernmental organiza-
tions. The seminar will have four sessions which will
discuss ways to check and uproot the disease, particu-
larly in Pakistan.


SJPRS-TEP-93-008
23 April 1993

International AIDS Conference in St. Petersburg

93WE0226H St. Petersburg NEVSKOYE VREMYA
in Russian 20 Nov 92 p 4

{Article by Anton Ubankov: “Investigation of AIDS: a
New Phase]

[Text] “We have nothing to do with these homosexuals”
was the express reaction of administrators of municipal
health care to the report about AIDS of Andrey Kozlov,
biologist. At that time, at the dawn of perestroyka
Kozlov, who had just completed his internship in the
United States, did not expect a different reaction.

Things are different now: Andrey Kozlov, who is a
laboratory head at the Institute of Particularly Pure
Agents, organized the International Conference on
AIDS, Cancer and Human Retroviruses, with the active
support of the Swiss millionaire, Bruce Rappoport.
Within the CIS, St. Petersburg is recognized as the center
for research and prevention of AIDS, and this is not the
first conference.

Russian scientists, guests from the United States, Fin-
land, Israel, Canada and our immediate neighboring
countries (about 40 foreigners) listened to about 100
Papers from morning til evening for a week.

Isaac Witz, head of the department of immunology at the
University of Tel Aviv stated: “Such forums are unique.
They make it possible to discuss the results of experi-
ments that have not yet been published. Please note that
the conference deals not only with AIDS. I personally
believe that HIV infection is not as great a problem as
cancer. There are several already known pathogens of
AIDS, whereas there are thousands for cancer.”

“Indeed, if we succeed in reducing cancer by at least 50
percent, it would be an unquestionably grand victory,”
continued Dr. Auli Leyniken, president of the Baltic
Association for AIDS Control. “We hope to also make
another step toward coordinating the control of AIDS in
Baltic countries at this conference.”

Mr. Rappoport and his wife who, incidentally, paid for
the trips of foreign participants, attending the opening
ceremonies of the conference, which started on 18
November at the St. Petersburg Hotel.

Yesterday, Anatoliy Sobchak, the mayor of St. Peters-
burg, hosted the conference organizers and commented
on the extreme importance of scientific measures related
to research on the HIV virus.

Andrey Kozlov believes that, in view of the new status of
St. Petersburg as interparlamentarian capital, our city
could become the official center for virological research
on AIDS.

CENTRAL EURASIA 65

Russian HIV Incidence Still Low

93WE0339A Moscow MOSCOW NEWS in English
No 12, 19 Mar 93 p 15

[Article by Lusy Jones and Alexander Tkachenko]

[Text] Research into the spread of AIDS in the former
Soviet Union shows a surprisingly low incidence of the
virus. Of the 24 million people tested for HIV last year
only 85 were found to be positive. These figures are
based on research conducted by the Scientific Method-
ology Centre of Prophylaxis and Fight Against AIDS in
Moscow

Homosexuals account for 29 of the new cases, 4 are
children born to infected mothers and the remainder the
result of heterosexual contact with foreigners. Moscow,
the centre for the still outlawed homosexual community
and prostitution, showed the greatest concentration of
cases. So far there have been three instances of the HIV2
virus and these were the result of sexual contact with
foreigners from endemic countries.

The anonymous tests were carried out by the 200
regional AIDS centres which were established under the
communist regime in 1987 to monitor the spread of the
virus. Pregnant women, people undergoing treatment for
sexual diseases and blood donors are automatically
tested for HIV. But also included in the survey were
clients of the AIDS clinics and volunteers.

The past 3 years have seen a low rate of spread of the
disease. Since 1990 eighty new cases have been recorded
each year.

The reason given for the low number of HIV cases is the
absence of imported blood products. “When AIDS
appeared in the States and Europe in the 1980s the
Soviet Union was a closed country. We never had an
AIDS problem until perestroika began by that time the
West had some experience in the fight against AIDS, and
we used it. We avoided imported blood products and so
avoided importing AIDS,” said Dr. Vadim Pokrovsky,
heading the HIV testing programme.

The regional AIDS centres send data to Moscow every
month. Last week the number of HIV and AIDS cases
recorded stood at 618. Of this figure 276 are children,
who were infected with HIV in children’s hospitals in
1989. “The Soviet Union’s experience of AIDS has been
very different to the West’s so far, with the high per-
centage of children infected. But with our country’s
breakup we are facing problems in the struggle against
AIDS. The committee formed to advise the government
on AIDS policy has not met for two years and inflation
means we can no longer afford to buy equipment,” said
Dr. Vadim Pokrovsky.



IJPRS-TEP-93-008
23 April 1993

“But that is the overall figure. If we separate by region,
the northern military district comes first with 7 percent.
The figure is higher when we consider provinces such as
Prayou (20 percent), or Chiang Mai (14 percent). We
found out that about 60 percent of recruits tested posi-
tive were living in the North Eastern region of the
country 2 years before they joined us,” he said.

To counter the problem, the Thai military is joining
hands with the US Army, the Public Health Ministry and
the World Health Organization in a project that will
mark the first test of AIDS vaccine in Thailand.

Col Dr Sorachai Pitayapan, Dr Narongrid’s colleague,
said; “We have submitted two protocols to the National
AIDS Committee set up by the Public Health Ministry to
oversee the AIDS situation. One concerns the testing of
the vaccine in HIV positive volunteers; the second
concerns the testing procedure on unaffected people.

“The World Health Organization is helping draw up a
National AIDS Vaccine Plan which will offer guidelines
for groups wanting to test the vaccine in Thailand,” he
said.

He said the AFRIMS plan was not the same as the one
earlier announced by the World Health Organization.

“WHO thought earlier that they would be able to launch
an AIDS vaccine test in Thailand. Later, they changed
their mind and decided to play a guiding body instead,”
he said.

If all goes well, the first test can begin next year and the
second within 6 months. The vaccine, he added, would
still be GP160, which is engineered from a part of the
genetic code making up the HIV virus.

“We plan to use 60 HIV positive volunteers in the first
test and 120 normal persons in the second,” he said.

Col Sorachai said that there are problems which need to
be overcome before the testing can be carried out.

“One is that the vaccine will render normal volunteers
test HIV positive with the normal testing method now in
use. This does not mean they actually have AIDS. It
might pose problems to the person later when he wants
to donate blood. Or, if hospitalized in case of an acci-
dent, such a person might find he is receiving less
medical attention because he has tested positive. This
may also pose as a barrier to a person wanting to
immigrate to a country whose laws bar the entry of HIV
positive persons,” he said.

One way to overcome the problem, he said, is for the
government to issue a special certificate stating that the
volunteer has been injected with GP160. The other is to
set up a special hotline network so that medical per-
sonnel at blood donation centres and hospitals can verify
that the person has received the vaccine.

“But there is one thing that I want to stress. While it does
not mean the person vaccinated has HIV it also does not

EAST ASIA 23

mean the person is protected from infection by it. That is
why we are expected to choose volunteers from groups
without programmes or activities which put them in a
high risk situation,” he said.

Dr Sorachai stressed that the only way to stop the spread
of the disease is for all government departments to join
hands in the fight against the disease.

“The AIDS problem is a very, very serious one to be
handled by any one department. We need to collaborate
if we are to control it,” he said.

Duangprathip Foundation AIDS Report

Chief Doubts Government AIDS Figures

93WE0088C Bangkok NAEO NA in Thai
25 Oct 92 p 13

[Excerpt] [passage omitted] Khruprathip Ung-
songtham Hata, the secretary-general of the Duang-
prathip Foundation, disclosed that in the course of its
past work the foundation had generated data indi-
cating that in Thailand the AIDS virus was spreading
at a rapid rate and that the spread of this virus was not
limited to drug addicts, homosexuals, and female pros-
titutes. It had spread to the general population
including fathers in households, housewives, and
people working in many professions. Therefore the
foundation felt that this training would be beneficial to
society because the housewives who received the
training would at least be able to relay the knowledge
they gained to their husbands, children, and other
friends. This could play an important role in reducing
the rate of spread of the AIDS virus.

Khruprathip went on to say that at present there were
about 400,000 people with AIDS. This figure was the
result of surveys done during the period when the
government was still not willing to admit that AIDS was
a serious problem. In any case she thought that the actual
number of those with AIDS had to be higher than that
because later on when blood was tested, it was discov-
ered that the frequency with which people with the AIDS
virus were found was much higher than before.

Dr. Praphan Phanuphak of the Thai Red Cross, who was
in charge of gathering data about AIDS and giving
advice about AIDS at the Niranom Clinic, said of these
circumstances that now the problem of AIDS was one
which should be discussed a great deal because it was not
a problem just of drug addicts, prostitutes, and homo-
sexuals but had spread to normal people who were
fathers in households and housewives. The figures for
AIDS among normal people was later found to be higher
than for drug addicts, prostitutes, and homosexuals.

The important reason that Thailand had a high rate for
the spread of AIDS was that Thai men liked to use
prostitutes. In a recent survey of the sexual behavior of
Thai men more than 50 percent responded that they
normally had sexual relations with a woman other than



IPRS-TEP-93-008
23 April 1993

be found it seems the research would not be possible due
to the fact that the polyclinic is closed because of funding
cutbacks,” says head doctor of the internal disease ward,
Juhani Lahdevirta.

Another person, besides Lahdevirta, who is planning this
research is the Public Health Institute’s HIV Depart-
ment director, research professor Pauli Leinikki.

Lahdevirta has received permission to conduct research
from the city ot Helsinki health department’s ethics
committee, and is currently applying for a permit for the
vaccine from the Research and Development Center for
Social and Health Related Matters. “I will get the per-
mits if I get money from anywhere.”

The shared Nordic project is one of two research projects
in which Finland might participate by testing an HIV
vaccine.

The other is a Pan-European research project to be
announced in Stockholm next week. Altogether three
vaccines have been developed to arrest the progress of
HIV and these are undergoing research in about 50
different projects throughout the world.

Layoffs and Bans on Substitutes Are a Problem

The test group of patients in the Nordic project would,
for the first two years, be given a U.S. vaccine that
strengthens the organisms’ immunilogical defenses while
the control group would be given a placebo.

The way the vaccine works is by giving cells antibodies
that prevent infection of the cell by the virus.

After two years the research plan would change in that,
provided the vaccine proves effective, those in the pla-
cebo group could switch, if they want, to the vaccine
group.

Research participants would be given 12 vaccinations in
a 2-year period. During the first 6 months there would be
several additional tests as their helper cell levels would
have been measured.

It is possible that the hospital will not be able to stick to
the research timetable since the Aurora polyclinic will
have to be shut down due to a pay freeze for summer
workers substituting for regular staff, and because of
3-week layoffs in 1-week intervals. At times the poly-
clinic operates with about half of its normal staff.

Seventeen European research centers are participating in
the project to be announced next week. This project will
test the vaccine of an Austrian producer.

WEST EUROPE 5

Helsinki Hospital To Test Austrian AIDS
Vaccine

93WE0270B Helsinki HELSINGIN SANOMAT
in Finnish 27 Feb 93 p 13

[Article by Paivi Repo: “University of Helsinki Hospital
To Begin AIDS Vaccine Testing”]

[Text] Next week the Dermatology and Venereal Disease
Clinic of the HYKS (University of Helsinki Central
Hospital) will begin testing an Austrian AIDS vaccine.
This testing is part of a large-scale project being con-
ducted with 200 patients in eight European countries.

“The clinic will vaccinate participating patients six times
during the first half-year and will take blood samples
from them prior to vaccination,” said research project
director, docent Annimari Ranki, an assistant instructor
at the clinic.

After the first half-year blood samples will be taken from
the patients once every 3 months for one year. After this
the researchers will decide on the subsequent procedure.

Twelve HIV patients from various parts of the country
will participate in the research. They will be tested in two
groups: those whose blood contains over 500 helper cells
per microliter, which is near normal; and those whose
blood contains 200-500 helper cells per microliter.

If a person’s blood has less than 200 helper cells per
microliter he or she is already very close to developing
AIDS.

Immune System Is Still Working

“We will include patients in whom the disease has not
progressed too far, whose own immune system is still
working,” says Ranki.

“We will be trying to arouse the body’s own defense
system so that it would become activated upon encoun-
tering a real HIV virus, thus preventing the spread of the
disease in the organism.”

HIV progresses at different rates in different individuals.
Some of Ranki’s patients are healthy even 10 years after
infection, others have AIDS within 3 years.

No Results in Less Than One Year

“We do not yet know if the vaccine will benefit anyone
and the participating patients are aware of this too. The
earliest we could have any results is one year. If the
vaccine proves beneficial it would be made available to
others also.”

Ranki terms the Austrian GP160 vaccine a test vaccine
at this time because there is no sure evidence that it
works. The producer has reported having invested
money to a 10-digit figure in this vaccine.

Besides Ranki, another Finnish researcher who will be
involved is Prof. Kai Krohn of Tampere. The HYKS



IJPRS-TEP-93-008
23 April 1993 6

DENMARK

Number of HIV-Infected Rises by 369 in 1992
[Henning Ziebe; Copenhagen BERLINGSKE TIDENDE, 25 Feb 93]
AIDS Study: Sexually Active Youth Avoid Condoms
[Henrik Larsen; Copenhagen BERLINGSKE TIDENDE, 23 Feb 93]
First Conviction of AIDS Carrier for Unsafe Sex. .....
Haitian Sentenced /Ida Lyngbye; Copenhagen BERLINGSKE TIDENDE, 13 Mar 93]
Impact on Sex Habits Seen
[Kirsten Sorrig; Copenhagen BERLINGSKE TIDENDE, 13 Mar 93]
HIV-Infected Man Indicted for Unsafe Sex
[Dorthe Wamsler; Copenhagen BERLINGSKE TIDENDE, 7 Mar 93]

FINLAND

Number of New HIV Cases Same for 1991, 1992

[Paivi Repo; Helsinki HELSINGIN SANOMAT, 19 Feb 93] .... 74
Helsinki Hospital To Test Austrian AIDS Vaccine
[Paivi Repo; Helsinki HELSINGIN SANOMAT, 27 Feb 93] ... 75

Physicians Join Debate on Spread of HIV
[Outi Lithen; Helsinki HELSINGIN SANOMAT, 4 Oct 92]

FRANCE

Statistics on AIDS Reported Paris France-Inter radio, 26 Feb 93] ....

AIDS Statistics for Paris Region Released [Paris LE MONDE, 13 Nov 92]

Search Launched for Transfusion Patients /C. Petitnicolas; Paris LE FIGARO, 3 Feb 93]

Developments in Trial of AIDS Scandal Ministers...
Socialists Block Trial (Paris AFP, 17 Dec 92]
Senate Relaunches Process To Try Ex-Ministers {Paris AFP, 16 Feb 93]

ICELAND

AIDS Prevention Commission Survey on ‘Safe Sex’
[Reykjavik NEWS FROM ICELAND, Feb 93]

IRELAND
AIDS Cases Reported Doubled in 1992

[Paula McMahon; Dublin IRISH INDEPENDENT, 2 Feb 93] .... 80
New Statistics on Spread of AIDS Given
[Eilish O’Regan; Dublin IRISH INDEPENDENT, 14 Oct 92) .. 80
ITALY
Method Discovered to Purify AIDS-Infected Sperm
[Giovanni Maria Pace; Rome LA REPUBBLICA, 27 Nov 92] . 81

SPAIN

‘Halt’ to Anti-AIDS Efforts Alleged /R. Najera interview; Madrid DIARIO 16, 1 Nov 92] sso 82


TT

IJPRS-TEP-93-008
23 April 1993 5

Total Cases Detailed /A. Boumediene; Algiers EL WATAN, 18 Jan 93] .... . 49

AIDS Day Emphasizes Behavior
[C. Maouchi, K. Benelkadi; Algiers EL WATAN, 18 Jan 93] 50
Blood Screening at Centers [Algiers EL WATAN, 18 Jan 93] . 50
AIDS Figures Said ‘Fragmented’ /Rabat L’OPINION, 20 Feb 93] . SL

INDIA

World AIDS Conference Held in Delhi ........ . 51
Health Minister, Others Speak (Bombay THE TIMES OF INDIA, 14 Nov 92] 51
AIDS Society Chairman Speaks {New Delhi PATRIOT, 11 Nov 92] .. . 52
Continuing Fight Against AIDS Reported ...... . 53
Alarm Justified /S. Kirpekar; Bombay THE SUNDAY TIMES OF INDIA, 22 Nov 92] .. 53
More Cases in Calcutta [Calcutta THE TELEGRAPH, 23 Nov 92] 54
More Developments in the Fight Against AIDS ..... 54
AIDS Control Panel Formed [Calcutta THE STATESMAN, 15 Feb 93] . 34
Disease Not Notifiable [Bombay THE TIMES OF INDIA, 17 Feb 93] . 55
Cases in Himachal Pradesh (Jagdish Bhatt; Bombay THE TIMES OF I , . 56
Madhya Pradesh Scheme /Sujay Gupta; Calcutta THE STATESMAN, 10 Feb 93] .... . 56

Government-Ordered Treatment
[Sabina Inderjit; Bombay THE TIMES OF INDIA, 11 Feb 93]... . 58
National Committee To Fight AIDS Formed [Calcutta THE STATESMAN, 6 Nov 92] . 58
Need for More AIDS Screening Centers Told {Madras THE HINDU, 9 Nov 92] . . 59
Ayuvedic Laboratory’s AIDS Claims Examined {New Delhi PATRIOT, 10 Nov 92] . 60

Over One Hundred AIDS Cases Reported in Bengal
[Amit Ukil; Calcutta THE TELEGRAPH, 14 Mar 93] . 60

West Bengal Battles Against AIDS /Sudhin Dey; Bomb [E TIMES OF INDIA, 2 Dec 92] ...... 61
Top Surgeons Said Contributing to Spread of AIDS [Delhi INDIAN EXPRESS, 7 Dec 92] . 62
Hospital Reportedly Supplying Blood Without HIV Screening
[Dethi INDIAN EXPRESS, 18 Mar 93] .... 62
ISRAEL
Possible Discovery Preventing the Spread of AIDS Tel Aviv DAVAR, 2 Dec 92] ..... 62

PAKISTAN

170 HIV, AIDS Cases Detected in 1992 [Islamabad THE MUSLIM, 7 Apr 93]
AIDS Said Spreading, Wider Spread Feared {Peshawar MASHRIQ, 11 Nov 92]
Minister Says AIDS ‘Fast Spreading in Country’ [Islamabad radio, 13 Dec 92]

CENTRAL EURASIA

International AIDS Conference in St. Petersburg

[Anton Ubankov; St. Petersburg NEVSKOYE VREMYA, 20 Nov 92] ...
Russian HIV Incidence Still Low /L. Jones, A. Tkachenko; Moscow MOSCOW NEWS, 19 Mar 93) .
618 Cases of HIV-Infection Officially Registered in Russia /Moscow INTERFAX, 16 Mar 93]
Shortage of Condoms in Moscow [Moscow MOSKOVSKIY KOMSOMOLETS, 3 Feb 93]
AIDS Committee Meets, Reports Nine AIDS Deaths in Ukraine [Kiev radio, 29 Mar 93]
Ukrainian Official on AIDS Control [Kiev PRAVDA UKRAINY, 15 Sep 92] ..
AIDS Awareness Day in Baltic Republics /Riga THE BALTIC OBSERVER, 10-16 Dec
Tajikistan: Dushanbe on Measures To Combat AIDS Dushanbe radio, 2 Dec 92] ...
Kazakh Health Minister on AIDS

[V.N. Devyatko interview; Alma-Ata KAZAKHSTANSKAYA PRAVDA, 1 Dec 92]
Seven HIV Cases in Dnepropetrovsk Oblast [Moscow KOMMERSANT-DAILY, 3 Dec 92] ..

WEST EUROPE
BELGIUM

Record New HIV-Positives Registered /Brussels DE MORGEN, 3 Mar 93]



12 EAST ASIA

BURMA

Health Minister Says Country Now Has 28 AIDS
Cases

BK0212040092 Rangoon Radio Burma in Burmese
1330 GMT 1 Dec 92

[Excerpts] A ceremoy to mark International AIDS Day
was held at 0900 in the Training Hall of the Institute of
Nursing today. Rear Admiral Than Nyunt, minister of
health, addressed the opening ceremony. [passage
omitted]

Speaking at the ceremony, Rear Adm. Than Nyunt
explained that International AIDS day is being observed
today in accordance with the resolution passed by the
international conference of health ministers held on 1
December 1988 in order to exchange data on AIDS and
to prevent social segregation of AIDS patients. [passage
omitted]

Rear Adm. Than Nyunt said according to latest statis-
tics, there are 4,500 persons in Myanmar [Burma] who
have tested HIV positive and 28 cases of full-blown
AIDS. He said these figures are less than the estimated
figures. He said this disease, which started in the country
among narcotic drug users, is gradually spreading
through sexual transmission.

He said AIDS can strike anyone regardless of one’s racial
or economic status, and it is a scourge which is threat-
ening the entire humanity. The campaign against AIDS
can be successful only if the entire public takes collective
responsibility through their physical labor and financial
contribution. Therefore, he said, the slogan—Let Us
Take Responsibility To Be Free From AIDS—is very
appropriate.

Rear Adm. Than Nyunt explained that the state govern-
ment is carrying out AIDS prevention and suppression
work in the form of a national campaign. Under this
campaign the Central Committee for Prevention and
Suppression of AIDS and its branches in township,
states, and divisions have been formed. The government
is fighting AIDS through preventive measures as well as
international cooperation. A delegation was sent last
Novemebr to the Second Asia and Pacific Region Con-
ference on AIDS. It is necessary to fight this scourge
through international cooperation. It is also necessary
for regional and social organizations to work together
with the health organizations in dealing with the eco-
nomic and social aspects of AIDS. [passage omitted]

CAMBODIA
45 HIV-Positive Cases Found Among Blood

Donors

BK0312031992 Phnom Penh Samleng Pracheachon
Kampuchea Radio Network in Cambodian 2300 GMT
Dec 92

[Also see earlier report in JPRS-TEP-93-004, 22 Feb 93,
p 8]

IPRS-TEP-93-008
23 April 1993

[Text] According to a report from the Ministry of Health,
the Pasteur Institute had found 65 carriers of the virus
that causes aids in Cambodia by 18 November. The
institute also announced that it had found 46 cases of
aids.

The Health Ministry has lately organized seminars with
a view to installing preventive measures and educating
the masses to know the cause and development of aids.
And the Council of Ministers has set up a national
anti-aids committee as well.

As for the UN Transitional Authority in Cambodia
[UNTAC], it has also launched an anti-aids campaign for
UNTAC personnel and the Cambodian people in gen-
eral: Banners with warnings against aids have been found
along roads in the city and the radios of the State of
Cambodia and UNTAC have also dedicated consider-
able attention to the aids issue.

The Health Ministry also said that the National Blood
Transfusion Center had found 45 HIV-positive cases
among 3,419 blood donors. And in view of the increasing
rate of aids carriers, the ministry has stepped up efforts
to effectively combat the disease.

INDONESIA

Health Minister Expresses Worry Over Spread of
AIDS

BKO0212053092 Jakarta ANTARA in English 0505 GMT
2 Dec 92

[Text] Surabaya, Dec 1 (OANA/ANTARA)—Health
Minister Dr. Adhyatma expressed his worry over the
spread of the Acquired Immuno Deficiency Syndrome
(AIDS) in Indonesia, saying that from 24 people who
have been suffering from the disease, 21 had died.

“This condition should not be allowed to continue. We
should curb the spread,” the minister said in his written
speech read by Director of Contageous Diseases Eradi-
cation Juhana Sumantri here on Tuesday.

There are also 70 people in Indonesia who have posi-
tively been infected by the human immune deficiency
virus (HIV).

The minister urged the people to avoid free sexual
activities since the activites have a high risk of getting
people infected by the virus. He added that both men
and women have the same risk to be contaminated by
the virus.

He explained that everyone could be infected by the
virus through direct sexual activities with a person who
is suffering AIDS or has been infected by HIV.



2 AFRICA

“Kitanda” is to provide the public with the fullest
information possible regarding AIDS prevention mea-
sures.

For 6 days, in the Kinaxixi Square, exhibits and video
films, magazines, and educational leaflets will be avail-
able to the public between 1100 and 2000.

Speaking at the opening of the exhibit, Dr. Maria
Oliveira Tores, secretary general of ALLSIDA, said the
association’s intent is to sound the alert to all members
of the society to assume their responsibility and to make
every effort to put an end to the epidemic.

The event was attended by a large number of people,
primarily young people, who voiced their satisfaction
with the initiative.

It is noted that “Kitanda Against AIDS” is a part of the
commemoration of World AIDS Day, to be observed on
1 December under the seal of “Community Health.”

Slow Response

93WE0135B Luanda JORNAL DE ANGOLA
in Portuguese I Dec 92 p 1

[Text] About 500 “serum-positive” patients have been
registered in Angola since 1985 and, although the AIDS
mortality rate in our country is unknown, clinical
sources admit that for every 100 cases, 25 to 30 patients
are dead in 2 years.

Dr. Teresa Cohen, president of the Association of
African Women in the Struggle Against AIDS in Africa
(SWAA), informed JORNAL DE ANGOLA that it was
only in 1983 that AIDS began to be mentioned in
Angola, and in a “very timid” way.

According to this public health specialist, the fact that
the National Program for the Struggle Against AIDS
(PNLCS) was initiated 3 years after the first five cases of
the disease had been diagnosed is an indication of the
delay in our intervention and is “also explained in that
AIDS established itself in a silent and serious way.”

The present epidemiological picture makes the situation
“much more serious than the official data at our disposal
[would indicate].”

In the opinion of Dr. Cohen, the war situation was one of
the factors contributing to the picture.

However, other issues have complicated the AIDS situ-
ation in Angola. To date “we have not succeeded in
establishing the PNLCS; social action is impeded by the
lack of working conditions.”

It should be noted that the first AIDS cases began to be
reported in 1981, at the same time that AIDS was being
announced to the world as the “communicable, serious,
and incurable disease.”

SJPRS-TEP-93-008
23 April 1993

Figures Given

93WE0135C Luanda JORNAL DE ANGOLA
in Portuguese 1 Dec 92 p 8

[Article by M.F.: “Number of HIV-Positive Individuals
Continues To Rise”]

[Text] About 500 individuals identified as “HIV-
Positive” have been registered in Angola since 1985.
According to Dr. Paula Baldaia, of the Central Military
Hospital of Luanda and secretary general of the SWAA
[Association of African Women in the Struggle Against
AIDS in Africa], up to the present time the number of
new cases reported annually has been gradually rising,
but she assured that, although they are carriers, not all
the reported victims are presenting clinical symptoms of
the disease.

In 1983 there were only four cases, and in 1991 the
number of new cases reached or exceeded 150.
According to Paula Baldaia, the male/female ratio,
which was practically equal (i.e., one infected man for
one infected woman) in 1990, has begun to change, as is
happening throughout Africa, and the number of
infected females is higher than the number of males.

As in all the countries, the most affected age group in the
country falls in the sexually active years (between 20 and
40 years of age), with the greatest incidence in the
bracket from 30 to 39 years. “In this group, the risk of
infection was as great for men as for women, although it
has been observed that women are infected at a younger
age,” she explained.

Among children born to serum-positive mothers, even if
the latter are asymptomatic, the risk of being born
HIV-positive is very high. After the age group cited
above, the incidence is greatest in the age group from 0 to
4 years; the high serum-positive percentage “possibly”
corresponds to the children of serum-positive mothers.

Mortality

Although the AIDS mortality rate in our country is
unknown, Dr. Baldaia estimates that, for every 100
diagnosed cases, 25 to 30 will be dead in 2 years.

The specialist also said that the mortality rate among
infants is very high. Among the reported cases, the
notifications appear up to the age of four and then
disappear, reappearing again at the age of 15, which
indicates that, in all the cases that were reported in
infancy, the victims have died, and those which appear
at 15 years of age are “recently infected.”

Affected Provinces

In Cabinda, Mbanza Congo, Uije, Lunda Norte, and
Lunda Sul, the situation is serious. The percentage and
prevalence of infection is high. However, there are
limitations in this study, which gives the idea that AIDS
is present only in the north of the country. The study was
conducted basically in the north because, among other


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IJPRS-TEP-93-008
23 April 1993

opinion into, in a way, judging a person guilty of
suspected crimes even before he is charged of anything in
court.

The way this comes about is that the media receives
information that is either confidential or the releasing of
which is the responsibility of the authority conducting
the grand jury proceedings. From the standpoint of
citizens’ rights I consider this development to be very
dangerous.

Does a Doctor Not Have an Obligation To Protect
Confidentiality?

Grand juries in Finland have also been conducted in a
way that has resulted in at least three complaints to the
parliamentary justice agent.

In one of the complaints the agent was asked to investi-
gate whether the judicial branch had acted illegally, and
if there was cause to sue for malpractice. According to
the complainant, the court had, during the grand jury
proceedings, pressed a doctor into revealing information
on the health of a person who was not suspected of or
charged with any crime.

In my opinion private citizens should be joined by,
specifically, the Doctor’s Union in really being con-
cerned about the methods being used under the umbrella
of the AIDS phenomenon to undermine the confidenti-
ality obligation of a doctor. This is, nevertheless, a
founding pillar of an effective doctor-patient relation-
ship.

Rape is a crime. If rape is proven to have taken place
then it must be punished. If someone who is fully
cognizant commits rape with the intent to transmit the
HIV virus then that is a crime. If it is proven to have
taken place then it shall be punished. But being infected
with HIV is no crime. The fact that a person is infected
with HIV does not justify breaking the law by others and
the practice of coercion.

In the article on AIDS last Sunday psychiatrist Kyosti
Rikala said that he considered it to go without saying
that a doctor has the right to test a patient.

This is so, but only with the consent of the patient. Any
time testing is done on the doctor’s decision alone it is
illegal. Without the intentional consent of a patient no
testing should be done. Not even an HIV test.

FRANCE

Statistics on AIDS Reported

LD2602181993 Paris France-Inter Radio Network
in French 1500 GMT 26 Feb 93

{Excerpt] There are 22,939 people suffering from AIDS
in France today. These figures were released this
morning by the Ministry of Health. The number of
people who are HIV-positive is of course larger, but their

WEST EUROPE 71

exact number is not known yet. It should be between
80,000 and 180,000 people. It is interesting to note that
in comparison with 1991 the increase rate is larger
among women than among men. [passage omitted]

AIDS Statistics for Paris Region Released

93WE0104A Paris LE MONDE in French
13 Nov 92 p 32

[Unattributed article: “Ile-de-France: One Death in Five
Among Men Aged 25 to 44 Due to AIDS”]

[Text] In Paris, one death of every three among men aged
25 to 44 is due to AIDS, and in Ile-de-France one of
every five, according to a study published by INSERM
{National Institute of Health and Medical Research] in
the General Health Directorate’s WEEKLY EPIDEMI-
OLOGICAL BULLETIN [BEH] dated 12 October.

Between 1983 and 1990, infection by the AIDS virus
increased the general mortality rate in this sector of the
population by 50 percent in Paris, by 20 percent in the
departments of the so-called “petite couronne,” and by
10 percent in those of the “grande couronne.” After
Paris, the department most affected was Haut-de-Seine,
where 20 percent of the deaths among men aged 25 to 44
were attributable to AIDS. It was followed by Seine-
Saint-Denis, 17 percent; Val-de-Marne, 15 percent;
Essonne, 11 percent; Seine-et-Marne and Yvelines, 9
percent; and Val-d’Oise, 7 percent. During the same
period, AIDS was declared the “main cause of death” for
4,366 persons domiciled in Ile-de-France, or more than
half the deaths by AIDS in all of France (8,121 deaths
between 1983 and 1990).

The study underlines, however, that “the ratio of AIDS
deaths to the general mortality owing to all causes has
regularly increased with time, but remains relatively low
for the entire Ile-de-France population.” In 1990, only
two deaths in 100 in the region were attributed to
infection by the AIDS virus. The same year, in Paris,
AIDS was the origin of 7 percent of deaths registered
among the male population.

In Ile-de-France, nine of every 10 deaths due to AIDS
were men. Among men aged 25 to 64 who died of AIDS
in the region, 16 percent were blue-collar workers, 54
percent pertained to intermediate professions, and 20
percent to higher professions. In Ile-de-France, of the
total number of female deaths in the 25-44 age bracket,
only 7 percent were a consequence of this infection. And
in Paris, one death in 10 was due to AIDS. This
represented only | percent of all female deaths in the
capital.



80 WEST EUROPE

Health, the study gives high marks to efforts to educate
the populace on ways the deadly virus is transmitted.

At the same time, results indicate that those acquainted
with HIV-positive individuals participate in higher-risk
behaviour than those persons not acquainted with
stricken individuals.

Icelanders related to HIV carriers or having infected
friends responded better when asked to define the term
safe sex.

The study also revealed that persons diagnosed with
sexual diseases two or more times are more likely to
indulge in unsafe sexual practices.

Knowledge of how the AIDS virus is passed was not
shown to be in any correlation to sexual preference, with
the same holding true for individuals who have had
blood tests compared to those who have not.

The survey posted a 65% response rate.
IRELAND

AIDS Cases Reported Doubled in 1992

93WE0298 Dublin IRISH INDEPENDENT in English
2 Feb 93 p3

[Article by Paula McMahon]

[Text] Anonymous HIV-testing is to be extended to
include out-patients and those being admitted to hos-
pital, according to National AIDS Strategy Committee
and Department of Health proposals.

Unlinked testing—where blood samples are taken anon-
ymously from donors—began in maternity hospital last
October.

Blood that is surplus to clinical requirements is batch-
tested for HIV as part of an effort to more accurately
estimate the general level of infection.

Testing will be expanded initially to include outpatients
and is expected to include those admitted to hospital
within a year.

The new form of surveillance is designed particularly to
determine the level of infection among the heterosexual
population and provide a basis for a more systematic
approach to providing services at all levels.

Voluntary, HIV testing as been available since 1985 and
will continue to be provided.

The total number of deaths from AIDS reported to the
Department of Health up to December 31 last reached
137. And 308 AIDS cases were reported.

The number of AIDS deaths which were reported in
1992 doubled to 42—compared to 21 in 1991—and the
number of new cases rose from 50-72.

JPRS-TEP-93-008
23 April 1993

Largest number of new cases and deaths were among
those whose infection was caused by intravenous drug
use. IV drug users accounted for 43pc of individuals
testing positive for the virus in 1992.

“This category continues to represent the single largest
pool of HIV infection in Ireland, and in Dublin in
particular,” the report says.

However, recent studies indicate that sexually-
transmitted HIV infection may be the most common
mode of transmission in the rest of the country, it adds.

Next largest increase was in the homosexual/bisexual
category, were there were 15 new cases and 12 deaths.

There were seven new cases and eight deaths in the
heterosexual category.

Most cases, 64pc, occur in the 20-34 age group and
85.5pe of cases occurred in males—with only 14.5pe in
females, of all ages.

Ireland now ranks 11th among the 12 EC states in terms
of cases per 100,000 of the population, at 1.80.

The rate of increase of both reported cases ad deaths on
an annual basis is less than previously anticipated.

The Department believes this is due to a combination of
factors—including a levelling-off of the spread of infec-
tion.

New Statistics on Spread of AIDS Given

93WE0106 Dublin IRISH INDEPENDENT in English
14 Oct 92p1

[Article by Eilish O'Regan]

[Text] Patients in hospitals around the country will have
routine HIV blood tests, following figures that show
AIDS spreading more quickly among heterosexuals than
in any other group.

Six babies born to drug addict mothers were among the
country’s 129 AIDS death toll, according to the latest
Government figures on the disease.

But the director of the support group Aidswise, Ger
Philpott said the heterosexual community showed the
biggest percentage increase—28 pc—in the past year.

Figures from the Department of Health show 1,283 with
the HIV infection and 294 being diagnosed with full-
blown AIDS, an increase of nearly 14pc since the begin-
ning of the year. Of the 294 cases of AIDS, a total of 129
or 43.8pc have died—an increase in deaths of 35.7pc
since the beginning of 1992.

Among drug abusers, 120 had progressed to the full
disease, which claimed the lives of 47.


18 EAST ASIA

WHO recommended Thailand because it believed that
national and international scientific institutions con-
ducting HIV research in the country have the technical
potential to develop, implement and review an HIV
vaccine-research programme.

The Public Health Ministry is organising a workshop in
mid-January to discuss the plan and its implementation.

Public Health Official Comments on AIDS
Vaccine

93WE0284A Bangkok THE NATION in English
25 Feb 93 pcl

[Article by Victoria Combek: “Human ‘Guinea Pigs’
Want Trial”)

[Excerpts] In the emotional and murky world of Aids,
few areas are as controversial or sensitive as vaccine-
testing.

Current plans to use Thailand as a testing ground for
Western medicines which may halt the Aids virus have
angered many. They see candidate vaccine trials—
controlled experiments in which potential vaccines are
tested on people with the virus—as a form of exploita-
tion in which poor Thais will be used as “guinea pigs” by
the developed world for cures which can only be used by
rich Westerners. [passage omitted]

AZT has been found to be one of most effective treat-
ments for people with symptoms of Aids, but it is too
expensive for Thais or the government to afford. Cur-
rently the annual cost for AZT treatment is US$2,500-
$3,000 which exceeds the annual income of the average
Thai family.

Testing will also be cheap. Costs of the vaccine trials will
be footed by pharmaceutical companies and research
grants. For the “guinea pigs” and the Thai government,
candidate vaccines will be free.

So why the delay?

The Director General of the Public Health Ministry’s
Communicable Diseases Department, Dr Prayoon
Kunasol said Thailand needs more time. “People are in
too much of a hurry,” he said. “We don’t want to jump
in. These things need to be well-prepared to ensure Thai
people will benefit.”

He fears that HIV-positive Thais will be exploited
because of their desperation for treatment. “It is unfair
for Thai people to be tested. The Japanese and other
developed countries should test their own drugs on their
own people. Is it ethical that Thais should be the
test-subjects? No country in the world would accept
this.”

He is not alone in his view. There is concern that the 14
candidate vaccines currently going through the first two

IJPRS-TEP-93-008
23 April 1993

phases of trials in the West will react differently on
Thias, who may be infected with different strains of the
disease. [passage omitted]

Nearly 30,000 people are falling sick with Aids each year
and the country only has 90,000 hospital beds, the
survey said.

Thailand needs help.

As a panacea to the nation’s pride, WHO has talked
about the excellent infrastructure which will make trails
easy to conduct and Dr Prayoon believes a chief reason
Thailand has been picked is because of its trained
medical personnel. These are all factors which will
enable trails to be conducted efficiently as long as they
are not thwarted by bureaucracy.

Dr Praphan Panupak, director of the Red Cross Aids
Programme, said he is frustrated by the foot-dragging of
government Aids committees. The initial candiate vac-
cine, which has been tested on US servicemen for the last
three years, should be made available to Thais as quickly
as possible, he said.

Dr Praphan said the candidate vaccine has been found to
produce neutralising antibodies in the blood which keeps
the body’s immune system working. “By giving HIV-
positive Thais no AZT and no candidate vaccine, this is
a also experimenting for natural history in Thailand,”
said Dr Praphan. “It is better to have something which
has been proved safe and beneficial in another country
than nothing at all.”

“Clear guidelines about the trial are vital so the people
involved can make an informed choice about whether
they want to take part,” said Dr Praphan, who believes
Thailand will benefit medically and scientifically in the
Jong term as personnel will have to be trained and
laboratories upgraded.

In addition, as a trial site, Thailand will be in a good
negotiating position with pharmaceutical companies to
buy any successful vaccines at affordable prices.

However, Dr Apichart Chamratrittirong, director of
Mahidol’s Population Institute, said he is concerned that
funds will be channelled into research and medicine, and
taken away from education campaigns. At last month’s
meeting for the National Plan for HIV/Aids Vaccine
Development, Dr Apichart stressed that money is
needed for development. “This is the best vaccine,” he
said. “It is our society that is sick.”

Dr Prayoon insists that no money will be diverted from
education into funding the trials. He wants preventative
campaigns to continue and fears that too much emphasis
on vaccines will hinder efforts to educate people into
changing their behaviour. “It may be more than 10 years
before a vaccine is available. At the moment, people are
expecting too much and misunderstand the benefits of
vaccines. We should not put all our hopes on a vaccine.
We should be independent and change things ourselves.”



IPRS-TEP-93-008
23 April 1993

Foreicn
Broapcast
INFORMATION
Service

' BEMIBOTCR PRTEMENS

<p Blwproved ter punks released
Diewituro: Unimred

REPRODUCED BY
U.S. DEPARTMENT OF COMMERCE:
NATIONAL TECHNICAL INFORMATION SEAVICE
SPRINGFIELD, VA 22161

]

PRS Report—

Epidemiology



IJPRS-TEP-93-008
23 April 1993

Seven were homosexual and drug abusers, and six of
these have died. While 20 were haemophiliacs, of whom
11 are now dead.

Mr Philpott said: “In its most recent AIDS update
Aidswise highlights a 28pc increase of HIV infection
among heterosexuals, a 22pc rise among gay men and a
10pc increase among intravenous drug users.”

Drug abusers continue to account of the largest number
(40.8pc) of AIDS cases, while homosexuals (35.3pc)
make up 104,

To date, 63,118 tests have been carried out, and within
the past month the number who tested positive has risen
by 18.

ITALY

Method Discovered to Purify AIDS-Infected
Sperm

93WE0114A Rome LA REPUBBLICA in Italian
27 Nov 92 p 18

[Article by Giovanni Maria Pace: HIV-Positive Men
Can Be Fathers and Have AIDS-Free Children]

[Text] Milan, 10 infants born with the new system devel-
oped by Professor Semprini

The Italian method for disinfecting sperm.

Milan—A method to purify sperm from carriers of the
AIDS virus and therefore permit them to beget healthy
children has been developed by Milanese researchers,
who describe it in this week’s issue of the authoritative
publication THE LANCET. “The method is very
simple,” explains 39-year old doctor Augusto Semprini,
a university research worker who directed the study at
San Paolo Hospital. “It consists basically of the centrif-
ugation of the sperm to separate the infected portion
from it: a simple method which, nevertheless, solves a
painful problem, that of a couple in which the infected
Partner can transmit the virus to the mother and the
child.” After centrifugation, the spermatozoa are sub-
jected to other treatments that select the most vital.
These are then placed in the mother’s uterus. “Since the
life expectancy of an HIV-positive person today is about
12 years,” Semprini says, “the possibility of having a
child is of great personal and social importance.”

Infants are a new group in the sad world of AIDS, in the
sense that their number—more than 2,500 in Italy—is
increasing rapidly in comparison with the classic groups
of drug addicts and homosexuals. A couple in which the
man has symptoms of the disease can now have children
without fear. So far, Semprini has obtained 15 “puri-
fied” pregnancies, five of which are still in gestation. The
10 babies already born—the oldest of which is three—

WEST EUROPE 81

are HIV-negative, and their mothers are also disease-
free. The problem of the increasing number of children
born of infected mothers unfortunately remains in the
background. The incidence of HIV infection among
patients hospitalized for abortion or childbirth is about
2.5 per 1,000, which means that in Latium, for example,
there would be 2,600 infected women.

In every case, an HIV-positive woman transmits anti-
virus antibodies to the child and, therefore, all of the
babies are HIV-positive at birth. However, the actual
disease develops only in about one-third of the infants.
This leads Fernando Dianzani, director of virology at the
University of Rome and member of the National Com-
mission on AIDS, to say that much caution is required in
evaluating the work of the Milanese researchers: The
number of case studies (of the children) presented by the
study’s authors is too small to exclude the possibility that
the success is due to chance.

In other words, Professor Dianzani, who was supported
by an analogous statement from Baccio Bacceti of the
University of Siena, believes that purification of the
sperm may lessen the possibility of infection but not
eliminate it, since it does not exclude the presence of
HIV inside the spermatozoa. Semprini admits that cau-
tion in science is a good rule when the data are limited,
but he believes that having waited for 3 years before
publishing the data is an adequate guarantee of their
validity. “Furthermore,” Semprini adds, “scientific cau-
tion cannot ignore the fact that clinical problems move
more quickly than our discoveries.”

A waiting period of at least 15 months is necessary in
order to know with certainty whether or not a child born
of an HIV-positive is infected. At the end of that period,
the child will have used up all of the mother’s antibodies
and, if it is not HIV-positive, it will not produce any of
its own.

The subject of spouses with AIDS created a moral debate
when Monsignor Carlo Caffarra, president of the Insti-
tute on Matrimony and a theologian close to the Pope,
had held that, when one of the spouses is infected by the
virus, sexual relations must cease. But if abstinence
should bear the risk, for either of the spouses, of falling
into incontinence or of committing adultery, then sexual
relations could continue, taking care however not to use
condoms. In other words, according to the Vatican
theologian, it is morally more acceptable to transmit a
mortal disease to the partner than to use the hated
instrument recommended moreover by health authori-
ties in all countries as an effective protection against
AIDS. Even if the Catholic position has little chance of
being shared by anyone who is really at risk, it has
provoked a strong reaction because of its integralist
character.



IPRS-TEP-93-008
23 April 1993

ANTIGUA AND BARBUDA

Government To Review Health Laws, AIDS
Program

FL0112153692 Bridgetown CANA in English
1516 GMT 1 Dec 92

[Text] St. John’s, Antigua, Dec 1, CANA—Antigua and
Barbuda announced on Tuesday it would review existing
health laws to see how they might be amended to protect
the rights of persons with and without the AIDS-causing
HIV virus. Health Minister Adolphous Freeland [words
indistinct] promised “every effort will be made to
address the real and serious problems of discrimination
which persons who are known to be HIV positive cur-
rently face.”

He also said the government's thrust for the future will
be to decide on, develop, and introduce various policies
and guidelines required to make the National AIDS
Programme more effective.

“More emphasis will be given to involving volunteers,
individuals, and groups, in addition to non-government
organisations, in the delivery of programme elements,
whether they be preventive, counselling, or caring,” he
said.

Freeland also pledged continued government support for
the training of health care personnel “so that the quality
of life for persons with HIV infection and HIV disease
and their relatives improves.”

He said the Ministry of Health had been notified of 61
HIV-infected persons in the country. Of the 61, 21 had
developed full-blown AIDS and 17 had died, he added.

BAHAMAS

Spread of AIDS Cases in Nassau Prison
‘Alarming’

FL1112161592 Bridgetown CANA in English
1454 GMT 11 Dec 92

[Text] Nassau, Bahamas, Dec 10, CANA—Prisoners in
‘Nassau are being “brutally sodomised” by other inmates
who are infected with the AIDS virus, according to
Attorney General Orville Turnquest.

Turnquest told the House of Assembly this week that the
close and squalid living conditions at Her Majesty’s
prison, and the inadequate number of wardens had
promoted the existence of rampant homosexuality.

Turnquest was speaking on the 1993 capital budget. The
26 million dollar (US) budget will cover only the first 6
months of 1993 because of a proposed change in the
fiscal year.

Turnquest accused the former government, headed by
Sir Lynden Pindling, of allowing the prison to become a

LATIN AMERICA 41

factory for the further criminalisation of law-breakers,
and making it a place where most first-time offenders
become confirmed anti-social activists.

Four of five prisoners share a cell designed to accommo-
date one person because of the problem of overcrowding.

“The former government knew long ago that these
horrible conditions existed at Fox Hill (the prison). Not
only did thy do nothing, but they allowed the conditions
to worsen as they kept packing in prisoners in a place so
reminiscent of the black hole of Calcutta,” Turnquest
said.

“It is not good enough to say that these are circum-
stances which exist in pretty much any penal institution.
That state of affairs at our prison has produced other
dreaded and deadly results - AIDS.”

Turnquest said that the number of AIDS cases at the
prison is “more than alarming.”

As long as current conditions exist, there is no telling by
what percentage the cases are multiplying “as young
inmates are put in blanket rolls and brutally sodomised
by infected persons,” he told Parliament.

He said that the state in which the new government
found the prison is “one of the most damning indict-
ments” of the previous government.

The great number of illegal immigrants awaiting depor-
tation have no place in the prison, he said.

“Not only are they occupying space badly needed for
regular prisoners, but it is wrong and immoral to put
them in a penal institution when they have been con-
victed of no crime in the country,” Turnquest remarked.

He said that the majority of prisoners will now be taught
a trade so that when they are released they will be able to
move meaningfully and usefully into the society.

Through the generosity of the Taiwanese Government,
the Bahamas Government will soon embark on an agri-
culture development programme at the prison, he said.

BERMUDA

Drop in AIDS Cases, Deaths Reported Versus
1991

FL0212002592 Bridgetown CANA in English
2230 GMT 1 Dec 92

[Text] Hamilton, Bermuda, Dec 1, CANA—Bermuda
recorded a drop in the number of AIDS-related deaths in
the first 10 months of the year, as compared with the
corresponding period last year, health officials
announced Tuesday. Between January and October this
year, 14 new cases were reported to the health depart-
ment and there were 17 deaths, compared to 22 new
cases and 23 deaths during the same period in 1991.



SIPRS-TEP-93-008
23 April 1993

steering committee. But this exposed yet another ten-
sion between, as one delegate put it, “different NGOs
claiming that they and they alone represented the
community.”

Unable to mediate the dispute, Mgijima closed the
conference prematurely. Later, he commented that:
“The NGOs are not the only sector who do not have
their house together, we all have to get our houses
together. We have all been caught with our pants down
but have to move.”

“We must democratise health. But democracy can take a
long time and we have to move now. AIDS cannot wait
for a transitional government.”

This last sentiment was echoed by all the public speeches
presented on the first day of the conference. In reality,
however, Nacosa appears to have spawned more of the
very red tape through which it was meant to have cut:
delegates are to report back to their groups; the enlarged
steering committee is to reconvene; the process slouches
forward at a far slower rate than the spread of the
epidemic.

With an estimated 400 HIV infections a day in South
Africa, this is simply not good enough.

AIDS Figures Said To Be Underreported

93WE0108C Johannesburg THE STAR in English
10 Nov 92 p I

[Article by medical reporter: “Country Has Lost Fight
To Prevent AIDS, Says Expert”]

[Text] South Africa has lost the battle to prevent AIDS
and could now only try to control it, AIDS Centre head
Dr. Ruben Sher said yesterday.

Sher was reacting to shocking statistics released at the
weekend by Dr. James McIntyre, of the department of
obstetrics and gynaecology at Baragwanath Hospital, on
the high incidence of AIDS in Soweto. McIntyre said:

¢ At least two HIV-positive women gave birth daily at
Baragwanath.

« About 200 women had been identified as being HIV-
positive in the first eight months of this year.

¢ Figures indicated that about 20,000 Soweto women
could be HIV-positive.

HIV (human immunodeficiency virus) is the precursor
to the deadly disease AIDS (acquired immune deficiency
syndrome).

According to the Department of National Health and
Population Development, very few AIDS cases outside
the heterosexual community were reported during the
last few months—confirming that AIDS has been firmly
established within the heterosexual community for some
time.

AFRICA 5

Sher said education should be targeted at the black
heterosexual community.

About 300 people a day were being infected with HIV, he
added.

Estimate

The high number of cases at Baragwanath has high-
lighted a growing problem of inadequate reporting of
HIV and AIDS cases. The department said 1,517 South
Africans had developed full-blown AIDS since 1982, of
whom 475 had died.

However, indications are that only a few new cases are
being reported as the present reporting system is unable
to cope with the load.

Township AIDS Project director Enea Motaung said it
was difficult to estimate how many cases of HIV and
AIDS there were in Soweto, where the project is based.

“I don’t think people are trying to ignore AIDS,” she
said. “The pattern in South Africa is still very much one
of HIV. We’ve shown people AIDS suffers but haven’t
shown them the symptoms of someone with HIV five, 10
or 15 years down the line.

“I think the other problem is that AIDS and HIV is not
the only problemin our community...it becomes very
difficult to highlight AIDS and HIV when people are
dying because of the violence all the time.”

The Township AIDS Project is the only nongovernment
organization working with AIDS cases in Soweto. Its aim
is to disseminate accurate information.

The high rate of sexuality in schools is another problem
facing the project.

“The fact is that there is no sex education in schools.
You can’t talk about AIDS when you haven’t tackled
sexuality,” Motaung said.

Western Cape AIDS Statistics Reported

93WE0108A Cape Town THE ARGUS in English
6 Oct 92 p 5

[Text] Reported deaths in the Western Cape caused by
AIDS totalled 85 by the end of July.

Medical officer of health, Dr. Michael Popkiss, said
AIDS cases totalled 157 in the same period.

The number of HIV-positive cases reported by August
this year was 1,870, compared to 1,061 in August last
year.



4 AFRICA

SOUTH AFRICA

Events at National AIDS Convention Analyzed

93WE0108D Johannesburg THE WEEKLY MAIL
in English 5 Nov 92 p 23

[Article by Mark Gevisser and Paul Stober: “‘Codesa’
Fails the AIDS Test”)

{Text] In opening Nacosa—the National AIDS Conven-
tion of South Africa—last week, African National Con-
gress president Nelson Mandela emphasised something
never before been said by any South African leader of
any hue: “Nature’s truth is that unless we guide the
youth towards safer sex, the alternative is playing into
the hands of a killer disease.”

Sure enough there was a pause, a tremor of uncertainty,
before he said the word “sex.” But he said it. In the
avuncular, modulated tones of an elderly and respected
statesman, he asked this nation’s moral guardians to
review their censure of teenage sex and move with the
necessity of the times: towards open talk about sex;
towards realism in the face of an epidemic that takes a
condom rather than a cross to ward off.

Coupled with Congress of South African Trade Unions
president John Gomomo’s explicit call for condom-use,
Mandela’s challenge represented a milestone in official
discourse on AIDS.

Nacosa, spearheaded by the ANC’s Department of
Health and the government Department of National
Health, set itself up to be a milestone. For the first time
in this country, all those dealing with AIDS—the non-
government service organisations, the mass-based move-
ments, the state departments—were gathered together
under one roof, pulled together to develop a national
AIDS strategy.

It was dubbed the “AIDS Codesa,” and a Codesa it was
for not only did it bring together previously opposed
organisations and perspectives but, like Codesa, it col-
lapsed. And, as with Codesa, the effect of its collapse was
important, for it exposed the naked fact lurking beneath
the reconciliatory rhetoric, that in AIDS, as in all spheres
of South African life, there are deep fissures that exist
beneath any attempt at unity.

As ANC director of health Ralph Mgijima, who chairs
Nacosa, put it: “Nothing was signed but we are bound by
the spirit of the agreement. It is a challenge to see how we
as a society so divided respond to an outside threat to the
nation.”

Johannesburg municipality AIDS chief Clive Evian was
harsher: “It was a sad day for AIDS work,” he said, “and
it bodes badly for the future. Rather than coming
together, too many people were intent on political point-
scoring. We are still using AIDS to fight the political
battles spawned by apartheid when what we really need
is a new paradigm to counter this epidemic.”

IJPRS-TEP-93-008
23 April 1993

What exactly happened? In its final plenary session
Nacosa had before it a proposal, distilled from hours of
group discussion, calling for the rights of HIV-carriers,
the need for community involvement and multi-sectoral
coordination, and outlining several elements, including
education and training, counselling, health care, welfare
services and research.

But, instead of ratifying or modifying this proposal and
transforming it into a binding document, the conference
degenerated into a no-holds-barred slanging match over
who should serve on the Nacosa steering committee.

This can be explained, to a point, by bad planning on the
part of the organisers. But another reason is that there
were so many tensions lurking beneath the surface that
Nacosa, as a constituted body, simply wasn’t ready to
embark upon a national strategy.

One would have expected the most obvious tension to be
that between the ANC and the government.

In his opening address, after all, Mandela said that “we
do have a problem with the efforts being made by the
South African government,” as these efforts “are viewed
with suspicion and as a ploy to control the population.
This government does not have the credibility to con-
vince the majority of black South Africans to change
their sexual behavior.”

But it appeared, in fact, that there was much agreement
between the two sides. Perhaps a little too much, partic-
ularly on the side of the state, which was clearly looking
for ways to bolster its credibility.

And this, perhaps, was the root of another tension:
annoyance, on the part of many grassroots AIDS mobi-
lisers, at what one delegate called “the ANC’s willingness
to jump into bed with the government, and ANC/
government high-handedness in organising this thing
without consulting the groups on the ground that have
been actually doing the work.”

At an important conference on AIDS in Maputo in 1989,
the still-exiled ANC mandated the internal National
Progressive Primary Health Care Network (PPHC) to
carry out AIDS work. Yet many PPHC officials felt they
had been left out of the loop—as was demonstrated by
the fact that the PPHC was not represented on the
steering committee.

“On the one hand,” commented one delegate, “there was
all this talk about being community-based, but on the
other it was clearly still a top-down initiative.”

The delegate added that “the ANC is being naive about
the state’s commitment. All that will happen is that ANC
ideas and personnel will be absorbed into the impossible
bureaucracy of state structures.”

In the light of this, it was decided that the nongovern-
mental organisations should appoint a member to the



54 NEAR EAST/SOUTH ASIA

“commercial sex workers” (a phrase used by health
authorities for prostitutes) in Calcutta is scheduled to
start soon.

A 52-member National AIDS Committee chaired by the
Union health minister, Mr. M.L. Fotedar, has been set
up to assist the National AIDS Control Board and advise
it on policy matters, including multi-sectoral collabora-
tion. Its members include Mr. Khushwant Singh, Ms.
Shabana Azmi, Dr. Raj Bothra (NRI of USA), Ms.
Rakhee Sarkar, Mr. Nikhil Chakravarti, Ms. Bachi
Karkaria, Dr. V. Ramalingaswami, Mr. Baby John and
representatives of various ministries, including railways
and defence. Ms. Nalini Singh, TV film-maker, has been
entrusted with the task of developing a script for a
tele-film on HIV and AIDS.

More Cases in Calcutta

93WEO140B Calcutta THE TELEGRAPH in English
23 Nov 92 p1

[Text] Calcutta Nov. 22: Two more AIDS cases were
detected in the city recently, according to sources in the
state health department. The preliminary Elisa test
revealed the presence of the AIDS antibody in the blood
samples of two men.

The Western Blot test of the two samples has also been
carried out and though the health department has not yet
received the final report, the sources said there were
indications that the test has proved positive.

One of the men is a young engineer whom the sources
described as “promiscuous” while the other is a
puchkawallah who frequents a redlight area in central
Calcutta.

Once the two cases are confirmed later this week, the
total number of AIDS-infected persons in the city and its
suburbs detected so far will rise to 52. The health
department sources emphasised that the number of cases
recorded in the city till now is 50 and not 52 as
erroneously stated earlier.

Meanwhile, the health department and government
institutions involved in the AIDS control programme are
preparing a report for the British experts who are to
arrive here later this week from the UK’s Overseas
Development Agency (ODA).

The ODA is to be requested to help fund the AIDS
awareness campaign that has been launched in various
parts of West Bengal, specially in redlight areas. The
report will detail the assistance the government is
already receiving from the World Bank and the World
Health Organisation and the ODA will be asked to
provide help in areas not covered by these two agencies.

The British organisation, though, does not plan to pro-
vide much of its help to the government. The major part
of its aid is likely to be given to the non-governmental
organizations which are involved in the AIDS control
programme in the city.

SJPRS-TEP-93-008
23 April 1993

The British experts are to meet the representatives of
several of these organisations such as the Calcutta
Samaritans, the Child in Need Institute, the West Bengal
Voluntary Health Association, the Society for Commu-
nity Development and the Vivekananda Education
Society. The organisations are also preparing plans to be
submitted to the British experts.

In addition, the British team will meet doctors and
representatives of the organisations working in the city’s
brothels and running the first clinic for sexually trans-
mitted diseases in the Sonagachhi area. A similar clinic is
planned to be opened in the Kalighat redlight area on
December 1.

According to the sources, some of the voluntary organi-
zations held a preliminary discussion with an ODA team
some months ago in New Delhi. The team had sought
more information about these groups.

More Developments in the Fight Against AIDS

AIDS Control Panel Formed

93WE0304A Calcutta THE STATESMAN in English
15 Feb 93 p 12

[Article: “National AIDS Committee To Review Latest
Situation”; boldface words as published]

[Text] With 290 full-blown AIDS cases in India a decade
after the first case was reported in America, the country’s
health authorities are worried. The battle against AIDS in
India brooks no delay.

New Delhi, Feb. 14—There are 290 full-blown cases of
AIDS in India a decade after the first case was reported
in the U.S.A. in 1981 and the health authorities are
worried over the rising trend of the incurable HIV
infection, reports PTI.

Data till January 31 show a cumulative total of Western
Blot positive cases of 11,406 in the 15,97,207 samples
screened, mostly from persons practising high-risk
behaviour over a 70-year period beginning October,
1985. This figure represents a sero-positivity rate of 7.14
a thousand.

The cumulative total of AIDS cases for the period is 290,
comprising 276 Indians and 14 foreigners. Heterosexual
promiscuity caused a majority of the infections, except
in the North-East, where intravenous drug use was the
cause.

As a Rs [Rupees] 223-crore World Bank-aided AIDS
control project completes 6 months of implementation
in the country, a high-power national AIDS committee
will take stock of the latest situation at its first meeting in
the capital tomorrow.

The project, launched in September 1992, is being
funded by World Bank assistance through a soft loan of
$84 million and also technical assistance from the World
Health Organization [WHO].


JPRS-TEP-93-008
23 April 1993

In charge: the Republic Health Protection Institute.

Examinations will be held and expert epidemiological
supervision will be provided by the health establish-
ments in all areas on the implementation of the stipu-
lated measures for containing and preventing the
spreading of communicable diseases. Records will be
supplied to the Republic Health Inspector and the
Republic inspectors in charge of the specific units and
the directors of health establishments.

The Republic Health Protection Institute will organize,
coordinate, and directly participate in providing expert
methodological assistance, and implementing the
requirements related to laboratory activities, treatment,
hospitalization, health education, and other efforts
aimed at fighting AIDS, in accordance with the achieve-
ments and practical experience acquired throughout the
world and the recommendations of the WHO. In this
connection, prompt information will be made available,
in addition to expert instructions and active participa-
tion in the work of the Republic AIDS Commission. It
will engage in regular expert cooperation and exchange
of expert and scientific knowledge and achievements
with all interested and responsible institutions and coop-
erate with the information media.

4, Activities of the Communicable Diseases and Febrile
Conditions Clinic of the Skopje School of Medicine

The Communicable Diseases and Febrile Conditions
Clinic in Skopje will provide serological studies on the
spreading of HIV virus antibodies among populations
with higher AIDS risk.

Individuals in the risk groups and those suspected of
being infected with AIDS will be clinically tested; all
individuals belonging to said group will undergo immu-
noenzyme testing. Health workers will be instructed,
informed, and given expert training.

According to their immunological status, patients suf-
fering from individual infections and individuals
belonging to the risk groups will be subject to additional
immunological-enzyme tests involving the use of other
enzyme markers.

In charge: Communicable Diseases and Febrile Condi-
tions Clinic.

Individuals who are confirmed carriers of the HIV virus
will be subject to confirmation tests to confirm the
diagnosis of AIDS.

Qualifications for and use of the Western blot test
method will be determined.

The Communicable Diseases and Febrile Conditions
Clinic will become qualified for the hospitalization,
diagnosis, and treatment of AIDS patients.

Further facilities will be installed and premises will be
organized for the hospitalization and treatment of the
sick.

EAST EUROPE 37

Further training of the medical cadres (physicians,
nurses, laboratory workers) will be provided by assigning
them to clinics and laboratories at home and abroad, and
for attending various seminars, symposia, and con-
gresses at which contemporary knowledge on AIDS
problems both at home and abroad will be shared.

In charge: Communicable Diseases and Febrile Condi-
tions Clinic.

The clinic will train counselors for work with patients in
the risk groups and other individuals who request an
examination, testing, and information concerning dis-
eases, in order to ensure their prevention. The clinic will
keep a diary and set up files for this purpose.

5. Activities of Stomatological Clinics of the Skopje
Stomatological Department

The Stomatological Clinics of the Stomatological
Department will carry out the following program
activities:

Provide expert supervision and expert medical assis-
tance to the stomatological services in the medical cen-
ters and health homes in the Republic. The purpose will
be to make health workers in stomatological activities
better familiar with the nature and means of preventing
the infection of patients and health workers, as well as
with means of disinfecting the equipment and instru-
ments used in ordinary stomatological practices. Fur-
thermore, they will be encouraged to procure the most
necessary equipment, instruments, and means of protec-
tion. All this is based on the view that dental help in the
Republic is sought annually by about 2,250,000 people, a
large number of whom bleed and are exposed to the risk
of AIDS infection.

In charge: the stomatological clinics.

Expert assistance will be provided to the stomatological
services of health institutions in formulating plans for
preventing the spreading of AIDS and in the activities of
dental services in health establishments.

In charge: the stomatological clinics.

Additional and updated expert instruction will be super-
vised, for protection from AIDS, provided by the stoma-
tological clinics and supplied in adequate amounts to all
stomatological services in the Republic. New instruc-
tions will be drafted as well.

In charge: the stomatological clinics.

Consultations for the health personnel engaged in sto-
matological activities will be provided on a regional
basis, informing them of the latest practices in the
prevention of such diseases, as practiced in other centers
in Yugoslavia and Europe. Such consultations will be
provided by expert personnel of the stomatological
clinics (4).



8 WEST EUROPE

Search Launched for Transfusion Patients

93WE0241A Paris LE FIGARO in French
3 Feb 93 p 12

[Article by Dr. Catherine Petitnicolas: “AIDS: On the
Trail of Transfused Persons”)

[Text] A gigantic search launched.

From 3,000 to 6,000 persons were reportedly infected
between 1980 and 1985. Some of them have probably
died, while many, HIV-positive without knowing it, could
spread the disease.

Public Assistance [PA] of Paris, the largest health care
group in Europe, has launched a search for persons who
received transfusions in the 1980's in order to find and
warn anyone who may have been infected with the AIDS
virus between 1980 and 1985. It is a long-range task that
will require the establishment of an emergency infra-
structure and substantial funds.

It is estimated that between 3,000 and 6,000 patients
were infected via transfusions during that period, a time
when the virus was spreading insidiously among the
population and before testing (which began on 1 August
1985) eliminated potentially dangerous blood donors.’
According to the Ministry of Health, half of these
infected persons are reportedly unaware that they are
HIV-positive and could continue to spread the disease to
sexual partners or, in the case of pregnant women, to
children.

In a circular dated 15 December, Bernard Kouchner,
minister of health and humanitarian action, asked all
clinics (public and private) to “take all necessary steps to
identify patients who received transfusions between
1980 and 1985 and urge their attending physicians to
propose that such patients be tested for AIDS.” Only
recently, in order to gain time, it urged all such patients
to have themselves tested without awaiting notification
from their hospitals.

For its part, Public Assistance, aware of what is at stake
and the risk, decided to move into action and set up
emergency procedures in hospitals providing short-term
care. Persons who received blood transfusions are being
identified from transfusion center records which should
contain their names and addresses and will in the coming
weeks receive a letter urging them to be tested for AIDS.
Such testing should be prescribed by the attending phy-
sician, as recommended by the ministerial circular, or
the hospital where they received treatment.

In Files

The letter will contain a telephone number either for the
original hospital department which could help them or
for an office specially set up to facilitate the search and
handle persons who turn out to be HIV-positive.

In order to speed up the search (some specialists estimate
that at the current rate it will take more than 10 years),

IPRS-TEP-93-008
23 April 1993

Public Assistance (AP) officials have decided to set up a
highly sophisticated system of logistics and hire tempo-
rary workers to collate data collected from the thousands
of persons transfused. However, this process will not in
itself solve all problems because many persons have
changed addresses since 1980, in which case it may be
possible to find them by going through PA files if they
have been subsequently admitted to other public clinics
in Paris. Another difficulty: Transfusion records some-
times show names but no addresses. In such cases, it will
be necessary to scan hospital files, no small matter unless
they are computerized. However, how many “hard” files
stacked in basement record rooms will still be usable?

In some cases, letters will arrive too late, after the
patient’s death, sometimes from AIDS. In order to avoid
such incidents, which could understandably come as a
shock, letters will be sent directly to the department head
who sees the patient regularly and will know whether he
or she is still alive. Such is not always the case, however.
Victims of traffic accidents seen at other clinics will not
be as well known as heart patients, for example, who
would generally be seen at a single clinic.

Finally, every hospital must be able to supply informa-
tion to patients who, in order to receive compensation,
must provide proof of a link between the transfusion and
infection. This will not always be easy because many files
are far from complete.

In the future, in order to avoid such problems, which will
unquestionably result in much litigation, the French
Blood Bank and other institutions are relying on the
establishment of a system to monitor blood products
that will ascertain quickly and without any possible
challenge the origin of a donation contaminated by
AIDS or hepatitis.

Footnote

1. Since that date, there have reportedly been from five
to 58 potentially dangerous donations because of a
dormant period during the early weeks when, despite
progress in testing, an infected donor cannot be detected.

Developments in Trial of AIDS Scandal Ministers

Socialists Block Trial

AUI712132892 Paris AFP in English 1307 GMT
17 Dec 92

[Excerpts] Paris, Dec 17 (AFP)—In a sudden change of
heart, French socialists late Wednesday blocked the trial
by parliament of two former ministers in France’s AIDS
scandal, and the consensus Thursday was that the gov-
erning party had shot itself in the foot.

Criticism from both friend and foe focused on Laurent
Fabius, the Socialist Party boss who was prime minister
when state-run transfusion centers knowingly distrib-
uted AIDS-tainted blood to patients between 1981 and
1985.


IPRS-TEP-93-008
23 April 1993

AIDS Among Trat Drug Addicts

93WE0088B Bangkok DAO SIAM in Thai
28 Oct 92 pp 11, 15

[Text] Lieutenant Khunthong Suttiphan, a Trat Prov-
ince public health doctor, disclosed that as part of the
Trat Province project to prevent and control AIDS in
the province for the 1992 budget year, the province
had been using every means to keep AIDS from
spreading further.

This project received the cooperation of Trat Province
officials. Mr Amon Anantachai, the Governor of Trat
Province, held a meeting of the owners of brothels in
the province on 12 June 1992 in order to ask the
owners to recommend to their customers that they use
condoms 100 percent of the time and to provide
condoms in the various brothels. The results of surveys
done up to the end of July 1992 indicated that only
76.23 percent of the customers in brothels used con-
doms. This indicated that condom use was not
accepted as much as it should.

The public health doctor also said that in addition to
fighting for 100 percent condom usage, the Office of
Public Health was also fighting for health education for
people in every profession so that they would know
about AIDS and how to prevent it. From the results of
tracking the disease every 6 months, it was found that
the spread of AIDS was increasing in Trat Province
especially among intraveous drug users. The statistics
from December 1991 to June 1992 indicated that
56.52 percent of this group had the AIDS virus. The
survey of female prostitutes taken in December 1991
found that 31.20 percent had the AIDS virus while in
June 1992 the incidence had increased to 40.27 per-
cent. After the numbers of those with AIDS were
published, Trat Province officials could not be uncon-
cerned. They will review their plans to prevent and
control AIDS in order to make them more effective.

70 Percent of Sex Workers in Chiang Rai
HIV-Positive

BK1604022193 Bangkok BANGKOK POST in English
16 Apr 93 p 3

[Excerpts] AIDS is spreading fast among prostitutes in
Chiang Rai Province, according to a survey that has
revealed that 70 percent, or seven out of every ten
prostitutes, have the HIV virus, the precursor of AIDS.

Medical tests conducted by researchers from the Ratch-
aphat Institute of Chiang Rai and the provincial public
health authority on prostitutes in this province indicated
that 70 percent of all sex workers are HIV-positive.

The survey also found that young village girls who finish
the compulsory education level of Pathom Suksa 6 prefer
to become prostitutes than pursue low paying but
respectable jobs.

EAST ASIA 25

Between 70-80 per cent of village girls leave school after
completing their compulsory education. The rate is as
high as 100 percent in some villages.

The practice of becoming a sex worker has long become
a local social value because young girls do not like to
work hard and have been taught for generations that
prostitution can help them make big money and save
their family from the hardships of poverty.

The survey was conducted under the Project for Promo-
tion of the Quality of Life for Rural Girls in Chiang Rai
Province by a team headed by Assistant Professor
Suthep Phongsiwat and Achan Witthaya Wannasiri.
[passage omitted on economic reasons for village girls
become to prostitutes}

The team of researchers comprising lecturers from the
Ratchaphat Institute of Chiang Rai, was helped by the
provincial public health authority to conduct medical
tests on prostitutes at all brothels in the province.

These tests revealed that 70 percent or seven out of ten
prostitutes were HIV carriers.

Northern Province Expects 22,000 AIDS Cases in
1993

BK1512035092 Bangkok BANGKOK POST in English
15 Dec 92 p 6

[Text] Chiang Rai will have about 22,000 full-blown
AIDS patients next year out of the province’s total
population of one million people, Deputy Public Health
Minister Dr Udomsin Sisaengnam said yesterday.

Dr Udomsin said that while waiting for a cure for the
fatal disease or vaccine to prevent it, legal bodies should
be firm in trying to solve this problem. He said the Prime
Minister had earlier stated that one of the main policies
is to completely abolish child prostitution, but “by
shutting down brothels, they’re making matters worse.”

The deputy minister, also a Phalang Tham [PDP] MP for
Bangkok, said it is a known fact that some police officers
shut down brothels on one day, and then ask for a
donation from the owners to allow the brothels to reopen
a little while later.

Dr Udomsin, after his inspection visit to Chiang Mai
and Chiang Rai provinces over the weekend, said he
was shocked to see the number of HIV-infected people
in hospitals. He said by next year, 15 percent of the
province’s population would carry the virus in its
initial stage.

“This year alone, over 200 patients died in Chiang Rai’s
Pracharak Hospital of AIDS-related diseases and about
the same number of babies born in this hospital have
tested HIV positive,” he said. The deputy minister said
of the 400 hospital beds in Pracharak Hospital, one of
the biggest hospitals in the province, 30 beds are occu-
pied by AIDS patients.



a LATIN AMERICA

Statistics released by the health department—coinciding
with the fifth annual World AIDS Day—showed that the
killer disease has claimed 175 lives here since Bermuda’s
first Acquired Immune Deficiency Syndrome-related
death was recorded 10 years ago. As of October 31, a
total of 213 AIDS cases had been reported locally,
officials said. They said most of the 213 involved people
[were] in the 20-49 age group. One case was reported in
the one-to-four age group, while eight involved people
aged 60 or above.

Males and intravenous drug users still make up the
largest group of reported cases, with males accounting
for 78.9 percent of the total, but officials said the
percentage of cases involving drug users had declined to
49.3 percent, or 105 cases. Homosexual/bisexual men
accounted for 58 cases, the officials added.

Premier Sir John Swan officially endorsed World AIDS
Day at lunch time today when he read the World AIDS.
Day proclamation. A large memorial quilt made up of
patches of messages sewn together by those who have lost
loved ones to AIDS, was also on display.

An opera concert was to be held Tuesday night to raise
funds for an AIDS education fund started by one of the
island’s Rotary clubs, and other events have been sched-
uled here this week to focus on AIDS.

BRAZIL

Life Style of Ex-Febem AIDS-Infected Residents

93WE0333A Sao Paulo ISTOE in Portuguese 13 Jan 93
bp 28-32

[Feature article by Valeria Franca with Antonio Carlos
Prado]

[Text] Hell has three gateways right in the middle of Sao
Paulo: a big house at 153 Rua Bueno de Andrade, a
boardinghouse at 424 Rua Doutor Tomaz de Lima, and
a hotel at Number 612 on that same street. Those who
enter those hells have already left all hope behind, on the
outside of life. These are minors who spend the day
stealing, very often to give the money to the despicable
adults who shelter them, sniff crack, and engage freely in
sex. But this hell is situated at an even lower level: almost
everyone has AIDS. Even lower is the hell they came
from: FEBEM [State Child Welfare Foundation]. In
1988, that institution tested all its inmates for the AIDS
virus: 480 were found to be infected, but only 48
received medical followup. ISTOE gained access to the
files on the tests and, using the record cards, reveals in
this exclusive story what happened to some of those
AIDS-infected kids, now that they have come of age.
Some have married and have children. Others are in
prison and still awaiting treatment. Many died of the
virus or when pursued by the police. And then there are
those living in filthy hovels in downtown Sao Paulo,
leading groups of young criminals who are also infected
with AIDS. Our story of this hell begins here.

SJPRS-TEP-93-008
23 April 1993

“T and all those boys over in that big house have AIDS,”
said Rosana Cruz, 21, who was tested for AIDS at
FEBEM in 1988 and whose name appears in the file
obtained by ISTOE. (Rosana would not let herself be
photographed). The big house she referred to is at 153
Rua Bueno de Andrade in the center of Sao Paulo. Until
28 December, when they were evicted and had to split up
between a boardinghouse and a hotel on Rua Doutor
Tomaz de Lima, about 20 adolescents lived there with
Rosana. “There are some who deny they are infected,
but I know everyone has AIDS. We are all addicts here,”
Rosana said. “She is the one with AIDS, I do not have
it,” retorted Edson Barbosa, 16. “But inside FEBEM,
there are a lot of AIDS victims who are not getting
medical treatment. You have to be in pretty bad shape to
go to the hospital,” he said.

Boyfriend of one of the girls at the big house, Edson
admits he regularly engaged in sex while at FEBEM.
“There are lots of woods there and no one sees you. One
girl was raped by 10 guys. After that, she started wanting
to have sex with everyone in there. We knew she had
AIDS, so I kept away from her,” he recounted. At the
end of 1991, Edson asked permission from FEBEM to
spend Christmas at home. He got it, but never went back.
Now he lives at the boardinghouse at Rua Doutor Tomaz
de Lima. “Before my latest departure, I had already been
in and out of FEBEM about 13 times,” he said. “I have
already lost track of how many times I ended up there,”
Rosana said. She figures she got AIDS by using intrave-
nous drugs, and she found out about her health status
when she was 16, while at FEBEM. Rosana began taking
“back” [preceding word in English} (cocaine diluted with
water and injected into a vein) at the age of 11. “I
learned to use drugs from my uncles. People called them
the Gold-Dust Twins. They were bandits, too. One was
killed by the police and the other ended up getting run
over by a car. I was raised in a violent environment, and
people like us die by their own hands,” she said.

“When they’re not crazy with crack (rocks of cocaine),
they talk to me a lot. Deep inside, I think most of them
are good-hearted,” explains Sonia da Silva, 45, who lived
for a while in the garage of the Bueno de Andrade house.
“But I never knew they had AIDS,” she said, in surprise.
Unemployed and homeless, Sonia was living on the
streets. A 16-year old boy, known among the kids as
“Honey-pot” [Camburao] because he is tall and husky
(no one would reveal his real name) was the one who
decided to help Sonia. Doing as much as a delinquent
could do to help someone in misery, Camburao took her
to the garage at the big house.

Who is this Camburao who inspires respect among
wayward boys and residents of the tenements in the
area? He is a young man who made his own rules for the
violent game that is his life. Camburao picked out a
boardinghouse. He forcibly evicted its residents. He then
brought in some juveniles, some with AIDS and some
not, whom he came to know at FEBEM—and who, like
him, are AWOL from the institution. There was a time
when Camburao had as many as three boardinghouses



24 EAST ASIA

their wives. When women were asked for their opinion
of the behavior of their husbands, most thought that this
was normal.

As for the number of female prostitutes in Thailand Dr.
Praphan said that at present there was a total of about
200,000. Of these 50,000 had acquired the AIDS virus.
Since these prostitutes serviced about four customers a
night, about 1,000 persons per night were acquiring
AIDS (based on statistics that on having sex 100 times
there would be one chance of acquiring the AIDS virus
and that half of those using prostitutes used condums). If
these figures were calculated for a year, the result would
be about 300,000 with AIDS. This would not include the
present number for those with AIDS of about 400,000.
Therefore it was thought that at the end of this year there
would be a total of about 700,000 people with AIDS in
Thailand.

Further Report

93WE0088D Bangkok MATICHON in Thai
23 Oct 92 p 14

[Text] A report from the project to prevent and control
AIDS of the Duangprathip Foundation disclosed the
results of its research into “the spread of the AIDS virus
among people in crowded areas” which was recently
completed. It stated that the rate of spread among people
in slums was very high especially among young people
and that this spread needed urgently to be stopped before
it was too late.

This research report was the result of studying three
target groups of people living in crowded conditions in
Khlong Toei, namely: drug addicts, prostitutes, and
those driving motor bikes for hire.

The report stated that the group using drugs in the
crowded conditions of Khlong Toei was the group whose
behavior put them at greatest risk of contracting the
AIDS virus. Blood tests of 170 drug addicts indicated
that 60 percent of them had the virus, and drug addicts
under the age of 20 had the highest incidence of infection
when compared with drug addicts in other age groups.
Among this group four out of five had the AIDS virus.

The report pointed out that young drug addicts had
insufficient income to buy the equipment to inject
themselves and so shared needles. In addition the
childrem among this group were young and strong and so
were not concerned about death and not interested in
Protecting themselves against the AIDS virus.

As for female prostitutes it was found that prostitutes
aged between 20 and 24 had the highest incidence of
AIDS: 35 percent. Next were those aged between 15 and
19, who had an incidence of 23 percent. Those aged
between 25 and 29 had an incidence of 13 percent. No
prostitutes older than 29 were found to have it.

SJPRS-TEP-93-008
23 April 1993

The report stated that of 72 prostitutes in the target
group, 95 percent knew that having sex without a
condom could cause AIDS, but 68 percent thought
incorrectly that mosquitos also could cause AIDS.

As for the behavior of the customers, 85 percent of the 72
female prostitutes said that they urged their customers to
use condoms, but only 15 percent of the customers
agreed to do as they were urged. When the customers
refused to use the condom, the prostitutes followed the
wishes of the customers because they wanted the money.

Among motorbike drivers, whose behavior put them at
great risk of contracting AIDS because they generally
went to brothels and did not use condoms, it was found
that 91 percent did not use condoms when they visited a
brothel and 71 percent visited brothels regularly, espe-
cially those who were married.

Of this group 56 percent said that using a condom was
annoying and caused them to feel less masculine.

At the end of the research report, the researchers con-
cluded that the problem of AIDS was serious and that
the rate of spread would be high among those with a low
educational level who lived in poverty. Based on their
research they made the observation that the rate of
spread of the AIDS virus was apt to be high among young,
people, and therefore what the government should do
was to promote educating children about AIDS before
they reached adolescence. The government should also
work urgently to improve the standing of the country by
raising the economic level of the people and releasing
them from the viscious circle of poverty.

The report also pointed out that the rate of spread of the
AIDS virus in Thailand was very rapid and so it was a
world problem in which everyone should be interested -
in the past 4 years it was estimated that the same number
of people contracted AIDS here as in the United States
which has been struggling with AIDS for 10 years and
has four times the population of Thailand. The rate of
spread of AIDS in Thailand was very high compared
with any other country in the world.

The researchers from the Duangprathip Foundation
made the observation that AIDS had spread rapidly in
Thailand as a result of certain factors which had facili-
tated the spread including both Thailand’s being a center
for the illegal drug trade and the illegal sex trade.

The researchers observed that a real effort to take care of
the AIDS problem had been avoided because of the fear
that if information of the spread of AIDS were dissem-
inated widely, it would affect foreign investment and
destroy the tourist industry at a time when the Thai
economy was expanding.



IJPRS-TEP-93-008
23 April 1993

Had there been a better turnout, the MLAs, especially
from the districts where hardly anything has been done
yet to build an awareness of the dreaded disease, would
have been able to return to their constituencies,
equipped with some knowledge about how the AIDS
virus spreads. An elected leader has as much a role to
play in the dissemination of facts as have government
officials, social workers and the media, a speaker at the
seminar pointed out.

That the meet proved useful can be gauged from the
responses to a questionnaire distributed to the legisla-
tors. Dr G.P. Dutta, MLA and chairman of the House’s
subject committee on health and family welfare, who was
one of the main organisers of the seminar, said that as
much as “76.2 percent of those who had responded did
not know much about AIDS, and 9.2 percent had no
idea.” But all agreed that a proper movement would help
prevent the spread of the virus.

“What happens if a client refuses to use a condom?” the
Speaker asked.

Summing up the proceedings, he said AIDS was a social
disease, the education and information of which must be
known to all in villages, in schools and in colleges. There
is danger if there is an attitude of shame in such matters,
for AIDS has become a fact of life and prevention is the
only way to check its spread.

West Bengal Battles Against AIDS

93WE0164 Bombay THE TIMES OF INDIA
in English 2 Dec 92 p 23

[Article by Sudhin Dey]

[Text] Calcutta, December 1—In West Bengal, there are
now currently 56 cases of HIV infection and nine AIDS
cases. Of the nine AIDS cases, four have died. Yet
another AIDS case detected by the virology department
of the School of Tropical Medicines has gone back to
Jamshedpur.

Meanwhile, the West Bengal government has prepared a
5-year AIDS prevention project which is to be imple-
mented with World Bank assistance. The state govern-
ment’s Rs 50-crore project has been sent to the Centre
for its approval. The project is to take off next year.

According to Dr Manish Sekhar Chakraborty, head of
the virology department of the government of West
Bengal, of the 56 cases of HIV positive cases in the state,
nine were AIDS patients, seven were haemophiliacs,
four foreign students, four were promiscuous persons,
five sexually-transmitted disease patients, seven prosti-
tutes, two pimps and the rest were voluntary blood
donors.

He said that a little over 80 percent of the AIDS cases
were sexually transmitted, ten to 12 percent through the
use of infected needles by drug users, two to three

NEAR EAST/SOUTH ASIA 61

percent due to blood transfusion and about one percent
from infected mother to child through breast-feeding.

Since there is always a chronic shortage of blood
required for medical treatment, the government does not
want to give too much publicity as the blood donors
might become panicky and few would come forward to
donate blood.

AS a preventive measure, the government has introduced
the Elisa test in most of the blood banks in Calcutta and
in some of the district blood banks for checking AIDS
virus in each of the donor’s blood samples. Those found
positive in the Elisa test are rejected. The particular
donor and the members of his family are then given the
bad news and counselled how to stop the spread of the
deadly disease to others.

There are at present 31 blood banks, including six
government and 25 private ones, in Calcutta. Of these,
27 have the necessary arrangements for Elisa test while
four private blood banks propose to have them by
January. The two district hospitals in Howrah and South
24 Parganas also have blood banks.

The state’s health secretary, Ms Leena Chakraborty, said
that apart from Calcutta, other vulnerable areas of the
state, like the Calcutta and Haldia ports, Siliguri and
Asansol were receiving the state government’s attention
in combating the spread of the deadly disease for which
no cure had yet been invented.

Elisa test arrangements would soon be made at the blood
bank at the North Bengal Medical College Hospital in
Siliguri as the town is the gateway to the entire north-east
India. There is a large volume of traffic through Siliguri
from the north-eastern states, many of which have now a
good number of AIDS patients because of the prevalance
of drug abuse. Similarly, since sailors from foreign
countries come to Calcutta and Haldia ports, the gov-
ernment’s attention has been drawn to these areas also.

Asked if the government could take any penal measure
against any blood bank for not carrying out the Elisa test,
Ms Chakraborty replied that till now there was no law to
compel them to carry out such a test. But the controller
of drugs, who issues licences to blood banks, could
always cancel such licences in the event of refusal by a
blood bank to perform such a vital test. The West Bengal
government had already requested the Centre to bring in
suitable legislation for compulsory Elisa test for detec-
tion of AIDS virus in all blood samples.

Ms Chakraborty said since the theme of this year’s
“World AIDS Day’ was “AIDS—a community commit-
ment,” the government had decided to start an intensive
campaign and inform the general public about AIDS,
dispelling the myths, educating the people involved in
high-risk behaviours, like drug users and prostitutes and
training medical and para-medical health personnel
about handling of AIDS patients. The government pro-
poses to provide assistance to the voluntary organiza-
tion, which is running a sexually-transmitted diseases



IPRS-TEP-93-008
23 April 1993

REGIONAL AFFAIRS

AIDS in Burundi, Rwanda

93WE0231A Paris LE MONDE in French
12-18 Oct 92 p 13

[Article by Christiane Chombeau: “The AIDS Genera-
tion”; first paragraph is LE MONDE introduction]

[Text] AIDS is devastating Burundi and Rwanda, espe-
cially in the cities, where 30 percent of the population is
estimated to be seropositive. Serge Moati filmed the
splintered families and abandoned children.

Legend has it that Rwanda and Burundi, the lands of
10,000 hills, were the paradise from which Adam and
Eve were driven. Rwanda and Burundi are two tiny
African states that are torn by conflict and flattened by
AIDS. Thirty percent of the population living in the
cities is thought to be seropositive. The countryside, long
spared, is now quickly succumbing as well, infected
through war-driven population movements (refugees,
troops, demobilized soldiers) or, more commonly, the
big transportation routes (railroads, highways) that bring
food, goods, but also disease.

“Special Correspondent’s” report on AIDS orphans
begins with a visit to the Bujumbura cemetary. Some-
times as many as 10 people a day are buried there, most
of them victims of the virus. The dates inscribed on the
crosses speak for themselves. The first are grouped in the
sixties. The others relentlessly repeat 1991 and, even
more often, 1992—watershed years for the illness. 1960-
1992: 32 years old; 1965-1992: 27 years old; 1954-1992:
38 years old. The epidemic is striking people in their
prime working years. An entire generation—of reproduc-
tive age and the movers and shakers of the country’s
economic life—seems slated to disappear.

Defeated families are splintering and orphanages cannot
keep up with the demand. Children who have not been
able to find a grandmother or uncle to take them in swell
the ranks of street urchins looking for a scrap of food. In
the countryside they survive through a tradition of
solidarity that is being strained by the growing poverty.
Alone, vulnerable, and starved, they become easy prey
for unscrupulous adults. “I can’t help feeling sad. I have
too many problems,” says one of them. “I don’t see any
way out. I constantly wonder what is going to happen to
me tomorrow.” He is afraid of the other children who are
always ready to steal what someone else has gotten. And
he is afraid of adults who “want me to do ugly things...
don’t see any future.”

A future! The future depends on preventing the disease,
which itself hinges on condom use. But in Africa the
practice runs up against a strong reluctance that is even
deeper than that in Europe, a reluctance fed by the
wildest rumors, The West, for instance, is suspected of
having incorporated the virus into condoms to extermi-
nate Africans!

AFRICA 1

The public stand of the bishop of Kigali (80 percent of
Rwanda’s population is Catholic) does not help matters
either. The bishop sees the epidemic as God’s punish-
ment for a dissolute society, argues for chastity and
fidelity, and casts doubt on the effectiveness of condoms.
Fortunately other Catholics—including those in reli-
gious orders—who are confronted daily with the damage
are more open-minded.

Non-government and international organizations,
including UNICEF, are offering assistance to the states
of Burundi and Rwanda, whose exhausted budgets have
long been unable to keep pace with needs. (The cost of
AZT treatment is 6,000 dollars a year per person, while
the average amount spent on health by African states
ranges between 8 and 50 dollars a year per inhabitant).

The testimony of prostitutes shows the limits of their
efforts. ‘It’s the men who refuse to use rubbers... Have
you watched your child cry from hunger? At moments
like that, you agree to anything. Even if you know you
are commiting suicide,” says one of them. “What differ-
ence does it make whether you die of hunger or AIDS?”
adds another.

Poverty, disease, and the impossibility of imagining a
better future drive men and women to a fatalism that
leaves them vulnerable. A growing stream of exhausted
victims are winding up in hospitals. Two and sometimes
even three people share one bed. Children come with
them. They sleep on the floor and wait for death to carry
off their father or mother, while the doctors look on
helplessly.

ANGOLA
AIDS Situation in Country Examined

Awareness Program

93WE0135A Luanda JORNAL DE ANGOLA
in Portuguese 25 Nov 92 p &

[Text] More than 500 cases of AIDS were reported
during the first half of 1992, it was reported in state-
ments to the press by the promoters of “Kitanda
Against AIDS,” which is taking place in Luanda from
24 November to 1 December. According to the source,
about 10,000 people are infected with the HIV and 10
cases a month are admitted to the Josina Machel
Hospital.

Cabinda and Luanda Provinces are among the most
severely affected. The source added that the AIDS
cases recorded in the border provinces are related to
[their proximity to] such countries as Zaire, the Congo,
and Zambia, which have the largest number of cases in
Africa.

“Kitanda Against AIDS” is promoted by the Angolan
Association for the Struggle Against AIDS (AALSIDA)
and the “Crusade of the Century.” The purpose of



JPRS-TEP-93-008
23 April 1993

LAOS

Anti-AIDS Committee Receives Fund From UK
Embassy

BK0204120893 Vientiane Vitthayou Hengsat Radio
Network in Lao 1200 GMT 1 Apr 93

[Text] On the morning of | April at the Institute of
Parasite Epidemiology, Ms (Rosalind Craig), third sec-
retary to the British ambassador, whose embassy office is
situated in Bangkok, Thailand, handed over a sum of
U.S. $6,938 to the National-Level Anti-AIDS Com-
mittee [NAAC] through Dr. Som-ob Kitsada, deputy
chief of the office of the Public Health Ministry in charge
of foreign relations activities.

The ceremony was held in the presence of [name indis-
tinct], representative of the Care Australia Organization;
Sithat Insisiangmai, director of the Institute of Parasite
Epidemiology and secretary of the NAAC; and a number
of officials concerned.

The fund will be spent on various activities for the
prevention and control of AIDS with emphasis on orga-
nizing seminars and sightseeing tours, and producing
anti-AIDS pamphlets and posters in five targeted prov-
inces in 1993. They are the Provinces of Sayaboury,
Luang Prabang, Bolikhamsai, Khammouane, and Cham-
passak. Only Champassak Province has obtained a
financial subsidy for the aforementioned purposes.

In the last half of 1992, the NAAC launched anti-AIDS
activities in the five Provinces of Phong Saly, Luang
Namtha, Bokeo, Vientiane, and Savannakhet. For the
future, the NAAC plans to carry out similar activities
against the deadly disease in the remaining provinces
throughout the country.

MALAYSIA

Number of HIV Carriers Expected To Reach
32,000 by 1995

BK0312135392 Kuala Lumpur BERITA HARIAN
in Malay 30 Nov 92 p 6

[Excerpts] Kuala Lumpur, Sunday—The number of HIV
carriers in the country is expected to reach 32,000 by
1995, Health Minister Datuk Lee Kim Sai said.

He was worried that it would be difficult to check the
number of AIDS and HIV cases without education and
information to warn the public about the AIDS danger.

He said that a survey by the ministry showed that there
had been 4,347 HIV carriers in the country as of last
October and the number would increase at a faster rate if
no serious attention was paid to the issue. [passage
omitted]

EAST ASIA 15

He said that the ministry had identified 67 AIDS
patients in the country, 42 of whom had died. [passage
omitted}

Families of Foreign Workers May Be Screened for
HIV

BK2312152892 Kuala Lumpur BERNAMA in English
0857 GMT 23 Dec 92

[Text] Kuala Lumpur, Dec 23 (OANA-BERNAMA)—
Compulsory medical screening may be extended to
family members of foreign workers, Malaysian Deputy
Health Minister Mohamed Farid Ariffin said Tuesday.
He said this was to curb the spread of dangerous
diseases.

Farid said the health status of foreign workers was
unsatisfactory. More than a third of the 500,000 regis-
tered with the Immigration Department so far were
found to be suffering from infectious diseases, including
having the AIDS virus.

“About 137,300 registered foreign workers were found
to be suffering from either one or more of diseases like
syphilis, leprosy, filiriasis, malaria and HIV [Human
Immuno-deficiency Virus] infection,” he said. He said
that less than one percent of the 137,300 were HIV
positive. However, he declined to reveal the actual
figure.

Farid said those with infectious diseases would be
deported.

NEW ZEALAND

Military Willing To Drop Ban on Homosexuals

BK0712030692 Hong Kong AFP in English 0146 GMT
7 Dec 92

[Text] Wellington, Dec 7 (AFP)—New Zealand’s Armed
Forces are willing to lift their ban on homosexuals
joining their ranks, a paper prepared by Defence Min-
ister Warren Cooper said Monday.

The paper was leaked by the New Zealand AIDS Foun-
dation. A spokesman for Cooper confirmed it was gen-
uine, but said it had not yet gone to the ruling National
Party caucus.

In the paper, Cooper said the New Zealand Defence
Force (NZDF) was willing to comply with proposed
human rights legislation banning discrimination on the
basis of sexual orientation.

However, in an apparent reference to the HIV virus that
brings on AIDS, it wished to still be able to exclude from
the forces people with organisms in their body that might
cause disease.

Homosexuals were rated as a high-risk group when AIDS
emerged in the West in the 1980's, as well as heroin



JPRS-TEP-93-008
23 April 1993

The public has been clamoring for Fabius and his
ministers of health, Edmond Herve, and social affairs,
Georgina Dufoix, to appear before a parliamentary High
Court to answer allegations that the government was
involved in the tragedy that led to hundreds of deaths.

Although all three had agreed to stand trial to clear their
names, Fabius became the first to change his mind,
leading to furor within socialist ranks.

The conservative-dominated Senate had ruled against
trying Fabius, but it was his own decision to refuse to
appear that led to criticism that he was sparing himself as
a potential presidential candidate.

The Socialist turnaround—in refusing to vote the High
Court action it had so far backed—was also seen as a
strong blow to Fabius, who had insisted that his party
vote for a trial he would be exempted from.

Socialist Party whip Jean Auroux said he refused to
“throw (Dufoix and Herve) to the wolves,” and Prime
Minister Pierre Beregovoy said he “regretted the situa-
tion” and hoped the parliamentary procedure would
continue.

This was unlikely, however, as the current session ends
on Saturday and no meetings are scheduled before the
new assembly convenes following legislative elections in
March.

The radical leftist MRG party, the socialists’ allies, said
both Fabius’ decision and that of the Socialist Party
were, “three months before the elections, a frightening
political error.”

“All three are evidently innocent,” the MRG said, “but
public opinion demands that they explain themselves.”
[passage omitted]

The latest twist in the AIDS scandal came as a year-end
poll published Thursday by the daily Le Parisien showed
that a majority of the French considered it the most
striking event of 1992, ahead of unemployment, famine
in Somalia and racism in Germany.

Senate Relaunches Process To Try Ex-Ministers

AU1602184893 Paris AFP in English 1803 GMT
16 Feb 93

{Text] Paris, Feb 16 (AFP)—A French Senate committee
Tuesday [16 February] relaunched legal proceedings
against former Prime Minister Laurent Fabius and two
of his ex-ministers in connection with France’s AIDS-
tainted blood scandal.

Fabius and his former ministers of health, Edmond
Herve, and social affairs, Georgina Dufoix, will be
charged with manslaughter and unintentionally causing
bodily harm, according to the text adopted by a Senate
ad hoc committee.

Prosecutors of the High Court—a parliamentary panel
which alone has the right to judge elected officials—had,

WEST EUROPE 19

on February 5, dropped charges of failing to assist
persons in danger against the three on grounds that it
came under a 3-year statute of limitations.

The limit for the new accusations is 10 years, well within
the deadline for trying the three Socialist ex-ministers on
grounds that they took inadequate and tardy measures to
halt the deliberate distribution by a state-run agency of
AIDS-tainted blood in 1984 and 1985.

Three leading health officials of the time have been
sentenced in connection with the scandal, which resulted
in the contamination of at least 1,200 haemophiliacs,
300 of whom have since died.

The officials had said at their trial on fraud charges that
they were innocent and had only applied government
policy.

Fabius, Herve and Dufoix, in testimony at the trial, had
rejected the charges and defended their government's
action.

Fabius, who is now first secretary of the governing
Socialist Party, had hinted after the charges were
dropped earlier this month that he would welcome a
retrial on manslaughter charges to clear his name.

Still, only opposition members of the Senate committee
voted on Tuesday to relaunch the legal procedure, while
Socialist members stayed away.

Claude Estier, the Socialist Party whip at the Senate, said
his group had stayed away because it did “not under-
stand the point of voting a resolution that will, in any
case, not be submitted to parliament before its next
session.”

The French national assembly has finished its spring
session, and will not meet again until legislative elections
next month.

ICELAND

AIDS Prevention Commission Survey on ‘Safe
Sex’

93WE0271A Reykjavik NEWS FROM ICELAND
in English Feb 93 p 6

[Article: “AIDS Survey: Changing Pattern of Behaviour
Among Homosexuals”)

[Text]

Gays and Lesbians Likelier To Practise Safe Sex Than
Their Straight Counterparts

Homosexuals are more likely to practice safe sex than
heterosexuals, according to a new survey of Icelanders’
awareness of how the HIV virus is spread.

Conducted by Landvernd (the National Commission on
AIDS Prevention) and the Directorate General of Public



52 NEAR EAST/SOUTH ASIA

AIDS. He stressed the need of responsible sexual behav-
iour and collaborative efforts on the international scien-
tific front to develop a cure for a vaccine.

Among the distinguished speakers at yesterday’s cere-
mony were Dr J.G.S. Makambi and Prof R. Kuti,
ministers of health of Uganda and Nigeria respectively.

Said Dr Makambi by 1995, it is estimated that the
developing world will account for 84 percent of the
cumulative global total of HIV infections ... we in
Africa did not have the warning or the wealth of

knowledge now available on how to control the disease
.. let what has happened to us not happen to you or
anybody.

He added that the lessons from AIDS control activities
in his country had been reassuring and the African
nations were already coordinating their efforts on this
front.

Prof Kuti spoke about the logistic problems in the fight
to prevent the spread of AIDS, such as lack of funds in
the developing world, the inability of poor people to
afford condoms and other related factors and stressed
the need to promote interaction between health agencies
of different nations to help combat the virus menace on
a global level. [Passage omitted]

AIDS Society Chairman Speaks

93WE0117B New Delhi PATRIOT in English
11 Nov 92 p3

[Text] Though an estimated 1.7 million people in Asia-
Africa region are infected with HIV, the deadly virus
that causes AIDS, the epidemic is largely hidden in the
region as there is gross under-diagnosis and under-
reporting in many of the countries.

This conclusion was reached on the third day of the
second International Congress on AIDS in Asia and the
Pacific being held in the Capital.

According to Prof. John Dwyer, chairman of the AIDS
Society for Asia and the Pacific, every hour 2,000 new
HIV infections occur in the region. By the year 2000,
between 15 and 45 million people in the Asia-Pacific
could be affected with the virus, he said.

Some of the health experts at various workshops in the
Congress felt that in India AIDS spreads through sex,
blood and ignorance. “Conservative governments and
societies have to realise the danger now and implement
interventional strategies,” they pointed out.

Governments cannot afford to presume that the whole
population practices desirable and correct sexual and
moral behaviour; rather they must respond to the pre-
vailing sexual and moral behaviour of the people. There
cannot be any complacency on this front, said Prof.
Dwyer.

Discrimination against those infected with HIV in the
region is leading not only to the violation of human

JPRS-TEP-93-008
23 April 1993

rights but the creation of an atmosphere that minimises
voluntary testing—a major platform in any defence
against the disease. Therefore, education must eliminate
discrimination, pointed out the experts.

Prof. Dwyer said that the Asia-Pacific region must
understand the enormous socio-economic consequences
of the AIDS epidemic. Most countries in the region are
developing and under-resourced.

HIV and AIDS control programme including care of
AIDS patients is very expensive. No country can afford
to divert their meagre resources for AIDS. For example,
Thailand will have lost US$9 billion the epidemic by the
year 2000. [sentence as printed] Currently HIV in Thai-
land is costing the country US$1.8 billion per year, he
said.

“This part of the world must realise that increasingly
AIDS is a problem for women and children and a major
emphasis must be placed on protecting women from
infection,” said Prof. Dwyer.

Therefore, effective implementation of preventive pro-
grammes to contain HIV and fighting discrimination
against those infected and providing them with the best
clinical and supportive care should form the major part
of the country’s health policy, he said.

Economic Implications:

The AIDS epidemic in India will have a regressive
economic impact and intensify inequality in society,
leading economists warned at the second International
Congress on AIDS in Asia and the Pacific in the Capital
on Tuesday reports PTI.

The direct and indirect costs of AIDS are likely to cross
$11 billion by 2000 AD, Professor David Bloom,
chairman of the Department of Economics at Columbia
University in the United States, said.

“AIDS is not merely a health problem,” Dr. Bloom said
in a special congress session on the economic impact of
AIDS on countries in the Asia-Pacific region, “It has
deep economic roots with potentially staggering eco-
nomic consequences.”

AIDS is disproportionately affecting low-income groups
in India, Thailand and Indonesia, according to the study
which is part of the first attempt to document the
economic impact of AIDS in Asian countries.

This disproportionate distribution of AIDS and the fact
that health care costs are limited and do not reach a
majority of the population could lead to increased eco-
nomic inequality in these countries.


6 WEST EUROPE

blood samples will be tested in the laboratory that is
under his direction. Krohn has been developing his own
AIDS vaccine with support from the Finnish Academy
and similar organizations in the European Community.
It is still being tested in animals.

The Aurora Hospital in Helsinki has been initiating
research on a competing product, a similar, U.S. vaccine.
This is part of a Pan-Nordic project involving 1,000
patients.

Due to the lack of 70,000 markkas, three-week layoffs in
one-week intervals, and a ban on summer substitute
workers this research would not commence until late fall,
if then.

In Sweden the project center has been forced to locate
outside of Stockholm due to the shortage of funds.

Physicians Join Debate on Spread of HIV

93WE0047B Helsinki HELSINGIN SANOMAT
in Finnish 4 Oct 92 pC 8

[Guest commentary by Outi Lithen, operations manager
of the AIDS support center: “You Cannot Change Peo-
ple’s Behavior By Force”’]

[Text] The HIV virus is a well-known peril throughout
the world.

Those infected with the HIV are members of our society.
They are our neighbors, family members, children, par-
ents etc. They are not some sort of “others,” outsiders to
our society. After infection by HIV, one is the same
person he/she was prior to infection. The only change is
that such a person finds it much more difficult to cope
with social reality than before.

Among Western democracies only Sweden has chosen a
HIV policy that permits legal force; and Sweden is
experiencing a lively debate on the advisability of the use
of legal force.

The reason coercive means were not chosen stems from
their inefficiency in fighting contagious diseases and also
on a substantiated fear that adopting them would make
it more difficult to care for problems brought about by
the AIDS phenomenon.

History shows no examples of coercive means having
changed the behavior of people. Prohibition brought an
increase in alcohol related problems and a new criminal
activity. Within the sphere of medical science syphilis
was brought under control once medication for the
disease was in existence.

Some believe that if the law would require persons to
reveal, for example, the identity of their sex partners,
then they would do so. Were the world to work that way
no prisons would be needed, the law would suffice.

IJPRS-TEP-93-008
23 April 1993

Sirkka-Liisa Valle, M.D., has publicly suggested that
those suspected of being HIV infected be tracked down,
so that they would be brought into the sphere of criminal
law. Compulsory testing would be an additional mea-
sure.

I consider the suggestion irresponsible because it
includes the assumption that an infected one is a poten-
tial criminal. To be infected with HIV is no crime.
Actions which confirm the prejudiced identification of a
person as a criminal because he suffers from a virus
disease are consistent with regarding an illness as a
crime. This kind of thinking belongs to the Dark Ages.

The medical authorities have already given instructions
in regards to so-called tracking down of sex partners.
These instructions are based on a realistic awareness of
the situation and they obligate the doctor to help the
infected person in informing sex partners of their pos-
sible risk of infection.

The goal is to give information on risk to those who need
it. Once they have the information they choose where
they wish to go for testing. The objective of finding the
partners is to prevent the spread of the disease, not to
bring people under the sphere of criminal law.

Is the Debate Shaping Public Opinion?

Finland has, for years already, had a court case on an
incidence of transmission of infection.

Last summer the Appeals Court rendered its decision on
the case, according to which it was impossible to prove
that the infection was transmitted to the plaintiff pre-
cisely by the defendant. Nevertheless the Appeals Court
increased the prison sentence from two years to four
without parole. In addition to this, the Appeals Court, in
its public statement, revealed that a person was HIV
infected even though he was not suspected or accused of
any crime, but was involved in the case as a witness. The
case is currently in the Supreme Court.

During the current year a lively debate has taken place in
the media specifically about an incident where a HIV-
infected person is suspected of having raped some
women.

Last year he had been sentenced to one year with parole
for rape. In addition he was accused last spring of
violating parole conditions for indecent assault. Right
now he is not accused of any crime. Nevertheless the
press has known his name and the newspapers have
published information which could not—were the law
was being followed—be known since the court proceed-
ings were conducted behind closed doors.

Unavoidably it can be conceptualized that the public
debate is being used as a device for steering public


82 WEST EUROPE

SPAIN

‘Halt’ to Anti-AIDS Efforts Alleged

93WE0093A Madrid DIARIO 16 in Spanish
1 Nov 92 p 20

[Interview with Rafael Najera by Beatriz Andrada in
Bayonne; date not given: “There Is a ‘Halt’ in Anti-AIDS
Action”)

[Text] In this interview, virologist Rafael Najera, our
country’s leading specialist in the disease AIDS, warns of
the danger of letting down our guard against the pan-
demic. He claims that there has been an undeniable halt
in the prevention and information campaigns for Spanish
society. As for the new cases with no virus, but with
immunodeficiency, that have appeared recently
throughout the world, Najera stresses their enormous
importance from a scientific standpoint, but doubts their
epidemiological significance.

Andrada: How important is the citizens’ effort in the
battle against AIDS?

Najera: It is fundamental.

Andrada: Nevertheless, the organizations are hardly
receiving any financial aid from the administration at
present.

Najera: It’s coming very slowly.

Andrada: Are we letting down our guard with respect to
AIDS?

Najera: Not in the scientific area, but I don’t know
whether we are letting it down politically. With Garcia
Vargas, it had a great impetus; there was support, par-
ticularly from the citizens’ committees, for reaching the
areas that the administration by itself didn’t reach. But a
new minister arrived, remaining less than a year; and
there was another change. The entire organization was
changed, and of course that caused the action against
AIDS to lack the forcefulness that it had previously.

Andrada: There have been no prevention campaigns
since “put it on yourself, put it on the other.”

Najera: There has unquestionably been a halt. Apart
from the controversy, the campaign of “put it on your-
self, put it on the other” served to open up the topic of
sexuality in family conversations. It isn’t a taboo subject
nowadays.

Andrada: Is the church’s position interfering with the
prevention campaigns?

Najera: The fact is that the church’s official position is
one thing, and that of the church’s members is something
else. They are working directly on the problem, and
doing a great job in the shelters. They are distributing
condoms to those infected.

IJPRS-TEP-93-008
23 April 1993

Andrada: In any event, there is still great fear of those
with the disease.

Najera: Ancestral fears arise anytime. On the other hand,
there has been a great deal of information. There has
never been such complete information on any other
disease among the population, within such a short time.
Over 90 percent know the ways in which it is trans-
mitted; so, the information is there. However, there
hasn’t been any major campaign for some time. This is
an obvious shortcoming, because great emphasis must be
placed on this subject.

Andrada: Did the campaigns, in their time, have an effect
on the control of the disease, and on slowing down its
spread among the population?

Najera: Yes, they were very important; although, even
earlier, and apart from the significant effort by the
citizens’ committees, all the relevant information was
being collected and disseminated by the commission.

Andrada: And what about the social exclusion of those
infected?

Najera: We must admit that, in the specific case of
children, there have been very few cases of that here,
thanks to the work of the citizens’ organizations. The
problem has been far more tragic in other countries. In
Spain, the AIDS issue has been handled with a certain
amount of logic and good deeds. The fact is that the
action must be intensified, because it obviously has
declined. It must be given the great impetus required by
a problem that is far greater now than when it began.

Andrada: What is needed at present?

Najera: All the authorities, both central and autono-
mous, must resume placing emphasis on the coordina-
tion of activities, on funds, on advertising campaigns,
and on support to the citizens’s groups. Because other-
wise, the population’s understanding and consciousness
of the problem will diminish and decline.

Andrada: And will the breeding ground for the spread of
the disease be created?

Najera: Of course, because such action obviously has an
impact on the transmission of the disease. The homo-
sexual groups have been fully aware of this from the
outset, and they are the only risk sector in which conta-
gion has declined.

Andrada: Was the plan against AIDS hampered by the
fact that, at first, the disease was rampant among socially
excluded groups?

Najera: Yes, it was undeniably a disease that originated
among persons already excluded from social groups.
There is no doubt that this imposed conditions on it, but
it also lent it a peculiar quality that attracted attention.
And it’s difficult to determine whether the one factor
hasn’t offset the other. A disease was created, and that


IJPRS-TEP-93-008
23 April 1993

illiterate and semi-illiterate rural youth in the non-
governmental technical sector. Mr Khanna, who is suf-
fering from ankolysing spondaylytus, is recently working
for voluntary health and education.

Need for More AIDS Screening Centers Told

93WE0119 Madras THE HINDU in English
9 Nov 92 p3

[Text] Madras, Nov 8—Since the first HIV positive cases
were detected six years ago in Madras, Tamil] Nadu has
been in the forefront in AIDS surveillance, counselling
and control programmes.

As the initial 10 cases seen were among a group of
prostitutes, it was thought that AIDS was the disease of
people who have high risk behaviour. That is not to be
and the epidemiological pointers are now towards the
youth in the age group of 18 to 21—the youngest having
the infection is a school student aged 15.

The enormity of the situation could be assessed from the
fact that the surveillance centre in the city which saw 10
cases in 1986 has now detected more than 2,000 serop-
ositives—an alarming but a clear picture of the rise in
infection rates in the State.

“When we began our work 6 years ago, utmost there used
to be two positive samples per week and not more than
four per month. But now we see one or two cases every
day and 40 to 60 positive cases a month,” say those
involved in screening activities. And according to statis-
tics, in the State as a whole there are 2,900 persons who
have contracted the infection. This is as against 10,300
recorded HIV infected people in India as of October.

Risk factors: Sexual transmission accounts for 75 per-
cent of all reported HIV infections. This is followed by
infections contracted during blood transfusions. Risk of
transmission following the use of contaminated needles
and syringes is estimated to range from 1-5 per 1,000
exposures.

The Union Government's initial thrust was on blood
safety programme. Elisa Readers for preliminary HIV
test through blood samples were supplied to States to
start more screening centres. In Tamil Nadu, 15
screening centres were to be established progressively—
eight in Madras, five in medical colleges and two at
district hospitals. But the setting up of these centres were
hampered for want of AC facility to preserve blood
samples, trained staff and necessary accessories and
equipment. The result of this apathy was that only four
centres, that too in Madras, could get the start but they
remain non-functional. Enquiries show that though they
have the Elisa Readers, each one of them costing Rs.1.5
lakhs, the Stanley and Kilpauk Medical colleges and
Kasturba and Woman and Children hospitals could not
put them to use for the simple reason that they are yet to
be supplied with appliances such as pipettes and
washers.

NEAR EAST/SOUTH ASIA 59

Lack of facilities: Similar is the case with regard to blood
screening centres for the development of each of which
the Union Government sanctioned Rs. 1 lakh. In the
absence of budgetary provision, they are yet to see the
light. It is stated that roughly 18 per cent of the infections
in India is caused through transfusion of infected blood.
The Tamil Nadu Government banned professional
blood donation system in October 1989. And a thrust
was given to voluntary blood donation campaign in
cities including Madras and Madurai. But persons
knowledgeable on how the system functions say that
many professional donors still donate blood coming as
replacement or relative donors.

The incidence of HIV infection among professional
donors has increased in the last 6 years from 0.5 percent
to 3.00 percent. And even among voluntary donors, the
infection is showing up. As a person who receives HIV
contaminated blood is sure to pick up the infection, they
stress the urgent need to develop testing facilities in
district headquarters. And taluk hospitals could be
linked to these district centres which could be supplied
with Serodia kits for testing. However, before the intro-
duction of the instrument-free testing system, the tech-
nical staff required to be trained. The Drug Control
authority is empowered to check even private blood
banks. But it is asked how the private blood banks could
be prosecuted for non-compliance of facilities when they
were lacking in the Government set up.

The AIDS cell at the Madras Medical College has been
systematically testing the high-risk group since the first
cases were detected and in the last 6 years the incidence
among persons suffering from sexually transmitted dis-
eases (STD) has gone up from 0.5 percent to 6.00
percent. So, this underlines the need to give a push to
STD control programme. But it appears that the STD
services in Government hospitals are not fully utilised
and the attendance at the STD clinics show a fall. This is
attributed to the psychology of patients many of whom
seem to feel that they would stand exposed if they
attended the Government service where they think the
confidentiality might be lacking.

Health education essential: Health education is an
important aspect of AIDS control programme. Doctors
admit that though much had been talked about this,
very little has been done in this regard. The set up for
health education at the State level is yet to be consti-
tuted. It is stated that the Centre sanctioned Rs. 15
lakhs in 1991 for health education and the WHO also
allocated funds for awareness creation. Sadly, they say,
these had not been utilised for putting through any
meaningful programme.

With all its constraints, it is said that the AIDS Resource
Group in Madras had conducted more than 100 aware-
ness programmes. Doctors say it would be worth the
while for the State to involve these experts in planning
strategies on health education. There is an AIDS Com-
mittee headed by Collector in each district. These com-
mittees, they say could be asked to meet frequently,



32 EAST EUROPE

CZECHOSLOVAKIA

CSFR: Twenty-Nine Cases of AIDS Registered

U0312141792 Prague CTK in English 1338 GMT
30 Nov 92

[Text] Prague Nov 30 (CTK)— Twenty people have died
of AIDS in the Czech Republic since 1985 out of a total
of 29 diagnosed as having the disease, representatives of
the Czech Ministry of Health told journalists today.

Nearly 3 million medical inquests have been carried out
in the Czech Republic since the end of 1985. Of those
examined, 139 were found to be HIV-positive and 29 of
that number sick with acquired immune deficiency syn-
drome, or AIDS, ministry representatives said.

The actual number of people infected with the HIV
virus, however, is probably ten times higher, Ministry of
Health representative Gustav Walter said. Many of those
infected are going to doctors only in the developing stage
of the disease, which is already late, he added.

Marie Stanikova from the third infection clinic of the Na
Bulovce hospital in Prague said that 78 patients diag-
nosed as HIV-positive have successfully extended with
medication the period before the onset of symptoms.

Czech Minister of Health Petr Lom emphasized the
importance of prevention and said that information
about this disease should be part of school programs.

{Bratislava PRAVDA in Slovak on 1 December on page
3 carries a 400-word Ivan Bielik report on the World
AIDS Day, which includes the following passage on the
situation in Slovakia. “In Slovakia, 39 persons, 13 of
them foreign nationals, have been identified as carriers
of the virus. This figure was arrived at after testing
700,000 blood donors, 160 drug users, 18,979 patients
with venereal diseases, 262,000 pregnant women, and
53,901 other persons. The European Center for Moni-
toring the AIDS Epidemiologic Situation states, how-
ever, that the number of HIV-positive persons in Slo-
vakia amounts up to 15,000.”]

POLAND

118 Aids Cases Registered, 2,500 Carriers
Identified

AU03 12131492 Warsaw PAP in English 2141 GMT
30 Nov 92

[Text] Warsaw, Nov. 30—Although Poland is a country
with a low incidence of the AIDS virus, this fact should
not be treated with complacency, Professor Andrzej
Stapinski of the Institute of Venereology at Warsaw’s
Medical Academy, announced on Monday.

Speaking on the eve of the UN-sponsored World AIDS
Day, which falls this year on December 1, Professor
Stapinski said that 118 AIDS sufferers had been

IPRS-TEP-93-008
23 April 1993

recorded in Poland, of which 60 were no longer alive. He
estimated that there might be around 12,000 persons
infected with the HIV virus, although only some 2,500
had so far been identified. Of these, Professor Stapinski
estimated that around 70 percent were intravenous drug
users, most likely infected through the use of non-sterile
needles.

Events in Poland relating to World AIDS Day began a
week ago with a scientific conference at Rydzyn (Leszno
province, western Poland), to discuss the links between
AIDS and drug abuse, and to discuss the problems of
caring for those infected with the virus.

Also, a concert under the slogan “Tolerance” was held in
Warsaw at the weekend to improve public awareness of
the disease, and to raise funds for the construction of a
hospice for aids sufferers.

ROMANIA

Of 2,235 AIDS Cases, 2101 Involve Children
Under 13

AU0604190093 Bucharest TINERETUL LIBER
in Romanian 1300 GMT 6 Apr 93

[Rodica Dirzu note: “At the Start of the Year, There
Were 2,235 Cases of AIDS in Romania, Without Taking
Into Consideration the Homosexuals and Prostitutes”)

[Text] Up till 1 January 1993, 2,235 people had tested
positive for AIDS, of which 2,101 were children between
Oand 12 years of age and 14 cases were over 13 years old.
The county with the largest number of cases continues to
be Constanta (644), followed by Bucharest (231),
Giurgiu (161), Bacau (125), and Galati (115). As Secre-
tary of State Professor Alexandru Oproiu said at a news
conference yesterday, 5 April, there are no pertinent data
for the high risk groups (homosexuals and prostitutes),
since international norms forbid the obligatory testing of
these categories of people.

YUGOSLAVIA

FRY: 239 Cases of AIDS; 137 Deaths, Mostly
Drug Addicts

AUI012182092 Belgrade POLITIKA in Serbo-Croatian
2 Dec 92 p 17

[S.Z. report: “In Yugoslavia Drug Addicts Are Mostly
Endangered”]

[Excerpt] Novi Sad, 1 Dec—On the occasion of World
AIDS Day, 1 December, Dr. Borisa Vukovic, president
of the Yugoslav Board for AIDS, stated to journalists
that there had been 239 cases of AIDS by that time, of
which 137, or 57 percent, have already died. Data
regarding the infected, which were presented by this
distinguished epidemiologist, who is one of the heads of



n WEST EUROPE

He added that there are probably many people who have
not had themselves tested in spite of suspecting that they
are infected. Finally, many people could be infected
without even thinking of being tested.

The figures show nothing about when an individual was
infected. Only that this is the first time he or she has been
diagnosed as HIV-positive.

A total of 699 HIV-infected people were reported in
1991 and 1992. Some 78 percent were men. Of the total
number of HIV diagnoses 143, or around 20 percent,
were immigrants. Among infected men 18 percent were
immigrants, while the figure for women was 43 percent.

The State Serological Institute is in the process of
studying whether there has been a change in the behavior
of infected heterosexuals in Denmark or if the increase
comes from outside.

AIDS Study: Sexually Active Youth Avoid
Condoms

93WE0303B Copenhagen BERLINGSKE TIDENDE
in Danish 23 Feb 93 p 2

{Article by Henrik Larsen: “One Out of Three Young
People Fail To Use Condoms”)

[Text] 4 new study shows that one-third of sexually active
13- to 20-year-olds often “take a chance.” Now parents
must become involved in the task of informing them about
contraception and AIDS, according to an AIDS adviser.

In spite of big public campaigns, over a third of sexually
active Danes in the age group 13-20 turn thumbs down
on using condoms.

Often they choose to “take a chance” instead when they
express themselves sexually and use nothing at all,
according to a new study from the City of Frederiks-
berg’s AIDS office.

Teacher Bjarne Rasmussen of the AIDS office has no
doubt about what the consequences of the study should
be:

“In the future we must involve the family when it comes
to informing young people about contraception and
AIDS. The biggest influence in these matters occurs at
home.

“Parents cannot evade this in the belief that the Public
Health Administration, the schools, and ‘society’ will
take care of it. We know it is easier for young people to
deal with the issue of contraception if their parents talk
to them about it.”

A total of 2,300 young people between the ages of 13 and
20 filled out the very comprehensive unsigned question-
naires on which the study is based. Some 1,250 of them
said they were sexually active. Only 64 percent of this
group “often used condoms.” Half of them reported that

JPRS-TEP-93-008
23 April 1993

they have had from one to three partners since their
sexual debut. Ten percent checked off the response “over
10 partners.”

“Young people are well aware that condoms provide the
best protection against AIDS and other sexually trans-
mitted diseases. But knowledge and behavior do not go
hand in hand in this area. And the more sexually active
young people are, the more often they fail to protect
themselves. Girls in particular are dissatisfied with con-
doms,” said Rasmussen.

First Conviction of AIDS Carrier for Unsafe Sex

Haitian Sentenced

93WE0307A Copenhagen BERLINGSKE TIDENDE
in Danish 13 Mar 93 p 6

[Article by Ida C. Lyngbye: “HIV-Infected Man Given
Historic Sentence”}

[Text] For the first time in Denmark a court has convicted
an HIV-infected person for exposing others to the risk of
infection. The convicted man was sentenced to a year and
a half in jail.

Haitian-born Diego Joanis, who is infected with HIV,
was sentenced yesterday to a year and a half in jail for
having endangered the lives of 23 women by exposing
them to the risk of HIV infection. He was also convicted
of having had sexual intercourse with minors plus two
other criminal charges.

Joanis had sex with 23 women in all, two of them
minors, without using a condom, and without telling
them he was HIV-positive.

The sentence is unique because this is the first time an
HIV-infected person has been convicted on charges of
exposing others to the risk of being infected with HIV.
HIV develops into the deadly AIDS disease. None of the
23 women was infected.

The judge explained that in determining the sentence
emphasis was placed on the fact that Joanis had had
intercourse many times over a long period without using
a condom.

The court found that it had been established that Joanis
had known since 1985 that he was infected with HIV and
had been told about the danger of infection and safe sex.
In spite of this he engaged in unprotected sex with many
women up until August 1992 without telling his partners
that he was HIV-positive.

The risk of infection in unprotected intercourse is prob-
ably between 0.1 and 1 percent, according to the experts.
However the judges found that the size of the risk was of
secondary importance because the risk of infection is
constantly present and it was only by chance that none of
the 23 women was infected.


IPRS-TEP-93-008
23 April 1993

the Vojvodina Institute for Health Protection, are par-
ticularly interesting. Namely, while in Europe the high
risk groups such as homosexuals and bisexuals are
mostly endangered, in Yugoslavia the situation is funda-
mentally different, with the largest group of infected
being drug addicts, 56 percent. Therefore, Dr. Vukovic
especially stressed the necessity of this high risk group
taking preventive measures against AIDS transmission.
[passage omitted]

All 44 AIDS Cases in Croatia Contracted Abroad

AU04 12123792 Split SLOBODNA DALMACIJA
in Serbo-Croatian 3 Dec 92 Europe Edition p 10

{G. Galic report: “In Croatia 44 Cases of AIDS”]

{Text] Zagreb— “There are 44 cases of AIDS registered
in Croatia so far, three of which are women. Thirty
people have already died. They contracted the HIV virus
(the carrier of AIDS) outside Croatia, and there is not a
single case of the disease being contracted ‘inside’ it. It is
particularly noteworthy that these cases cannot be con-
nected with blood transfusion,” Prof. Dr. Berislav Bor-
cic, head of the epidemiology service with the Institute
for Health Protection of Croatia said at a news confer-
ence, which was held on the occasion of World AIDS
Day (1 December).

According to the estimate of the World Health Organi-
zation, two million people in the world are now HIV
Positive, and it is believed that some five thousand more
become infected daily. Considering these figures,
Croatia finds itself at the very bottom of the table. The
largest number of those infected belong to the high risk
groups, such as homosexuals and intravenous drug users,
but it is interesting to note that out of 412 tested drug
users in Croatia not a single one was HIV positive.
“Among those infected with the virus, there are three
hemophiliacs, which is considered to be a consequence
of the use of imported medicines, so we have to test all of
them,” Dr. Borcic emphasized.

“The fight against AIDS is a duty of the community”—
this is the motto with which the Croatian Red Cross has
joined the World Health Organization in the struggle
against the “plague” of the 20th Century. For that
purpose it is necessary to establish a humanitarian fund
in order to help the sick, but also to expand advertising
activities. “Croatia has also joined the European Center
for AIDS Control, which is a part of the World Health
Organization,” Dr. Borcic said.

Croatia: Medical Officials Give Details of AIDS
Statistics

LDO0112211692 Zagreb Radio Croatia Network

in Serbo-Croatian 1600 GMT I Dec 92

[Excerpt] Dr. Nenad Javornik, secretary general of the
Croatian Red Cross, and Dr. Dragoslav Borcic, head of

EAST EUROPE 33

the epidemiological department of the Republic of
Croatia’s Health Protection Institute, addressed a news
conference today, World AIDS Day, about the state of
this illness in our country and in the world.

According to the number of infected people per million
inhabitants, Croatia is in 24th place in Europe. Up to the
end of September 44 people have become infected in
Croatia, and of these 30 have died. Of those who became
infected, 41 are men and 3 are women [passage omitted]

Macedonia Issues Program To Prevent Spread of
AIDS

93WE0187X Skopje SLUZBEN VESNIK
in Macedonian No 40, 4 Jul 92 pp 705-711

[Program for the Protection of the Population in the
Republic of Macedonia From the Acquired Immune
Deficiency Syndrome for 1992; signed by Prime Min-
ister Doctor Nikola Kljusev under No. 21-1883/1, 23
June 1992, Skopje]

[Text] In accordance with Article 6, Paragraph 3 of the
Law on the Protection of the Population From Commu-
nicable Diseases Threatening the Country (SL. LIST NA
SFRJ, Nos. 51/84 and 63/90), and Article 3, Paragraph 2,
and Article 6, Paragraph 3, of the Law on the Protection
of the Population From Communicable Diseases
(SLUZBEN VESNIK NA SRM Nos. 18/76, 18/82, and
37/86), the government of the Republic of Macedonia
has drafted a program for the protection of the population
in the Republic of Macedonia from the Acquired Immune
Deficiency Syndrome [AIDS] for 1992.

1. Purpose of the Program

The purpose of the program is the intensive implemen-
tation of measures and activities aimed at preventing
and controlling AIDS in the Republic of Macedonia,
and, at the same time, applying the concepts and trends
adopted by the World Health Organization [WHO].

The program will be implemented by the health insti-
tutions in the Republic in collaboration with the edu-
cation authorities and institutions, the Red Cross, and
the public information media—the daily press, radio,
and television—and in cooperation with other
Republic and health institutions and the Macedonian
Red Cross Association.

Specially programmed epidemiological, serological, and
clinical studies will be made in the Republic on an
organized basis; data will be collected on the outbreak
and epidemiological characteristics of destructive dis-
ease with a view to determining the spreading of the
asymptomatic presence of the HIV virus among the
population.

Steps to prevent infection, spreading, and for controlling
the disease will be formulated, taken, and monitored.



48 LATIN AMERICA

television to mark World AIDS Day, also said hetero-
sexual activity was the most common mode of transmis-
sion of the disease here.

The 37 AIDS cases included 27 males and 10 females.
Twenty-two have died. Four new cases were identified so
far this year. Dr. Jones said there were also 43 persons in
the country carrying the HIV virus, which can eventually
trigger the development of full blown AIDS.

Speaking of the Health Ministry’s strategy for combating
the spread of the disease, Dr. Jones said a medium term
plan launched earlier this year placed emphasis on public
information, education, and communication.

“If AIDS is to be controlled, a positive effort must be
made to change the present pattern of sexual behaviour,”
he said.

“Tt should be less macho to have several partners and to
boast of large numbers of children with several part-
ners,” he added. “The rapid rise in the population and
the presence of teenage pregnancy have to be addressed.”

ST LUCIA

Health Officials Report 5 New Cases of AIDS

FL1304212893 Bridgetown CANA in English
1853 GMT 13 Apr 93

[Text] Castries, St. Lucia, April 13, CANA—St. Lucia
health officials on Tuesday said five new cases of
Acquired Immune Deficiency Syndrome (AIDS) had
been diagnosed here, raising the tally to 91. So far, the
island has recorded 44 deaths from AIDS, an incurable
condition which kills by destroying the body’s immune
system. The Ministry of Health said it would be issuing
its latest quarterly bulletin on the AIDS situation here
next week.

ST VINCENT & THE GRENADINES

Incidence of AIDS ‘Increasing Rapidly’

FL0212003792 Bridgetown CANA in English
2239 GMT I Dec 92

[Text] Kingstown, St. Vincent, Dec 1, CANA—The
incidence of AIDS (Acquired Immune Deficiency Syn-
drome) is increasing rapidly in St. Vincent and the
Grenadines and health officials are worried that the
situation may get out of hand. Registrar of the main

SJPRS-TEP-93-008
23 April 1993

Kingstown General Hospital, Dr. Dave Dasilva, who is
also chairman of the hospital’s AIDS committee, said
indications suggest that people were not taking the
warnings seriously.

“What we are seeing now is that AIDS is ... Overtaking
us and this has tremendous (implications) for our med-
ical system. We are in a serious situation,” he said.

Dasilva said 107 people had tested positive for the virus
which causes the disease since a record system was
instituted here in 1984, and 43 victims had so far died.
But he noted this was just the tip of the iceberg.
According to available statistics, 28 persons had tested
positive for the virus in 1991, as against 12 in 1990. He
said if the formula recommended by the World Health
Organisation (WHO) to obtain a more accurate picture
of AIDS was applied, it meant that 1,605 persons were
carrying the virus.

“What this means for us is that for every 1,000 persons,
we will have 14 HIV positive cases,” he said. Like the
trend elsewhere, the disease is killing off the most
productive age group, he added.

Dasilva said although a survey had not been conducted
to determine why persons were responding the way they
did to information about AIDS, his conclusion was that
they still harboured the myth that they could easily
idenfity carriers from physical appearances and could
therefore avoid getting the virus by refraining from
contact with such persons. He said the fact that there was
still a high incidence of teenage pregnancies and doctors
were still treating large numbers of people for venereal
diseases was an indication that people were not prac-
tising safe sexual intercourse.

“To make a serious dent on the AIDS problem, it is
important to have proper treatment and follow-up of
STD (Sexually Transmitted Disease) patients and their
sex partners,” he said. Dasilva said doctors often treated
such patients without attempting to treat their sexual
contacts.

“Even worse,” he said, “we have seen situations where
even pharmacists and nurses are treating venereal dis-
eases because ... Patients might feel more comfortable
approaching them.”

Health Minister Burton Williams told CANA that his
ministry was seeking a facility from which to counsel
AIDS carriers and their relatives.



IJPRS-TEP-93-008
23 April 1993

Dangerous Life-style

It is the productive segment of the population that is
being stricken. The cost of care alone could swallow
one-tenth of GNP (the sum of goods and services) in the
year 2000.

One can only speculate about how this will affect pro-
duction. But the present economic boom could be halted
for this reason alone.

“It is quite clear that we must change our life-style.
Today the commercial pressure from the brothels inter-
acts with our permissive view of sex outside marriage in
an unfortunate way,” said Dr. Wat.

But a true Buddhist really has only one woman, he said.
In addition to educational campaigns he hopes that
religion can play a positive role.

All Thai experts agree. The only salvation lies in altered
values, changed sexual habits. But this kind of thing
requires patient adjustment and takes time. In the mean-
while the infection is spreading like wildfire.

“Yes, we will have to get used to AIDS, we must try to
help each other,” said Dr. Wat.

AIDS Budget Gets Increase

93WE0128B Bangkok BANGKOK POST in English
3 Nov 92p1

[Article: “Government Ups Budget in War on AIDS”]

[Excerpt] The Government has decided to raise its
prevention budget against AIDS by 200 million baht in
an intensified effort to fight the killer disease.

Government spokesman Abhisit Vejjajiva said the funds
would be drawn from the cancelled Khor Jor Kor land
resettlement programmes set up by the Army to relocate
villagers who had encroached on national parks.

The highly controversial programme was cancelled ear-
lier this year. Its total budget was worth two billion baht.

Two-hundred million baht of that money will be added
to the Government’s original budget of 870 million baht
for anti-AIDS activities for fiscal 1993, said Mr Abhisit.

The rest of the available funds will be divided among a
number of government institutions.

Experts currently estimate that 200,000 to 400,000 Thais
have the Human Immuno-deficiency Virus (HIV), which
leads to AIDS. [Passage omitted]

EAST ASIA 2

Budget Bureau Grants Funding for AIDS
Publicity

BK1903013593 Bangkok BANGKOK POST in English
19 Mar 93 p 6

[Text] The Public Health Ministry is the only govern-
ment unit whose proposed AIDS publicity budget was
not slashed by the Budget Bureau. In fact, it received
additional funding. The ministry received its suggested
515.46 million baht plus an additional 388 million baht.

The Interior and Education ministries were the only two
government units which did not receive direct funding
for AIDS publicity programmes, even though they
requested budgets of 178 million and 45 million baht. A
total AIDS publicity budget of 1,141 million baht was
sought by government units, but the final package was
1,121 million baht.

The additional funding of 388 million baht for the Public
Health Ministry came from the budgets sought by the
Interior, Defence Education and University Affairs min-
istries and the additional funding sought by the Prime
Minister’s Office.

Permanent Secretary for Health Phaichit Phawabut said
the Prime Minister’s Office had sought about 169 mil-
lion baht for its AIDS campaign plus about 155 million
baht for other units. It received only the 169 million
baht. He said the Defence Ministry’s request for 12.38
million baht was slashed to three million baht, whereas
the Education and Interior ministries did not receive any
direct AIDS funding. The University Affairs Ministry
sought 65 million baht, but received 45 million baht.

The Public Health Ministry yesterday held its first
meeting on the AIDS publicity budget after the respon-
sibility was transferred from the Prime Minister’s Office.
The meeting discussed the use of the additional budget
of 388 million baht given the ministry.

The ministry has distributed its total funding of 904.5
million baht to various departments. Other ministries
like Interior and Education can request funds from the
Public Health Ministry for their publicity projects.

Dr Phaichit said any government units which did not
receive direct funding for AIDS publicity projects would
have to forward their funding requests to the Public
Health Ministry and it would take the matter up with the
Budget Bureau. He said any working unit at the local or
provincial levels wanting funds could forward their
requests through their relevant ministry or department
to the Ministry.

The Office of the Permanent Secretary for Public Health
received the largest share of the ministry’s AIDS budget,
amounting to 477.6 million baht, followed by the Com-
municable Diseases Control Department with 392.8
million baht.

Dr Phaichit said the funding for the Defence and Edu-
cation ministries would emphasise preventive methods.



IJPRS-TEP-93-008
23 April 1993

by using ELISA (confirmatory test), which is performed
by highly trained technicians. But the necessary supplies
must be obtained and lab technicians need certain basic
materials to protect themselves against the risk of acci-
dental infection, as the reactive substance consists of
virulent viruses. “Antiseptics and gloves are doled out to
us in limited quantities,” the center’s medical supervisor
lamented.

However, the transfusion center in Blida is better sup-
plied than the center in Boufarik, which is not even able
to perform the ELISA. The Sidi-Fredj screening center, a
laboratory of reference connected with the Pasteur Insti-
tute, is still the only institution authorized to perform
HIV testing.

While the government has placed health among its
highest priorities, the availability of public funds to
build such centers is doubtful, given Algeria’s eco-
nomic woes. How many individuals are unwitting
carriers of HIV?

AIDS Figures Said ‘Fragmented’

93WE0306B Rabat L’OPINION in French
20 Feb 93 p 9

[Article: “Over 130 AIDS Cases in Algeria”]

[Text] Over 130 individuals, 70 of whom have died, have
contracted AIDS in Algeria since the first case was
discovered in 1985, according to official figures from the
Ministry of Health.

According to the same source, there are 334 seropositive
individuals in Algeria, but Professor Bouguermouh,
president of the National Committee Against AIDS,
estimates that the number is higher than that.

During an AIDS information day held in Algiers on
Wednesday, experts said that of the 121 cases diagnosed
in 1992, 35 were drug addicts and 29 had contracted the
virus abroad.

The experts also said that figures on the AIDS virus
were sparse and “fragmented,” making it impossible to
detect a trend with any precision. They estimated,
however, that the disease was spreading at a “‘moder-
ate” rate.

“We absolutely do not know how many seropositive
individuals there are in Algeria,” said Prof. Bouguer-
mouh, who emphasized that the percentage of women
was increasing in comparison with the percentage of
men. “It used to be 8 percent, but now it is up to
one-third of those infected,” he said in an interview
with the daily newspaper EL WATAN.

NEAR EAST/SOUTH ASIA 51

INDIA
World AIDS Conference Held in Delhi

Health Minister, Others Speak

93WE0117A Bombay THE TIMES OF INDIA
in English 14 Nov 92 p 10

[Excerpt] New Delhi, November 13—The second inter-
national congress on AIDS in Asia and the Pacific came
to an end in the capital yesterday without any list of
recommendations and suggestions being made public.
According to the organisers, it will take about a week for
the list to be prepared.

The last day of the congress was also marked by an
elaborate protest by homosexuals and the AIDS Bhed-
blav Virodhi Andolan (ABVA). While Mr M.L. Fotedar,
the health minister, and other national and international
dignitaries praised the approach and contribution of the
congress, ABVA described it as a jambooree, which is
going in the name of AIDS conference.

It alleged that collosal amounts of funds were being
wasted, while the actual issues facing HIV positive
persons and AIDS patients are being ignored. The gay
delegates at the congress have already accused the orga-
nisers of employing a pejorative and superficial
approach to their problem.

Gay rights and ABVA activists marched around the
conference room yesterday carrying protest placards
while strains of Louis Banks’ song, especially composed
for the inaugural ceremony of the congress and originally
supposed to be the voice of unity and understanding on
the subject, provided an ironical accompaniment.

In his concluding address, Mr M.L. Fotedar called for
more community awareness on AIDS and added that
India had planned a multi-sectoral strategy to contain
the pandemic. He said at the political level there was
total commitment to the programme and a firm resolve
to back it up with adequate support and resources.

However, the minister ruled out the suggestion, inciden-
tally also made by ABVA, to facilitate the availability of
safe needles and syringes to HIV-prone drug users. He
said “we are not in favour of doing anything that may
convey the impression that we condone drug abuse.”
However, he stressed the government’s commitment in
preventing discrimination against HIV patients.

Noting that India was heavily dependent on professional
donors for blood, Mr Fotedar said, our efforts are to
raise the level of voluntary donation and to put the blood
to optimal and rational use. Once this is done, the need
for commercial blood banks and professional donors will
disappear. At the same time, one must ensure that all the
blood used for transfusion is scrupulously tested.

The minister also called for the education and economic
uplift of women in order to give them the rights and
knowledge that might reduce their vulnerability to



60 NEAR EAST/SOUTH ASIA

chalk out education programmes and identify non-
Government organisations in the area for AIDS work.

As the number of full-blown AIDS cases admitted to
Government hospitals are slowly increasing, specialists
involved in the programme want an urgent plan of action
to train medical and para-medical personnel in the
districts. Such a training programme was conducted in
early 1991. Since then some of the doctors may have
been transferred and hence the suggestion for a contin-
uous training programme.

Ayuvedic Laboratory’s AIDS Claims Examined

93WE0118 New Delhi PATRIOT in English
10 Nov 92 p4

[Editorial: “AIDS in India”]

[Text] At a time when the scourge of AIDS is spreading
in India and more and more HIV positive cases are
coming to light, the claim made by an Ayurvedic labo-
ratory of Kochi in Kerala about having cured an HIV
positive and another a full-blown AIDS case with an
Ayurvedic compound calls for investigation. According
to the laboratory’s managing director, a 25-year-old
mother of a baby girl was found to be HIV positive soon
after her husband, a full-blown AIDS patient, died of the
disease a year ago. After the local press highlighted her
plight, the laboratory treated her for 45 days after which
an elissa test found her to be HIV negative. The other, a
27-year-old full-blown male patient of AIDS, showed
clear signs of the disease in the form of chronic cough,
loss of weight, diarrhoea, high fever and skin infections.
After 70 days’ treatment he was relieved of most of his
problems and his blood test showed HIV negative. It has
been reported that the Ayurvedic compound used in the
treatment had been developed in accordance with the
prescriptions in the ancient Ayurdevic book ‘Ashtan-
gahrudaya’. People are conditioned to accept AIDS as
incurable. But that was so with tuberculosis and leprosy
till their complete cure was found. It is an undenying fact
that, notwithstanding the rapid advances made by the
modern system of medicine, it has not been able to
provide answers to some of the diseases like stone
formation and asthma. It is well known that herbs and
plants are the basic sources of the medicines in the
mainstream pharmacopoeia. Even though Ayurveda is
one of the most ancient systems, lack of research has
retarded its progress. Homoeopathy, however, was
encouraged in Germany and the United States and is
now being prescribed even by practitioners of modern
medicines to work wonders in certain conditions where
allopathy fails. In a situation where one system has so far
been unable to find a cure for the dreaded AIDS, there is
every reason to verify the claims made by any other
system. There need be no prejudgment either to favour
or oppose any system. An objective investigation of the
claim made at Kochi would be necessary. Tackling the
menace of AIDS calls for urgent steps in India. The
incidence, according to WHO estimates of South-East
Asia, comes second, next to Thailand. Up to four lakh

JPRS-TEP-93-008
23 April 1993

women in India are infected by HIV. The velocity of its
spread can be seen in the fact that while the number of
full-blown AIDS cases rose from five in December 1986
to 237 in August this year, the seizures of HIV positive
cases went up from 71 to 10,362 during the same period.
With Manipur topping the list, the scourge is taking a
heavy toll in Maharashtra, Bombay in particular, and is
threatening to play havoc in Nagaland, Madras, Delhi
and UP. The 5-day second International Congress on
AIDS in Asia and the Pacific in Delhi, with participants
from 40 countries, will no doubt take due note of the
alarming situation in this part of the world.

Over One Hundred AIDS Cases Reported in
Bengal

93WE0316A Calcutta THE TELEGRAPH in English
14 Mar 93 p 6

[Article by Amit Ukil]

[Text] Calcutta, March 13—West Bengal has crossed a
gruesome landmark with the number of persons with the
AIDS virus since 1986 exceeding 100.

The official figure with the state authorities till January
this year was 63 but since then the AIDS monitoring
office at the School of Tropical Medicine (STM) has
received reports that the National Institute of Cholera
and Enteric Diseases had detected 26 more cases, and
the Command Hospital run by the Army, another 10.

Three new cases have tested HIV positive at the STM in
the last 2 months, taking the official known figure to 102.
In addition, there are quite a few cases that have been
detected at private nursing homes and pathological lab-
oratories in the city, the results of which are not always
intimidated to the STM.

“We have reached a stage where screening blood is no
longer necessary to find out the prevalence of the virus in
the state,” Dr M.S. Chakraborty, West Bengal’s pro-
gramme officer for the National AIDS Control Pro-
gramme, told THE TELEGRAPH today. He was one of
the main speakers at the first-ever AIDS awareness
seminar for legislators held at the Assembly lobby.

“There is no denying the fact that conditions for the
spread of the AIDS virus exists in India, and surveillance
and testing have shown that an increasing number are
being infected,” he told the 80-odd MLAs who had
turned up for the seminar. The House has about 290
members.

Surprisingly, the health minister, Mr Prasanta Sur, who
was to have inaugurated the proceedings, and the min-
ister of state for health, Mrs Chhaya Bera, did not attend.
The Speaker, Mr Hashim Abdul Halim, who presided
over the seminar, for once could not haul up members or
ministers for a lack of quorum as the “session” was just
a seminar, even though an important one.


IJPRS-TEP-93-008
23 April 1993 3

AIDS Morbidity, Economic Costs /Bangkok THE NATION, 10 Nov 92]
Duangprathip Foundation AIDS Report ....
Chief Doubts Government AIDS Figures /Bangkok NAEO NA, 25 Oct 92]
Further Report /Bangkok MATICHON, 23 Oct 92]
AIDS Among Trat Drug Addicts /Bangkok DAO SIAM, 28
70 Percent of Sex Workers in Chiang Rai HIV-Positive
[Bangkok BANGKOK POST, 16 Apr 93) ....
Northern Province Expects 22,000 AIDS Cases in 1993
[Bangkok BANGKOK POST, 15 Dec 92) ....
Poll on Attitudes Regarding Prostitution /V. Combe; Bangkok THE NATION, 30 Jan 93]
Law Would Increase Penalty for Selling Daughters

[Stockholm DAGENS NYHETER, 23 Feb 93] ...... 26
VIETNAM
AIDS Explosion Seen as ‘Inevitable’... 26

Health Minister’s AIDS Day speech [Andrew Sherry;
Observance of AIDS Day [Hanoi VNA, | Dec 92] ...
Nguyen Khanh at Seminar on Implications of HIV/AIDS [Hanoi VNA, 7 Dec 92] ..
Vo Van Kiet, Nguyen Khanh Urge More Anti-AIDS Efforts [Hanoi VNA, 14 Apr 93]
First AIDS Deaths Reported [Hong Kong AFP, 29 Mar 93] ....
29 New HIV Carriers Discovered in South (Hanoi radio, 13 Apr 93]
55 More Tested HIV Positive in Ho Chi Minh City [Hanoi VNA, 24

EAST EUROPE
REGIONAL AFFAIRS
. 29

Eastern Europe Reportedly Facing HIV Epidemic /Hamburg DIE WELT, 8 Apr 93) .....
‘Mobile’ East European Prostitution Spreading HIV
[Per-Anders Mardh; Stockholm DAGENS NYHETER, 2 Feb 93]

ALBANIA

Official Discusses Nation’s Response to AIDS Virus /Tirana ZERI I RINISE, 18 Nov 92]... 31
BULGARIA

Health Authorities Contemplate Stricter Measures on AIDS [Sofia BTA, 30 Nov 92]

CZECHOSLOVAKIA

CSFR: Twenty-Nine Cases of AIDS Registered [Prague CTK, 30 Nov 92] . 32
POLAND

118 Aids Cases Registered, 2,500 Carriers Identified /Warsaw PAP, 30 Nov 92] .... 32

ROMANIA

Of 2,235 AIDS Cases, 2101 Involve Children Under 13
[Rodica Dirzu; Bucharest TINERETUL LIBER, 6 Apr 93] .....

YUGOSLAVIA

FRY: 239 Cases of AIDS; 137 Deaths, Mostly Drug Addicts (Belgrade POLITIKA, 2 Dec 92] ...... 32
All 44 AIDS Cases in Croatia Contracted Abroad

[G. Galic; Split SLOBODNA DALMACIJA, 3 Dec 92]_....
Croatia: Medical Officials Give Details of AIDS Statistics /Zagreb radio, 1 Dec 92] ..
Macedonia Issues Program To Prevent Spread of AIDS _/Skopje SLUZBEN VESNIK, 4 Jul 92]



40 EAST EUROPE

Epidemiological, serological, and clinical tests;
Formulation of operative programs;

Cooperation with educational and instruction institu-
tions and the Red Cross and other entities interested and
responsible in connection with the health instruction of
the population, especially in the schools and among
young people and among individual high-risk population
groups.

3. Activities of the Republic Health Protection Institute:
5,600,000 denars.

4. Activities of the Communicable Diseases and Febrile
Conditions Clinic: 4,200,000 denars.

5. Activities of stomatological clinics of the Skopje
Stomatological Department: 4,200,000 denars.

6. Activities of the Republic Transfusion Institute:
4,900,000 denars.

7. Activities of the Bardovci Hospital for Nervous and
Mental Diseases Hospital, Skopje: 1,400,000 denars.

8. Activities of the Macedonian Red Cross: 700,000
denars.

9. Activities of the Republic Commission: 350 million
denars.

Total: 47,550,000,000 denars [sic]

JPRS-TEP-93-008
23 April 1993

10. Fund Sources

Sources for basic health protection (outpatient-
polyclinical testing and treatment) and hygiene-
epidemiological activities in the opstinas and Republic
medical establishments and the Macedonian Red Cross
involved in the implementation of the program will be
provided, for the first 80 percent, out of funds for health
insurance, and 20 percent from the Republic’s budget, as
follows:

Health insurance funds: 38 million denars;
The Republic budget: 9,550,000 denars;
Total: 47,550,000 denars.

The allocation of funds out of such sources will be based
on the regular supervision of work done and reports and
receipts received and, the proposed expert consideration
of the Republic Expert Commission on the Organization
and Submission of Measures for Protection From AIDS.

The implementation of this program will be assigned to
the Ministry of Health, which will regularly report to the
government of the Republic of Macedonia.

The mentioned program shall be published in the
SLUZBEN VESNIK NA REPUBLIKA MAKEDON-
IA.



38 EAST EUROPE

In charge: the stomatological clinics

The curriculum for students will include lectures on this
problem in order to acquaint them with the features of
that disease and the ways and means of the spreading of
the infection and of the means of prevention.

Dentistry students and graduates will be trained in the
easy detection of the individual infections in the mouth
in the early stage of the disease.

In charge: the stomatological clinics

Repeated expert supervision and control will be prac-
ticed during the third quarter in all dental services in the
Republic of Macedonia in order to provide further
expert assistance to the stomatological workers, and
determine the steps that were taken and the implemen-
tation of their operative programs drafted in the first half
of the year.

Separate reports will be submitted to the Republic San-
itation and Health Inspectorate and the supervised
health institutions.

In charge: the stomatological clinics

6. Activities of the Republic Transfusion Institute

To prevent the transmission of AIDS (HIV infection)
and hepatitis (infection with HBV and HCV) through
blood and blood derivatives.

A total of 65,000 containers will be tested for AIDS and
hepatitis B (HIV antibodies and HBAg) by the Republic
Transfusion Institute and 11 transfusion stations in the
Republic in the following cities: Kavadarci, Tetovo, Stip,
Titov Veles, Strumica, Prilep, Ohrid, Bitola, Kocani,
Gevgelija, and Kumanovo.

In 1992 another seven blood transfusion centers will be
equipped for blood testing: in Struga, Gostivar, Kicevo,
Negotino, Kriva Palanka, and Debar.

Additional equipment must be supplied to the transfu-
sion centers as well as trained personnel for testing for
AIDS and HBAg so that all transfusion centers will be
able to test for HIV antibodies and for HBAg. For the
time being, such testing for centers without the proper
equipment will be serviced by neighboring centers, so
that all blood can be tested.

In charge: Republic Transfusion Institute and transfusion
centers

Testing for infectious HCV (6,400 samples from dif-
ferent donors in various cities in the Republic of Mace-
donia for HBAg positive and HBAg negative), half of the
total in 16 cities in Macedonia: Skopje, Kavadarci,
Tetovo, Stip, Titov Veles, Strumica, Prilep, Ohrid,
Bitola, Kocani, Gevgelija, Kumanovo, Struga, Kicevo,
Kriva Palanka, and Gostivar, 400 samples per city, for
200 HBAg positive and 100 HBAg negative. In the
future, such testing will be gradually expanded.

IJPRS-TEP-93-008
23 April 1993

In charge: Republic Transfusion Institute

Seminars will be held with physicians working in the
transfusion services in the Republic, as follows:

Seminar for protecting the health of donors and of
personnel handling blood and blood derivatives;

Seminar for work in and supervision of laboratory work
related to the identification of HIV, HBAg and HCV
antibodies, documentation on the work done and pro-
cessing of the results;

Seminar for the health education of donors related to
infectious HIV, HBV, and HCV in schools, university
departments, and work organizations, as part of the
program for the health education of donors (the program
will be aimed at the donors through the radio, television,
the press, and other types of promotion).

In charge: Republic Transfusion Institute

Competition for writing the best article (description) of
current knowledge concerning infectious HIV, HBV, and
HCV, describing comprehensively problems related to
infectious HBV, and activities of the WHO related to
protecting the population from infectious HIV, HBV,
and HCV. The conclusions of the Second Scientific
Gathering on Virus Hepatites, held by the Macedonian
Academy of Arts and Sciences on 4-5 October 1990, shall
be made public and discussed. On a bimonthly basis the
material must be published in the daily press and broad-
cast on radio and television. Such activities to be
repeated on an annual basis.

In charge: Republic Transfusion Institute

The Institute will provide expert supervision and expert
assistance to the blood-transfusion centers in the indi-
vidual opstinas, particularly in connection with labora-
tory testing for AIDS and hepatitis B.

Reports must be drafted and submitted to the Republic
Sanitation and Health Inspectorate, the Republic Health
Protection Foundation, and the medical facilities in
charge of providing expert supervision.

7. Activities of the Bardovci Nervous and Mental
Diseases Hospital

The Nervous and Mental Diseases Hospital will formu-
late an annual program for the prevention and spreading
of drug dependency and early identification of drug
addicts who will be subject to specialized health super-
vision. The purpose of such program activities, in addi-
tion to the struggle with drug addiction, will also be
aimed at preventing the spreading of AIDS among and
by drug addicts.

In addition to the Skopje Consultation Center, expert
and methodological aid will be provided in organizing
and advancing work done in other consultation facilities
in the larger centers in the Republic.


JPRS-TEP-93-008
23 April 1993

synthetic products, known as “molecular inducement
devices,” were created in the faculty laboratories.

The optima! inducement device has a higher capacity to
connect itself to the virus. A virus caught by the induce-
ment device will be unable to enter the cell and will be
removed from the blood by the immune system.
According to Prof. Gershoni, “Eighty percent of the
receptor’s molecular structure is not involved in the
identification process; our present research is focused on
the remaining 20 percent.”

The first group of artificial inducement devices have
already been tried out on AIDS patients in the United
States, but did not lead to a cure. “What we really need
is a model from which we can learn the basics of
developing functional inducement devices, and in this
field we are already making great progress,” said Prof.
Gershoni.

Professor Amnon Hisi of the Faculty of Medicine heads
another group of researchers investigating the second
stage of the contagium. After the virus has penetrated the
cell’s envelope, it must pass a further stage in which it
reproduces itself, before entering the cell’s nucleus. After
the penetration of the nucleus, the virus is absorbed by
the cell’s genetic matter, thus resulting in infection.

Prof. Hisi’s research examines the molecular qualities of
the enzymes involved in reproduction, in the hope that it
will be possible to prevent the procedure. “The more we
know about enzyme structure, the greater our ability will
be to prevent the process, and to create specific treat-
ments that do not endanger the active cells”, said Pro-
fessor Hisi. In the investigation into the possible causes
of damage to the enzyme structure, the scientists are
studying scores of natural materials from the Red Sea.
Thus, proteins that had been synthesized under methods
of genetic engineering were launched aboard the space
shuttle “Columbia” in the hope that in the absence of
gravity the more productive proteins may be synthe-
sized.

According to Prof. Gershoni, AIDS research is pro-
gressing very slowly due to, among other factors, the
rapid transformation of the virus and to the fact that the
virus develops a quick immunity to treatment.

PAKISTAN

170 HIV, AIDS Cases Detected in 1992

BK0704084893 Islamabad THE MUSLIM in English
7 Apr 93 p 4

{Text] Islamabad—April 6—The total number of HIV
and AIDS cases, detected by the end of December 1992
are 170. Out of this figure 25 are AIDS cases. This was
told in a high level meeting of AIDS, held here at the
Ministry of Health.

NEAR EAST/SOUTH ASIA 63

The meeting was chaired by Minister for Health, Syed
Tasneem Nawaz Gardezi and attended by senior offi-
cials of Health Ministry and National AIDS Programme
(NAP). The participants of the meeting reviewed in
detail the progress and activities in connection with
prevention and control of AIDS in Pakistan, particularly
during the present regime.

Dr Satwar Habibur Rehmam Deputy Director General
Ministry of Health informed the minister that 25 AIDS
screening kits and materials are being provided free of
cost and tests are being carried without any change in
these centres, he added.

It was told in the meeting that more than 263,828
persons have been tested for AIDS till December 1992
while this number will reach around 365,000 this year.
Dr Sarwar who is also national coordinator of NAP
informed that the AIDS tests have been conducted on
cross sections of population including prostitutes, inject-
able drug users, prisoners, sailors, people returning from
abroad referred cases, TB patients, blood donor, refugees
and volunteers for AIDS testing.

The participants of the meeting were also informed that
it has been decided that AIDs free certificates will be
mandatory for foreigners and sailors coming to Pakistan.
Similarly these certificates are also required on all
import of blood, blood products, vaccines etc. Further-
more, blood transfusion services, both governmental and
private will be recognised to exclude any possibility of
AIDS dissemination by this process.

The meeting also reviewed the steps for creating aware-
ness among masses for the preventation and control of
AIDS.

AIDS Said Spreading, Wider Spread Feared

93WE0132A Peshawar MASHRIQ in Urdu
II Nov 92 p 10

[Editorial: “The Problem of AIDS in Pakistan Requires
Attention”]

[Text] Following his tour of the Northern areas and
Hazara division, a foreign doctor, [?Sircles Broad],
announced that more than 10,000 individuals in the
Frontier province and northern areas were suffering
from AIDS but that due to the lack of screening facilities,
these individuals had not been diagnosed as AIDS
patients. He said that Pakistani doctors had estimated
that there were 250 individuals suffering from AIDS but
that statistics could be relied upon only up to a limited
extent. Because of the speed with which AIDS is
spreading throughout the world, it is necessary to estab-
lish AIDS diagnostic centers in poor and backward
countries; Pakistan is also a developing country.
Recently, Dr. [?Eram] disclosed that AIDS diagnostic
appliances ordered for Pakistan were lying idle because
no one knew how to operate them. At present, the



8 AFRICA

In commercial farms, workers were being given pay
packets which include condoms. The response of the
workers was said to be gradually improving, judging by
the decline in numbers of sexually transmitted diseases
treated at clinics within farming communities.

The World Health Organisation estimates that at least
6.6 million adults are infected with the AIDS virus, a
figure expected to rise to 10 million next year.

It said the better educated and more productive workers
in cities are infected in disproportionately large num-
bers. But taking care of patients was likely to use up a
substantial share of available funds for health pro-
grammes, and the economic and social costs were
expected to be enormous as well.

Mr Frazier-Mackenzie said it would be important to
sustain the progress in AIDS awareness through surveil-
lance, training and improvements in the accessibility
and quality of health care.

Far too little was left for medicines and other essential
inputs, while infrastructure for health delivery had vis-
ibly deteriorated particularly in rural areas.

While between 30 and 50 percent of hospital patients
were said to be infected with the AIDS virus, about 50
percent of Zimbabwe army and police personnel was

JPRS-TEP-93-008
23 April 1993

believed to be HIV positive. No comment was available
from the Ministry of Health and Child Welfare last
night.

AIDS Statistics in Bulawayo Reported

93WE0290B Harare THE HERALD in English
18 Jan 93 p$

[Text] Bulawayo—A total of 76 people died of AIDS or
HIV-related diseases in Bulawayo, representing 17 per-
cent of all the deaths recorded in the city in November
last year, according to the latest council minutes.

The highest number of 20 deaths, due to the disease, was
recorded in the 0-4 age group. According to the minutes,
more men than women died that month because of the
disease.

Councillor Dennis Ndlovu asked about the possibility of
terminating the pregnancy of an HIV-positive mother.
The deputy director of health services, Dr Rita Dlodlo,
said this was medically possible, although it was not yet
being practiced in the city.

Responding to questions from the town clerk, Mr Mike
Ndubiwa, Dr Dlodlo said there was a 30-50 percent risk
of a newly born child getting AIDS from its mother at
birth.

She said there was also a 50-70 percent chance of
survival for the child even if he/she had AIDS.



50 NEAR EAST/SOUTH ASIA

Number of Individuals Reported HIV Positive From

December 1985 to September1992
Year Adults Children Total
1985 6 0 6
1986 7 0 7
1987 23 0 23
1988 58 0 58
1989 61 1 62
1990 85 4 89
1991 31 3 34
1992 59 6 65
Total 330 14 344

AIDS Day Emphasizes Behavior

93WE0292B Algiers EL WATAN in French
18 Jan 93 p 14

[Article by C. Maouchi and K. Benelkadi: “Prevention Is
the Only Medicine”)

[Text] AIDS Day, a conference among specialists orga-
nized by the health district of Hussein Dey, took place
yesterday at the Aurassi Hotel, drawing a relatively large
number of participants.

In opening the discussions, Professor Bouguermouh felt
it was important to begin with a few figures that provide
a better understanding of the rate at which this deadly
disease is progressing: “There are now more than 130
cases of AIDS in Algeria and 340 individuals who are
HIV positive. The disease appears to double every 18
months, If that pace continues, we will see the number of
AIDS cases grow to 300 or 400 over the next 3 years.”

For a country that is discovering an “evil” long consid-
ered taboo, the picture is a grim one. Far from taking a
complacently optimistic view, the professor warned that,
“You will see increasing numbers of these cases in the
hospitals, in your milieu. What should be done? What is
the attitude to take? Two approaches are possible:
avoiding the spread of infection by providing complete
care for the ailing, and prevention.”

The purpose of the organizers, in fact, was to demon-
strate that only prevention can soften the impact of this
contagious disease. The task of correcting misconcep-
tions fostered by sensationalistic talk will be an enor-
mous effort.

The press is proving to be very helpful. The goal is to
deter certain types of behavior. “To possess information
is not enough; it must be applied to risky forms of
behavior,” a speaker noted. In a presentation peppered
with statistics, Doctor Chakkar described the magnitude
of the disease: “According to the WHO, 90 to 95 percent
of reported cases were sexually transmitted. The disease
knows no barriers. The first case was detected in the
United States in 1981 and the virus was identified in

IPRS-TEP-93-008
23 April 1993

1983. There is still no treatment or vaccine against the
disease. Nothing seems able to stop it.”

In 1992, a worldwide total of 2 million HIV-positive
individuals was reported. At that rate, there will be 20
million AIDS patients by the year 2000. Certain African
countries are threatened with extinction. Japan is the
only country to have escaped this “unique disease.”

Doctor Amrane spoke of the AIDS patients treated at the
El Kettar University Hospital Center. Forty of the 60
patients have died; the whereabouts of 14 others are
unknown; and six are still receiving medical care.

They are 20 to 40 years old. Most of them contracted the
virus through drug use. Among those lacking an occupa-
tion, a majority lived abroad for several years.

Promises that a vaccine may be imminent are all that
sustain those who suffer from AIDS in a hostile environ-
ment. AIDS in children was the focus of a presentation
by Dr. Djenaoui. Using slides, he discussed the danger
posed by an AIDS-afflicted mother to her child during
pregnancy. According to Dr. Djenaoui, the disease may
even be transmitted through breast milk. The meeting
also addressed the subjects of blood screening, a link
between prostitution and AIDS, ethics, and regulations.

The gathering was an opportunity for specialists to
exchange information and to dispel misunderstandings.
A national program to combat AIDS is necessary if the
ravages of the disease are to be kept to a minimum.

Blood Screening at Centers

93WE0292C Algiers EL WATAN in French
18 Jan 93 p 14

[Article by N.B.: “Where Does AIDS Testing Now
Stand?”

[Text] When Dr. Bouguermouh, an epidemiologist by
profession, suggested in a televised discussion that as
many as 30,000 individuals in Algeria may be HIV
positive, the country was stunned. That is a legitimate
reaction in the absence of a clear understanding of the
correlation between the modes of transmission and the
modes of prevention for a disease that has long been the
subject of myth.

The Blood Transfusion Center in Blida, which accepts
patients from the provinces of Algiers, Tipaza, and
Medea, receives an allotment of only 192 diagnostic tests
every two months from the Pasteur Institute. “We are
not even able to perform the required analyses on
samples of the blood we collect—a monthly average of
300 samples,” we were told by Mr. Hanachi, the director
of the center.

As part of pre-operative testing, surgeons occasionally
require patients to undergo the HIV test. In other cases,
a medical examination may reveal symptoms that lead a
doctor to suspect that a patient is afflicted with AIDS.
The Blood Transfusion Center is able to screen for HIV



56 NEAR EAST/SOUTH ASIA

Cases in Himachal Pradesh

93WE0304C Bombay THE TIMES OF INDIA
in English 18 Feb 93 p 14

[Article by Jagdish Bhatt: “Rise in HP AIDS Cases
Alarms Medics”]

[Text] Hamirpur (Himachal Pradesh). February 17. Doc-
tors here are of the view that three AIDS deaths, six
existing HIV-positive cases and a suspected AIDS
patient (his blood is yet to be tested) may only be the tip
of the iceberg regarding the number of carriers of the
deadly virus in Himachal.

They say that as no screening of either the high-risk
group or those not responding to treatment has been
done in other districts of the state, there is a possibility
that many carriers of the virus may remain unidentified.

The experts say that several factors are making Himachal
a high-risk state. There are many people here who work
as truck drivers and helpers and operate on metropolitan
routes. Their purported promiscuity could make them
AIDS carriers.

Besides, a large number of foreigners throng Kullu,
Manali, Dharamshala and other resorts. The prevalence
of the high rate of sexually-transmitted diseases in cer-
tain parts of the state and the practice of polyandry and
polygamy also go a long way in making Himachal a
high-risk state.

Incidentally, of the three deaths that occurred, two were
in this district while the third, an ex-serviceman, died
recently in the adjoining Bilaspur district. All the HIV-
positive cases and the suspected AIDS patient also
belong to this district.

Ironically, the first reported case of AIDS came to light
only after Ashok of Sunwin village returned from
Bombay in April last. He was treated at the Galore
Primary Health Centre for tuberculosis.

When he did not respond to treatment there, he was
referred to the district hospital at Hamirpur. Here, too,
he underwent the same treatment, without any results. It
was only at the instance of a doctor, who suspected the
worst and referred him to the Indira Gandhi medical
college at Shimla, that it came to light that Ashok was
full-blown case of AIDS.

His family, ignorant of his disease, brought him home
and got him treated by faith healers, ojhas, hakims and
quacks. He died on December 4, leaving behind his wife
Neelam, 23, and a one-and-a-half-year-old daughter,
Ritu, both HIV-positive. Medical experts here claim that
Ashok was HIV-positive even before marriage.

They said subsequently a screening drive was launched
in the district. The screening was done primarily of
people working as drivers in the metropolitan cities or
those operating on metropolitan routes. Their families
were also considered to be prime suspects.

JPRS-TEP-93-008
23 April 1993

Later, Raghubir Singh, 27, a truck driver of Makkar
village, was tested HIV-positive. His wife and one-
year-old daughter have also tested positive.

Raghubir, at present, is not suffering from any overt
symptoms of the disease. His wife and child also show no
sign of the disease. The local doctors have preferred to
keep them uninformed.

Though Ashok was the first reported case of AIDS in the
state, the first casualty was Mahinder, 40, a truck driver.
The Dhaneta Primary Health Centre had treated him for
abscesses on his legs. His blood was found HIV-positive
and he died 4 months ago. His wife, two sons and a
daughter have, however, tested HIV-negative.

A resident of Harsaur village, in his early twenties, who
too did a stint in a metropolitan city has also been found
HIV-positive.

According to a doctor at the Galore Primary Health
Centre, Naresh Kumar, 22, of Gindwin village, is also
suspected to be an AIDS carrier. However, he is yet to be
tested.

“He worked as a truck cleaner in Delhi and has been
running fever for almost 2 months. He has been under
our treatment for the last few days. We will soon be
sending his blood for test to the district hospital at
Hamirpur,” the doctors added.

The district hospital here is ill-equipped to test the blood
for the HIV virus. “We conduct the Sirodia test and not
Elisa as it is cheaper. When we find any sample positive
we sent it for further confirmation to Delhi or Shimla,”
a pathology department spokesman revealed.

He added that the hospital had conducted 47 tests since
January 16 “thankfully, all have reported negative.”

The director of health and family welfare, Himachal
Pradesh, Dr C. L. Malhotra, said a technical advisory
committee on AIDS has been constituted to keep vigil
and ensure that the disease did not spread.

Madhya Pradesh Scheme

93WE0277A Calcutta THE STATESMAN in English
10 Feb 93 p7

[Article by Sujay Gupta; first paragraph THE
STATESMAN comment]

{Text] Fifty-nine HIV cases detected in three regions of
Madhya Pradesh and speculations that the total figure
may be much higher has led to a plan to check the spread
of AIDS.

Bhopal, Feb. 9—The Government of Madhya Pradesh
has recently formulated a major scheme to check the
spread of AIDS following the detection of some 59 HIV
positive cases in the Bhopal, Jabalpur and Gwalior
regions alone. But officials in the State Health Depart-
ment feel that the total number of AIDS cases is far
higher.


10 CHINA

The polysaccharide medical middle series: sodium hep-
arin, hyaluroic acid and cordyceps polysaccharide;

The clinical immunity diagnosis reagent series: reagents
used for fast diagnosing typhoid, paratyphoid, hepatitis
A, B, C and E.

AIDS Peril Warning in Guangdong Province

54004803A Beijing CHINA DAILY (National)
in English 23 Feb 93 p 3

[Article by staff reporter Zheng Caixiong]

[Text] Guangzhou—AIDS (Acquired Immune-
deficiency Syndrome) is threatening the southern Chi-
nese province of Guangdong, an official from the Pro-
vincial Public Health Bureau has warned.

As of the end of 1992, at least two people had contracted
the disease and another 55 had been detected as carriers
of the HIV virus, which leads to the fatal disease.

Guangdong began AIDS tests in the middle of the 1980s.

Of the two persons who had the disease, one died last
year, and the other went back to Hong Kong for treat-
ment. The one who died was an overseas Chinese from a
Southeast Asian country.

Of the HIV virus carriers, two-thirds were local resi-
dents. Most of them contracted the HIV virus when they
went abroad. Some of the HIV virus carriers were drug
abusers.

AIDS is transmitted mainly through sexual activities and
blood transfer, the official said in an exclusive interview.

So far, a total of approximately 890 mainland Chinese
have been detected as carriers of the HIV virus.

“Guangdong, which fringes Hong Kong and Macao, has
now become one of the provinces in China where more
HIV virus carriers are detected,” the official said.

Yunnan Province, bordering Myanmar, takes the lead in
detecting the number of AIDS victims and HIV virus
carriers in China.

Guangdong has taken the lead in introducing reform and
opening policies, resulting in an increasing number of
overseas visitors and investors in recent years.

JPRS-TEP-93-008
23 April 1993

The official predicted that the number of AIDS victims
and HIV virus carriers would continue to increase as
more overseas visitors come to the province.

Guangdong now has three AIDS examination centres up
to world standards. They are the Guangdong Provincial
Epidemic Prevention Station, Guangzhou Municipal
Epidemic Prevention Station and Shenzhen Municipal
Epidemic Prevention Station.

At these three epidemic prevention stations, AIDS tests
are offered by the World Health Organization (WHO).
Local doctors receive special training before adminis-
tering the tests, the official said.

To prevent the fatal disease from spreading throughout
the province, the Provincial Public Health Bureau has
called for a drive to raise the public’s awareness about
the fatal disease.

Mainland Chinese should pay more attention to pre-
venting AIDS themselves, the official said.

Meanwhile, the Bureau has urged strict control over the
importing of blood products from abroad.

Economists Join in AIDS Research

0W2812063592 Beijing XINHUA in English
0551 GMT 28 Dec 92

[Text] Beijing, December 28 (XINHUA)—Chinese
economists have shown interest in AIDS research.

Experts from the Economics Institute of the Chinese
Academy of Social Sciences said that some preliminary
work has been done.

They have drawn the conclusion that AIDS is not merely
a medical question but it influences socio-economic life
as well.

For instance, investments and loans have to be used as
AIDS-treatment funds, they noted.

The economists’ first job in AIDS prevention is to
evaluate the cost of the spread of AIDS, thus providing
data for policy decisions in this field, experts say.

In this process, the economists must work out academic
models to forecast the impact on labor markets, invest-
ment practices and economic growth.

Other research items include the relationship between
AIDS and the rural labor flow to the cities, and the
relationship between infection and high-labor-flow jobs.

China now has 969 reported cases of AIDS.



JPRS-TEP-93-008
23 April 1993 2

AIDS Peril Warning in Guangdong Province [Zheng Caixiong; Beijing CHINA DAILY, 23 Feb 93] ...... 10

Economists Join in AIDS Research [Beijing XINHUA, 28 Dec 92] 10
EAST ASIA
REGIONAL AFFAIRS
ASEAN Countries To Establish AIDS Task Force {Hong Kong AFP, 1 Apr 93] i
Japan’s Foreign Ministry Announces AIDS Assistance to Thailand 11
‘Comprehensive’ Plan /Tokyo KYODO, 18 Mar 93] ..... IL
Thai Radio Report [Bangkok Voice of Free Asia, 23 Mar 93] 11
BURMA
Health Minister Says Country Now Has 28 AIDS Cases [Rangoon radio, 1 Dec 92] .... 12
CAMBODIA
45 HIV-Positive Cases Found Among Blood Donors /Phnom Penh radio, 2 Dec G2] esses 12
INDONESIA
Health Minister Expresses Worry Over Spread of AIDS [Jakarta ANTARA, 2 Dec 92) ... 12
Official Views AIDS, HIV Cases in Country [Jakarta THE INDONESIA TIMES, 2 Apr 93] 13
New AIDS Cases Found in Outlying Areas (Jakarta KOMPAS, 5 Feb 93] 13
JAPAN
Watanabe May Broach Joint Japan-U.S. Fight Against AIDS /Tokyo KYODO, 10 Feb 93] 14
Research Team Produces Antibody Targeting HIV Enzyme /Tokyo KYODO, 5 Mar 93] 14
LAOS
Anti-AIDS Committee Receives Fund From UK Embassy [Vientiane radio, 1 Apr 93]... 15
MALAYSIA
Number of HIV Carriers Expected To Reach 32,000 by 1995
[Kuala Lumpur BERITA HARIAN, 30 Nov 92] .... 15

Families of Foreign Workers May Be Screened for HIV [Kuala Lumpur BERNAMA, 23 Dec oy 15
NEW ZEALAND

Military Willing To Drop Ban on Homosexuals [Hong Kong AFP, 7 Dec 92] ....
THAILAND

Ministry of Public Health Updates AIDS Information (Bangkok BANGKOK POST, 19 Dec 92] ... 16

15

Doctor Projects AIDS Cases: 1 in 4 /Bangkok DAILY NEWS, 10 Nov 92) ...... 16
Doctor Reports on AIDS Incidence [Long Likhit; Bangkok NAEO NA, 21 Oct 92] 16
WHO Approves Plan for HIV/AIDS Vaccine Development

[Bangkok BANGKOK POST, 16 Dec 92] 17
Public Health Official Comments on AIDS ine

[V. Combek; Bangkok THE NATION, 25 Feb 93] .... 18

‘Uncertainty’ Surrounds Proposed Tests of AIDS Vaccine

[W. Klatalumphon; Bangkok THE NATION, 18 Apr 93} ....
Drug Use, Second High Risk Factor for AIDS /Bangkok BAN MUANG, I Nov 92]
Campaign To Slow HIV Through Condoms Seen Failing

[G. Leijonhufvud; Stockholm DAGENS NYHETER, 23 Feb 93] ..... 20
AIDS Budget Gets Increase /Bangkok BANGKOK POST, 3 Nov 92] .. 21
Budget Bureau Grants Funding for AIDS Publicity /Bangkok BANGKOK PO: 21


SIPRS-TEP-93-008
23 April 1993

words in English]—that is, they would sell attractive
products from home and buy goods to take home. Those
girls were often quickly “bought up” by Turkish pimps
and made to work in brothels. When they are picked up
by police, they are deported. These figures should also be
viewed in light of the fact that Turkey has a very large
number of men (numbering several million) who often
return home with a lot of money in their pockets that
they have earned as immigrant workers in Central
Europe, where they also visit prostitutes, thereby fol-
lowing a common social pattern in their homeland.

That is another factor contributing to the spread of
serious venereal diseases in Europe. In Istanbul with its
10 million inhabitants, there are estimated to be more
than 100,000 prostitutes working full-time or part-time.
In Istanbul, prostitution involving foreign girls is now
organized by criminal elements. The income from just
one customer is the equivalent of a month’s pay in a
girl’s homeland.

When it comes to mobile prostitution in West Europe—
in Amsterdam, for example—about 90 percent of the
girls are from Central or South America (the Dominican
Republic, Colombia, and so on) or Africa (25 percent),
while only 10 percent are Dutchwomen.

Tosum up, mobile prostitution has become a frightening
human, socioeconomic, and medical problem calling for
attention and energetic effort.

ALBANIA

Official Discusses Nation’s Response to AIDS
Virus

AU2212092992 Tirana ZERI I RINISE in Albanian
18 Nov 92 p 1

[Unattributed report: “Has AIDS Entered Albania?”]

[Text] Albania is delayed in relation to the circulation
of the AIDS virus, and perhaps this is the only positive
thing of the half century of political and geographic
isolation of Albanians. However, the breaking down of
the walls of the communist dictatorship made young
Albanians have to face AIDS, this social wound that
corrodes the Western world. Now the only obstacle for
the entrance of the infection has broken down, and
nothing can prevent the entrance of AIDS into
Albania. The specialist doctors say that the AIDS
history in Albania would have started at the beginning
of nineties with the silent circulation of the virus
among the first infected carriers. They do not make
this assertion, because according to them, all the
dubious cases examined so far have not been proved to
be such, not only in the Albanian but also in the other
specialized laboratories.

Do infected persons, displaying no sign of the disease,
exist in Albania? No one can answer this question
precisely; only hypotheses can be made. A total of 10,000

EAST EUROPE 31

serums from various groups of the population have been
examined in Albania so far. No positive carrier has been
found. The specialist doctors assert that this, however,
does not exclude the opportunity of the circulation of the
virus secretly and silently. They stress that now is the
most convenient time to be protected against it.

The World Health Organization has supported Albania
in this field. It has brought three modern laboratories,
two of which are now functioning. The examination of
half of the blood donors have already started, and this
number is expected to increase in the next months by
putting into operation the third laboratory and starting
examinations in the blood centers of five big districts.
The diagnostic materials have already arrived and are
waiting to be put to use. However, the health employees
should work a lot in this respect in informing the
middle-level medical personnel, ameliorating the steril-
ization procedures, sensitizing the broad public, espe-
cially those who go abroad, as the opportunity of getting
into contact with the virus is much more greater. Dr.
Besim Nuri, deputy health minister, confirms in the
periodical SCIENCE AND LIFE that “AIDS is some-
where hiding secretly. We have a great struggle ahead,
whose majority of battles we can win if we act in time.”

BULGARIA

Health Authorities Contemplate Stricter Measures
on AIDS

AU0112075092 Sofia BTA in English 1940 GMT
30 Nov 92

[Text] Sofia, November 30 (BTA)—111 People in Bul-
garia are HIV-positive but their actual number is prob-
ably about 800, Dr. Popova, senior expert at the Min-
istry of Health, told BTA in connection with the
International Day for Combating AIDS to be marked on
December 1. Seventeen people have reached the clinical
phase of the disease since 1986 when aids testing began
in Bulgaria, thirteen of them died.

Consulting rooms where those willing can go for AIDS
tests have been recently opened in 28 Bulgarian towns
and cities. The latest data arouse great concern as they
show that young people are increasingly falling victims
to AIDS. The National AIDS Programme and the Pro-
gramme Council for Combating Aids will propose the
adoption of legislation under which people spreading the
disease deliberately will be liable before the Law.
According to specialists, the matter is urgent as there
have been established cases of deliberately spreading
AIDS.



|

|

JPRS-TEP-93-008
23 April 1993

“An unprotected sexual act with an HIV-infected person
Poses an obvious danger to life and health,” the judge
said when he read the reasons for the verdict.

In imposing the sentence the judges took the fact that the
women had voluntarily consented to have sex into
account. The three judges agreed on the question of guilt,
but did not agree on the sentence. One of the judges
wanted a sentence of only a year in jail while the other
two set the jail term at a year and a half.

The two 13-year-old girls each received 15,000 kroner in
damages because they were under age. The 21 other
women received no compensation because the court felt
they should have made sure a condom was used them-
selves, By not doing so they accepted a risk of being
infected.

Diego Joanis and his defense attorney, Bent Unmack
Larsen, immediately appealed the sentence to superior
court.

Impact on Sex Habits Seen

93WE0307B Copenhagen BERLINGSKE TIDENDE
in Danish 13 Mar 93 p 6

{Article by Kirsten Sorrig: “Doctor: HIV Verdict May
Change Our Sex Habits”]

[Text] The sentence of a year and a half in jail that was
handed down to HIV-positive Diego Joanis is an effective
safe sex message. That is the opinion of the Public Health
Administration and practicing physicians. It has been
criticized by people who are HIV-positive,

“It is a verdict that will make people think twice.”

Chief physician Michael von Magnus of the Public
Health Administration is convinced that the sentence of
a year and a half in jail that was handed down to
HIV-positive Diego Joanis will have an effect.

“It will make no difference to Denmark’s AIDS policy.
But it will remind people that the infected person does
not have sole responsibility but shares it with uninfected
people,” said von Magnus. “The case seems to indicate
that many women do not believe there is any risk.
Therefore it is good to emphasize that both parties have
a responsibility. One cannot see whether people are
infected by looking at them. One simply has to protect
oneself.”

The chairman of the practicing physicians’ association,
Ole Svendsen, wanted to use the verdict to make an
appeal to his members:

“Tt is important for doctors who counsel HIV-positive
patients to do more than simply stress practicing safe
sex. They must make it clear that it is totally immoral for
HIV-positive people to go to bed with others without
telling them they are infected,” he said.

WEST EUROPE B

Prof. Finn Trunk Black, M.D., of Marselisborg Hospital
in Arhus agreed that it is not enough for HIV-positive
people to use condoms.

“Their sexual partners must have an opportunity to back
out—and condoms can break too. Safe sex is not safe sex,
it is safer sex,” he said.

Dr. Black thinks the verdict may have positive effects.
Partly by attracting attention and partly because doctors
can now use the verdict to emphasize the responsibility
of HIV-positive people.

“But actually the case is totally atypical. Our experience
has been that HIV-positive people are very responsible.
On the other hand I cannot help being amazed that so
many women were ready to practice unsafe sex with a
man who comes from one of the highest risk areas in the
world.”

Among HIV-positive people the verdict met with criti-
cism. Peter Sander, chairman of the Positive Group,
called it unnecessary.

“If the established public health system had lived up to
its responsibility in time this could have been avoided,”
he said. “HIV-infected people are left on their own far
too much when they have to figure out how to function
in a time of deep crisis. That is the way it was in 1985
when the Haitian acquired his HIV status and that is the
way it is today,” he said.

The Positive Group has around 200 members, provides
counseling to HIV-infected people, and refers them to
self-help groups.

The new verdict is expected to have great fundamental
importance for similar cases in the future. Among others
for a case in Vordingborg where two women have
reported a 25-year-old man for practicing unsafe sex
even though he knew he was HIV-positive. The case is in
the hands of the public prosecutors who wanted to wait
for a verdict in the Joanis case before deciding whether
to file charges.

HIV-Infected Man Indicted for Unsafe Sex

93WE0303C Copenhagen BERLINGSKE TIDENDE
in Danish 7 Mar 93 p 4

[Article by Dorthe Wamsler: “HIV-Positive Man
Charged With Unsafe Sex”]

[Text] Vestre Superior Court released a 32-year-old HIV-
infected man yesterday who is charged with rape and
endangering the life of others.

Vestre Superior Court released a 32-year-old HIV-
Positive man charged with rape and endangering the
life and health of others from custody yesterday. Arhus
Municipal Court had ordered the man detained for
four weeks on Friday [5 March], according to Detec-
tive Inspector Christian Frokjaer of the Arhus police
department.



IJPRS-TEP-93-008
23 April 1993

The term vaccine tends to be associated with immuni-
sation and Dr Prayoon is concerned people will hear
about vaccine trials and assume that they need not worry
about protecting themselves anymore from the disease.

Research into a different kind of candidate vaccine—a
prophylactic vaccine which will immunize people from
the virus—is still a long way from being licensed. In the
meantime, Dr Prayoon and Er Praphan both believe
Thailand should focus on learning from the tragedy of
the current epidemic and improve social morality so the
sex trade is no longer accepted by men and women.

But changing people’s sexual behaviour is proving
harder than people expected in the early 1980s when the
disease first emerged in Thailand. Despite intensive
public health campaigns over the last 3 years, men and
women are still having unprotected sex.

“Thailand is now Aids-aware and most poeple know
about the disease, but they still put themselves at risk,”
said Dr Praphan.

For 10 years, Dr Praphan has worked with Aids and HIV
patients and has seen the disease spread. In the last 6
months, the number of patients coming to his Tuesday
morning clinic at Chulalongkorn Hospital has doubled
and instead of being mostly male patients, half his
patients are female.

He is against money being funnelled away from Aids
education, which he says must be a priority. “We need
good educators to make people committed to changing
their behaviour. This is still the best protection against
the virus.”

The Ministry of Health is now in the preparation stage
for vaccine trials and the education budget remains
intact. In the next year, it plans to equip the laboratories
and set up the medical personnel. The first step towards
trials was made last month at the HIV/Aids Vaccine
National Plan meeting when the scientific community
was alerted to get ready for trails.

Dr Prayoon does not expect any trials to begin for at least
ayear. He is still wary and said, “We should not sacrifice
the life of a Thai citizen to an inappropriate and uneth-
ical study.” But most HIV-positive people feel they are
capable of making their own choice. [passage omitted]

‘Uncertainty’ Surrounds Proposed Tests of AIDS
Vaccine

BK1804021493 Bangkok THE NATION in English
18 Apr 93 p A2

[By Wanchat Klatalumphon}

{Text] Testing a potential Aids vaccine on local volun-
teers as proposed by the Army Medical Science Depart-
ment should not present any ethics problems, but

EAST ASIA 19

whether it is carried out will depend on the National
Aids Committee (NAC), a senior health official said
yesterday.

The secretary of the Medical Department’s committee
studying the Aids vaccine test on humans, Doctor
Wichai Chokwiwat, said the panel concluded late last
month that the proposed test would not create any ethics
problems.

The NAC, he said, will now be asked to consider the
proposal.

Wichai said the committee on April 23 will consider
another project involving the testing of a potential Aids
vaccine on humans being proposed by Chulalongkon
University’s Faculty of Medicine.

But a highly-informed source in the Communicable
Diseases Control Department said yesterday that there
was uncertainty about the proposed Aids vaccine test
and other anti-Aids projects because the NAC’s status
has yet to be formally established.

Although Prime Minister [PM] Chuan Likphai has
endorsed the appointment of the committee members,
whose names were submitted to the PM’s Secretariat late
last year, the Cabinet has not yet approved the panel’s
status, he said.

Until the committee gets the Cabinet’s approval, anti-
Aids projects proposed by different health agencies
cannot be implemented, the source said.

An informed source in the Medical Department’s com-
mittee which agreed to the Aids vaccine test said yes-
terday that the NAC may yet reject it. The source based
his opinion on earlier views by NAC senior members
that a vaccine is not the most suitable way to fight the
deadly disease.

The NAC members, he said, prefer a campaign to urge
people to be restrained in their sexual behaviour.

The former director general of the Army Medical Science
Department, Lt Gen Phinyo Siriyaphan, now an adviser
to the proposed test of a potential Aids vaccine on Thai
volunteers, said yesterday the department planned to
test the GP-160 vaccine on 24 volunteers in the first
stage. Experiments involving the vaccine are under way
in the United States.

The number of volunteers would increase to more than
100 in the second stage, he said.

Phinyo said all the volunteers would be military per-
sonnel holding ranks from private to colonel.

The director of the Thai Red Cross Society’s Aids
Project, Dr Praphan Phanuphak said yesterday the vac-
cine that Chulalongkon University’s Faculty of Medicine
planned to test on Thai volunteers is the type developed
from GP-120, which is also being tested in the United
States.



Epidemiology

AIDS
JPRS-TEP-93-008 CONTENTS 23 April 1993
AFRICA
REGIONAL AFFAIRS

AIDS in Burundi, Rwanda [Christiane Chombeau; Paris LE MONDE, 12-18 Oct 92] ...
ANGOLA

AIDS Situation in Country Examined ... 1
Awareness Program [Luanda JORNAL DE ANGOLA, 25 Nov 92] 1
Slow Response /Luanda JORNAL DE ANGOLA, 1 Dec 92] .. 2
Figures Given /Luanda JORNAL DE ANGOLA, 1 Dec 92] 2
Epidemic Disease Statistics for Luanda Revealed [Luanda JORNAL DE ANGOLA, 22 Aug 92] ... 3
KENYA
Estimated Over 750,000 HIV Positive [Nairobi THE KENYA TIMES, 3 Dec 92] 3
NIGERIA
In 3 Years 4 Million May Be AIDS Carriers
[O. Orere, B. Ukwuoma; Lagos THE GUARDIAN, 14 Jan 93] ... 3
Federal Government Earmarks Fund To Fight AIDS Lagos radio, 1 Dec 92] 3
SOUTH AFRICA
Events at National AIDS Convention Analyzed
[M. Gevisser, P. Stober; Johannesburg THE WEEKLY MAIL, 5 Nov 92] .... 4
AIDS Figures Said To Be Underreported Johannesburg THE STAR, 10 Nov 92] .. 5
Western Cape AIDS Statistics Reported /Cape Town THE ARGUS, 6 Oct 92] ... 5
Prisoners With AIDS To Receive AZT
[Alex Dodd; Johannesburg THE WEEKLY MAIL, 3 Dec 92] .... 6
Charter of Rights for AIDS, HIV Victims Launched
[James Brittain; Johannesburg SUNDAY TIMES, 22 Nov 92] 6
UGANDA
Senior Army Officer Arrested in ‘Major’ Crackdown [Paris AFP, 15 Dec 92] .... 6
ZAMBIA
More Than 6,000 AIDS Cases Reported /Lusaka TIMES OF ZAMBIA, 17 Jan 93] .... 7
ZIMBABWE
17 Percent of Population Reportedly Carry AIDS Virus Johannesburg Africa radio, 18 Jan 93] .. 7
At Least 1.5 Million Infected With AIDS {Harare THE HERALD, 18 Jan 93] 7
AIDS Statistics in Bulawayo Reported {Harare THE HERALD, 18 Jan 93] .. 8
CHINA
AIDS Cases Update [Chen Ke; Beijing RENMIN RIBAO, 25 Sep 92] .... 9
970 People Tested HIV Positive [Beijing ZHONGGUO XINWEN SHE, 19 Mar 93] . 9
Faster Way Developed To Identify AIDS Victims (Beijing CHINA DAILY, 8 Mar 93] 9



IPRS-TEP-93-008
23 April 1993

under his supervision. Some he used not only to house
the minors, but to rent out rooms to people down on
their luck, provided they did not interfere with his
lifestyle. A few days ago, Camburao was arrested and
sent back to FEBEM. This news came from Fabiano dos
Anjos, 16, who was in that juvenile house of correction
when Camburao arrived. “I and some other boys man-
aged to escape again,” said Fabiano. “But Camburao had
a hard time jumping over the wall because he is so fat
and heavy.” Evicted from Bueno de Andrade and with
Camburao no longer around, the juveniles had to dis-
perse. “Now I have no fixed address,” Rosana said.
Some of the boys went to a boardinghouse at 424 Doutor
Tomaz de Lima, and another group went to the Hotel
Classic, at Number 612 of that same street. Rosana is the
gatekeeper for the boys at the hotel, which serves as a
sort of hideout. If you ask at the door, however, you find
out that no one has ever seen or heard of Rosana and the
boys. Last Friday night, 6 January, ISTOE inquired as to
the rates at that hotel. The answer from Fatima, the
receptionist, was that the rates are negotiable: “It is
really cheap, don’t worry, it will be no more than
100,000 cruzeiros.”

In these places where they live, the juveniles become
virtual prisoners of their own fears. On the streets, they
always travel in groups. At home, they keep the windows
closed and the doors chained and padlocked to make it
harder for the police to raid them or for strangers to get
in and steal crack. They follow a ritual in using the drug.
For example, one often sees kids asking for or simply
scrounging disposable spring water cups in the bars and
on the streets. Reason: they put the crack in those little
cups. Then they make several holes in the walls of the
cups. They insert soft drink straws in those perforations.
They heat the crack, which melts easily, by putting a
lighter near the mouth of the cup and then they smoke it
through the straws. Like a pipe with several stems, it
allows several boys to use crack at the same time.

Usually they stay awake smoking all night. They sleep
mornings, and most prefer to take to the streets at about
1500. “That is the time to get moving (working), to cook
up some scheme,” said Rosana, who is a sort of leader of
the gang. “Some days we can pick up about | million
cruzeiros, enough to pay for our stuff (crack),” she
explained. This system also includes a mother figure. At
the big house on Bueno de Andrade, for example, Vera
de Souza, 25, is the one who provided the “family
atmosphere.” The same AIDS-infected juvenile delin-
quents who lived with Rosana at the house and are now
scattered along Doutor Tomaz de Lima use some of the
proceeds from their thefts to support Vera and her two
daughters, one 4, the other still an infant.

Although Rosana found out directly from FEBEM
during the 1988 testing that she had AIDS, there are
others who were given that same test but not told of the
results. This situation is more serious when the carrier of
the HIV virus gets married and has children. This is what
happened to Ronaldo Santos, 21. He has been infected
with the AIDS virus since at least 1988, which means

LATIN AMERICA 43

since he was 16. But he did not find out about this until
ISTOE located him through the files and showed him the
test results. Incredulous, Ronaldo reacted as though
asking himself: “If I have AIDS, does my family have it
too?” After a few moments of reflection, he added: “That
is not impossible, I have tried all sorts of stuff, especially
intravenous drugs.”

Ronaldo was born in Sao Paulo, in the Americanopolis
neighborhood in the city’s southern zone. But because of
several problems with the law, he had to move. Now he
is hiding out on the Sao Paulo coast and trying to resume
life with his wife, Ana, and two small children. Ronaldo
married as soon as he got out of prison, promising Ana
that he would move heaven and earth to turn his life
around. “Americanopolis is a pretty hot neighborhood.
You could not even sleep at night because of the gun-
fire,” said Ana, who says she still does not believe her
husband has AIDS. Ronaldo’s first trip to FEBEM came
at age 12, when he was working as a “car-watcher” at the
Ibirapuera Shopping Center in Moema, a neighborhood
near Americanopolis. “I was just a boy and I needed
money. If someone told me that in hell they pay you a
quarter to wash a car, I would be there in a flash,” he
said.

“My father died when I was little and everyone at home
had to work to help my mother,” Ronaldo reported. So
he used to go out every morning “to look for odd jobs.”
“I got lost in the city several times and did not have
enough money to get back home. What protected me—
my good fortune—was that I learned to be street-smart
like the older boys.” That apprenticeship in cleverness
earned him other trips to the institution. Ronaldo has
this to say about his school: “The first time, I went to
FEBEM for glue-sniffing. The second time, it was
because I had become a thief. The third time, a mugger.
The fourth, a murderer.” He also explained that “all
these phases are necessary steps in winning the respect of
the other inmates.” “If you are a patsy (a dupe) at
FEBEM, the least that can happen to you is to be raped
every day,” Ronaldo concluded.

Surprisingly, Ronaldo is in favor of FEBEM. “Without
it, the thieves would be running loose on the streets,” he
said, seemingly forgetting he is a fugitive from the law.
The biggest problem he mentioned is poorly trained
staff. In his opinion, some of the monitors are afraid of
the inmates and give in to them, and so are forced to
leave their jobs. Others resort to violence and win the
respect of all. “The boys at FEBEM are not saints. If the
staff is not strict, we could take over the place,” he
explains. Although avoiding giving much explanation
about his life or the reasons behind his legal troubles, he
let it slip that there are at least eight charges against him,
including one for homicide. “This here (pointing to a
scar on his forehead about 5 cm. long) was nothing,” he
said. “I cut my forehead on a car windshield while
escaping after a bank robbery. Since I am a very good
driver, I always drove the getaway car. No ROTA [the
elite Sao Paulo police force] vehicle can overtake me.”



JPRS-TEP-93-008
23 April 1993

Nguyen Trong Nhan in a speech marking international
AIDS day. But Nhan acknowledged that “these figures
are certainly far from reality” because only 140,000
people have been tested.

While Vietnamese health officials would make no esti-
mate of the actual figure, they said they feared that an
explosion of the fatal disease was inevitable.

“All the necessary factors for an explosion are present,”
said Le Dien Hong, vice chairman of the national AIDS
committee. “We have increasing contact with the exte-
rior, especially along the Cambodian border, while
inside the plague of prostitution and drug abuse is
increasing uncontrollably,” he said.

All but eight of the 79 people found to have HIV are
foreigners, principally Thai fishermen, while the Viet-
namese carriers included prostitutes who had returned
from Cambodia, he said. Furthermore, Vietnam does
not have the means to screen blood transfusions for the
virus, he said.

Foreign experts here praised Vietnam for waking up to
the threat of AIDS ahead of an epidemic, but warned
that viewing the disease as a foreign phenomenon was
dangerous.

“Once the virus is here, it doesn’t matter if it came from
the CIA (the U.S. Central Intelligence Agency), the
Soviet Union or Vietnam itself,” said World Health
Organization representative Bernard Moniere. “The
worm is in the apple.”

Moniere pointed to a recent anti-AIDS film clip por-
traying a young Vietnamese woman as contracting the
virus from an overseas Vietnamese man who returned to
his homeland via Bangkok.

“That teaches people to blame their neighbor,” he said.
“People think that if they have sex with a (local) Viet-
namese it’s safe.” “That’s a major diversion. By the time
people realize that they’re also at risk, it’s too late.”

In Thailand, AIDS spread rapidly from high-risk groups
such as prostitutes to the general population. This is also
certain to happen in Vietnam, said Barbara Franklin of
the aid organization CARE International. She said the
preliminary results of a survey of Vietnamese prostitutes
carried out as part of CARE’s anti-AIDS program found
that half of them were married, and continued to have
sex with their husbands. Only 12 percent used condoms
with their customers.

A stunning 90 percent said they did not think they were
at risk of catching AIDS, explaining in most cases that
they “only have sex with Vietnamese,” she said. “I think
the biggest barrier to AIDS prevention in Vietnam is the
idea that Vietnamese people don’t have AIDS.”

EAST ASIA 2

While the government has begun educating secondary
school students about the risk of AIDS, many of the
measures being considered by the national AIDS council
are clearly targetted at foreigners.

“We think the lifestyle from abroad is strongly influ-
encing our young people,” Hong said.

He said the government would try to target testing on
Vietnamese returning from Cambodia—where the pres-
ence of some 17,000 United Nations troops has fueled
the booming sex trade—as well as foreign workers and
fishermen.

The council has also asked the government to make it
more difficult for ‘shoestring travellers” to enter
Vietnam, he said. “We think that’s one of the ways AIDS
comes in—because they are uncontrollable.”

In reality, however, Asian and Western businessmen
who frequent the red-light districts of Bangkok or Manila
are more likely to carry the AIDS virus to Vietnam than
20-year-old foreign backpackers, foreign experts said.

“Sex tours” to Ho Chi Minh City and the beach resort of
Vung Tao have become increasingly popular over the
last year despite official crackdowns, with the alleged
absence of AIDS in Vietnam a major selling point.

Police sources say Ho Chi Minh City now has close to
50,000 prostitutes, about 10,000 more than in 1975
when the city was known as Saigon.

Observance of AIDS Day

BKO0112162492 Hanoi VNA in English
1454 GMT 1 Dec 92

[Text] Hanoi VNA Dec. 1—A meeting was held here this
morning by the National Anti-AIDS Committee in
response to World AIDS Day-1992.

Present at the meeting were Minister of Public Health
Nguyen Trong Nhan; Minister of Labour, War Invalids,
and Social Affairs Tran Dinh Hoan; Deputy Minister of
the Interior Pham Tam Long; Deputy Minister of Edu-
cation and Training Luong Ngoc Toan and representa-
tives of various public offices, mass organizations,
schools, etc.

Representatives of the UNDP [UN Development Pro-
gram] and WHO were also present at the function.

By the end of November 1992, Vietnam had found 79
persons (including 8 Vietnamese) HIV seropositive from
140,000 blood sample tests.



36 EAST EUROPE

especially in higher-risk areas in which, in previous
years, victims or carriers of the AIDS virus have been
registered, in border areas, in areas with limited traffic
and gatherings, and in tourist areas.

In charge: medical centers and health homes in coopera-
tion with the Republic Health Protection Institute

Regional councils will be organized with the heads of the
health organizations, of medical-hygiene and epidemio-
logical establishments, and Republic sanitation and
health inspectors. At such gatherings steps and activities
will be formulated to prevent the spreading of AIDS in
the area and in each specific separate unit (4).

In charge: the Republic Health Protection Institute

Regional seminars will be held at which health workers
will become closely acquainted with the spreading and
condition of AIDS and with the epidemiological mea-
sures taken, the epidemiological and clinical picture, the
diagnosis of and a number of other features of AIDS, as
well as with the steps that must be taken to prevent the
spreading and ensure the detection of carriers of the
AIDS virus and the sick.

In charge: the Republic Health Protection Institute and
the Republic organizations listed in the operative plan of
the Republic program

The serological diagnosis for AIDS will be based on a
standard methodology. A seminar will be held on
improving the methodology for laboratory diagnosis,
mastering methods, and interpreting results.

In charge: the Republic Health Protection Institute,
Republic Transfusion Institute; Communicable Diseases
Clinic, and health organizations

Epidemiological research and serological control will be
carried out in the Republic, aimed at the early detection
of the sources and ways of transmission of AIDS, and
improving knowledge on the behavior of specific high-
tisk population groups; Yugoslav workers returning from
work in high-risk areas and in other risk areas (border,
tourist, areas with diagnosed cases of the disease, or
carriers of the virus, and so on) will be kept under
serological observation.

In charge: the Republic Health Protection Institute, med-
ical centers, and health homes

Epidemiological and serological tests will be conducted
for each newly diagnosed case of the disease and of
carriers of the AIDS virus with a view to identifying
those infected.

In charge: Health organizations and the Republic Health
Protection Institute

In the case of each confirmed patient or carrier of the
AIDS virus, the special form will be filled on infection
with or death caused by AIDS. It will be submitted to the
Hematological Control Service or the Health Protection

IJPRS-TEP-93-008
23 April 1993

Institute of the respective area; three copies of the form
will be submitted to the Republic Health Protection
Institute; the Republic Health Protection Institute will
submit two copies to the Republic Health Ministry.

In charge: Medical centers, health homes, and the
Republic Health Protection Institute

The epidemiological study of the disease will be made
and advice regarding suitable treatment will be provided
by the epidemiologist of the health organization and the
Republic Health Protection Institute to any person con-
firmed as carrier of the AIDS virus. Positive carriers will
be placed under constant epidemiological supervision,
and their health condition will be monitored. The
moment the initial symptoms of the disease are mani-
fested, said individuals will be mandatorily hospitalized
in the proper communicable disease clinic. Patients
whose condition caused by a specific disease has been
temporarily healed and who have been released by the
Communicable Diseases Clinic, will be once again sub-
ject to epidemiological supervision.

In charge: Health organizations and the Republic Health
Protection Institute

The medical establishments and the Republic Health
Protection Institute will keep on file the specific data and
documentation concerning the carriers of the virus,
especially those infected with AIDS, and fill a special
form on cases of illness or death caused by AIDS.

In charge: Health organizations and the Republic Health
Protection Institute.

Steps will be taken to provide health information and
instruction to the population to ensure a responsible
attitude on the part of every individual and to train a
broad range of health workers in charge of social and
child protection and education, as the basic step for the
prevention and containment of AIDS. Health-education
materials, leaflets, posters, films, cassettes, pamphlets,
the NARODNO ZDRAVJE periodical, and other means
will be used.

In charge: The health organizations, the Republic Health
Protection Institute, the Red Cross, and the other
Republic health organizations included in the operative
plan of the Republic’s program.

Scientific research at home and abroad will be moni-
tored and records will be kept on studies and scientific
research done in the Republic. Specialized publications
will be procured.

The time tracking of all seropositive cases in the
Republic will be organized, with a view to determining
the duration of the asymptomatic period of the carriers
of the virus and the factors influencing that duration.
Increases in seropositive cases and the factors which
contribute to such increases will be monitored.


2 EAST ASIA

University Affairs Deputy Permanent Secretary Kasem
Watthanachai said about 20 million baht of the minis-
try’s budget would be used for a study into whether it was
possible for temples to be used as rehabilitation centres
for AIDS carriers forced from their jobs and families.

Education Deputy Permanent Secretary Athon Chan-
thawimon said the ministry would start a new project
using “karaoke” video cassettes on AIDS for distribu-
tion at entertainment centres.

AIDS Morbidity, Economic Costs

93WE0128A Bangkok THE NATION in English
10 Nov 92 pp B7, 8

[Article: “The Silent Killer Spreads Net: Threatens
Expectant Mothers and the Children in the Womb”]

[Text] The acquired immuno-deficiency syndrome
(AIDS) virus, which only 3 years ago was confined to
high risk groups, is steadily spreading among the general
population in spite of awareness campaigns.

A group of doctors attending the 18th Congress on
Science and Technology of Thailand last month who
portrayed the AIDS scenario in Thailand said the epi-
demic is encroaching on unsuspecting segments of the
society.

Less than a decade after the first case of AIDS was
reported, Thailand is already the country with the
highest number of cases testing HIV positive in Asia.

“Data gathered by us show that the number of HIV
Positive cases among drug addicts has stabilized at about
35-40 percent since 1989. The rate of increase of infec-
tion among members of high risk groups like prostitutes
and their male clients is falling. On the hand, however,
we find the percentage of people representing the general
population testing HIV positive to be on the rise,” said
Dr Khanchit Limpakarnjanarat, a Thai Public Health
Ministry official who also directs the HIV/AIDS Collab-
oration, a joint project of the US Centres for Disease
Control and the Thailand Ministry of Public Health.

Such a trend, Khanchit added, spells both social and
economic disaster.

“In the estimate of Thai Working Group, a non-
governmental organization set up by former Deputy
Minister Meechai Ruchupan, Thailand will have the
about 2.4 million human hosts of the HIV virus by 2000.
Each patient will require a spending of Bt500,000 to
Bt1,000,000 on mediation to keep alive, and will not be
productive during the time. It will amount to an eco-
nomic drain of Btl.5-2.4 trillion,” he said.

Public health officials are concerned that pregnant
women, considered one of the lowest risk groups, are
increasingly reporting cases HIV positive; the number of
cases rose from nil in the middle of 1990 to 1 percent this
year.

SJPRS-TEP-93-008
23 April 1993

“With about one million pregnant women in Thailand, it
means 10,000 mothers-to-be are coming down with the
AIDS virus each year. Statistically one-third of them will
pass the virus to the child. That is, over 3,000 children
will inherit the HIV annually. The number will increase
as the percentage of HIV in pregnant women rises,” he
said.

Khanchit’s estimate concurs with a recent report sub-
mitted to the Public Health Ministry which counts 3,000
mothers with the AIDS virus. The real figure could be
higher.

“The data came from big public hospitals in major
provinces with the facility to check expectant women’s
blood samples,” said a medical source in the public
ministry.

“But the figure does not cover other medical facilities
like private hospitals and rural medical clinics. The
actual figure could, therefore, be higher,” the source
added.

Khanchit said the Public Health Ministry is making
concerted efforts to bring the disease among all the
groups under control though without much success,

“I must admit we have not succeeded everywhere. For
example, we have been able to control the spread of the
virus in drug addicts and, after launching the ‘100
percent condom’ programme, prostitutes. But we have
yet to think up measures to effectively clamp down on
the virus’ growth in other groups such as pregnant
women,” he said.

Part of the problem, he said, stems from husbands being
reluctant to use condoms during intercourse with their
wives. “The husband who is willing to use a condom
when visiting a prostitute thinks otherwise when asked
to do the same with the spouse. The problem stems from
men’s attitudes to the use of condoms; disease preven-
tion in the first case and birth control in the second,” he
said.

The worry over AIDS is not confined to the Public
Health Ministry. At least one other government organi-
zation is equally concerned; the Thai military.

Thai military officials have admitted that there are AIDS
cases among their men in the northern provinces. “Data
on new recruits force us to designate the northern
provinces as areas of alarm with over 10 percent cases
reported,” said Col Dr Narongrid Sirisopana, who works
at the Armed Forces Research Institute of Medical
Sciences (AFRIMS). “I never thought we would see a
read-marked map once again since the days of commu-
nist insurgency decades ago,” he said.

According to Narongrid, a survey by the military shows
an overall increase in the percentage of HIV positive
cases among army recruits from 0.5 in 1989 to 3.2 this
year.



6 AFRICA

Prisoners With AIDS To Receive AZT

93WE0138A Johannesburg THE WEEKLY MAIL
in English 3 Dec 92 p 5

[Article by Alex Dodd]

[Text] THE Department of Correctional Services could
be confronted with a huge bill for AIDS drugs, following
a ground-breaking ruling in the supreme court last week.

On an urgent application by a Pretoria Central Prison
inmate with full- blown AIDS, Cecil van Biljon, the court
tuled that the department should allow the prisoner to be
examined by an Aids specialist of his choice and supply
whatever drugs are prescribed.

The drug most likely to be recommended is AZT, which
costs between R40000 and R100000 a year for a single
patient. According to the department, there are 215
HIV-infected prisoners in South Africa and 12 with
full-blown AIDS.

However, it is unclear whether the department or the
patients themselves will foot the bill. Department
spokesman Colonel D.J. Immelman said: “The under-
taking given at the supreme court was only to allow
access to prisoner Van Biljon to a medical examination
by a consultant of his choice.”

Van Biljon’s attorney Craig Snoyman believes payment
is the responsibility of the state: “These people are in the
custody of the state, therefore it is the state that must
bear the cost,” he said.

He also stressed that the ruling by Mr. Justice J.
Mahomed was “ground- breaking. It will make the next
person’s application easier,” he said.

Van Biljon, whose condition deteriorated into full-blown
AIDS in April this year, is suffering from white sores in
his mouth, blisters in his ears, swollen glands, weight loss
and sweating and vomiting.

To date, he has only received the standard treatment
allotted to other prisoners who complain of weight loss
or those who do gym—vitamin supplements of the kind
readily available at supermarkets.

According to Dr. Steven Miller, one of South Africa’s
foremost experts in the research and treatment of AIDS,
AZT is internationally recognised as the standard care
for people with HIV infection, meeting specified clinical
and immunological criteria.

IPRS-TEP-93-008
23 April 1993

Charter of Rights for AIDS, HIV Victims
Launched

93WE0138D Johannesburg SUNDAY TIMES
in English 22 Nov 92 p 5

[Article by James Brittain}

[Text] A two kilometre red ribbon—the world’s longest
ever—will wind its way from Pieter Roos Park in Park-
town to the Hospice Tree of Light at Braamfontein Civic
Centre to mark World AIDS Day.

The shiny crimson material, sewn together by AIDS
Link, will be carried through the streets on December 1
in a public show of care and love for people living with
HIV and AIDS.

A South African Charter of Rights on AIDS and HIV,
drawn up by lawyers at the Centre for Applied Legal
Studies at Wits University, will also be launched to
coincide with world AIDS Day.

The new charter, drawing on international practices sets
out 12 principles for the fair and just treatment of people
affected by the virus.

The charter will be launched at the Wits Club, west
campus, at 5.30 pm on November 30.

UGANDA

Senior Army Officer Arrested in ‘Major’
Crackdown

AB1612141392 Paris AFP in English 0116 GMT
15 Dec 92

[Text] Kampala, Dec 15 (AFP)—Ugandan police have
arrested senior Army officer Yosam Byanyaga in a
major crackdown on people suspected to be involved
in a recent wave of armed robberies around the
country. Captain Byanyaga, 29, was arrested on
Tuesday, along with three other people, after police
had trailed a car he was travelling in after allegedly
commanding robbery missions.

Byanyaga, commander of an Army battalion near
Mbarara town, some 260 kilometres (162 miles) west of
here, told AFP at his detention cell in a Kampala police
station that he had never been involved in robberies. He
added, however, that he was suffering from the deadly
Acquired Immune Deficiency Syndrome (AIDS).

Earlier press reports had alleged that he was involved in
robberies to find money to complete his house under
construction in a Kampala suburb.

Police say at least 60 incidents of armed robberies
involving Army officers operating through underground
hit-squads, have been uncovered in the last few months.

President Yoweri Museveni recently told a rally of
veterans of his 5-year guerrilla war which brought him


58 NEAR EAST/SOUTH ASIA

Government-Ordered Treatment

93WE0277B Bombay THE TIMES OF INDIA
in English 11 Feb 93 p 11

[Article by Sabina Inderjit]

[Text] The Times of India News Service, New Delhi,
February 10—The government has instructed the coun-
try’s premier medical institution, the All-India Institute
of Medical Sciences (AIIMS), not to refuse treatment to
any AIDS/HIV positive patient, even if it calls for
surgical intervention.

The instructions were issued recently by the Union
health ministry to the AIIMS authorities, following sub-
mission of the long-awaited report into the controversial
handling of an AIDS-related delivery at the hospital in
June 1991.

In its report, the four-member expert group regretted
that unequivocal policy guidelines on the management
of AIDS/HIV positive patients at the AIIMS does not
exist. The disturbing factor came to light in the then
medical superintendent, Prof $.K. Verma’s letter which
stated that though the AIIMS hospital was equipped to
admit and manage a full-blown case of AIDS with
medical complications, arrangements for surgical inter-
vention and other invasive techniques are yet to be
made.

The letter has been seen as a poor reflection on the
hospital. Senior ministry officials have in fact expressed
concern over it. They see no reason why the country’s
topmost hospital or for that matter any hospital should
have any reservations about performing surgery on
AIDS/HIV cases. “We have taken up the matter with the
AIIMS administration and have been assured that a
decision in this regard would be taken soon,” said an
official.

The report notes that every individual has a right to
medical care in a hospital. And it does not behove upon
the staff of the premier medical institute to refuse to
provide care to a HIV patient merely because clear cut
guidelines for handling such cases have not been laid
down by the management.

It may be recalled that a pregnant woman was referred by
the Safdarjang Hospital to the AIDS unit under Prof
AN. Malaviya at the AIIMS after she was detected to be
HIV positive, in May 1991. The patient was referred to
the head of the obstetrics/gynaecology department, Prof
Kamal Buckshee. However, when it came to conducting
the delivery, the hospital administration had to fall upon
the help of an outsider (a former faculty member, Dr S.
Kumar) as the two professors had differed on the facili-
ties available.

The incident was reported in the press and the govern-
ment asked the AIIMS authorities to submit a report.
Not satisfied with the report, the government instituted
an inquiry on July 18, 1991. Interestingly, the committee
never met for seven months even though parliament had

IPRS-TEP-93-008
23 April 1993

been assured a report would be made available within 3
months. Another committee was set up on March 20,
1992 and had to submit its report within a month. But,
it did so only last November.

The committee was to examine the facts and circum-
stances under which Dr Kumar’s help was sought and
whether there was any lapse on the part of the hospital
staff. Besides, it was to review arrangements for thera-
peutic care to AIDS/HIV positive patients in 13 identi-
fied hospitals, recommend improvement in hospital
inspection control system, spell out the type of special
attention required in various departments and recom-
mend steps for training of staff.

The report neither confirms that there was a lapse nor
does it attempt to fix responsibility. The expert group
merely notes that there was a reluctance on the part of
the senior staff of the gynaecology department to deliver
the HIV positive patient.

And apparently there was an anxiety on their part with
respect to inadequacy of infection control facilities,
absence of guidelines for control of infections, fear of
acquiring HIV infection and lack of assurance about
compensation to those acquiring the infection.

What did the hospital authorities do to help the depart-
ment concerned overcome its fears, asks an official. And
why was there anxiety over hospital infection control
facilities when the AIIMS had claimed to have set
guidelines a year ago?

National Committee To Fight AIDS Formed

93WE0116 Calcutta THE STATESMAN in English
6 Nov 92 p 16

{Text] Chandigarh, Nov 5—In a major step to prevent
AIDS in the country, the President of India has consti-
tuted a high-level National AIDS Committee in the
Ministry of Health and Family Welfare, which would be
a forum to bring together various Ministries, non-
governmental and private voluntary organizations with a
view to coordinating the programme to prevent the
spread of AIDS.

According to a Government of India notification the
Minister of Health and Family Welfare will be the
chairman and the Minister of State for Health and
Family Welfare the vice-chairman of the National AIDS
Committee, comprising 50 members. The members
include senior officers of different Ministries as well as
prominent personalities like noted journalists, including
Mr Khuswant Singh, Mr Nikhil Chakravarty and Ms
Bachi Karkaria. The noted actress, Shabana Azmi, will
also be on the panel.

The lone member taken from Chandigarh in the com-
mittee is Mr Vineet Khanna, director of the Youth
Technical Training Society, a voluntary organization,
which has done remarkable work for the rehabilitation of


14 WEST EUROPE

The man, who is from Cote d’Ivoire in Africa, was
arrested 2 weeks ago and indicted for having raped a
16-year-old girl from Arhus in a restroom for the hand-
icapped on the express ferry between Kalundborg and
Arhus on 15 February.

At his first court appearance the man was jailed for 2
weeks. Yesterday the prosecuting authorities requested
that the detention be extended.

During the subsequent investigation it was learned that
the 32-year-old was infected with HIV and at his court
appearance on Friday he was indicted for endangering
the life and health of others. HIV-positive persons
develop the fatal AIDS disease. It is not yet known
whether the 16-year-old girl has been infected.

The doors were closed at the appearances in both munic-
ipal and superior courts and a name disclosure ban was
imposed. The prosecutor protested this in municipal
court. He said the man’s identity should be made public.
That would give women who may have had contact with
the indicted man a chance to be tested for HIV.

A similar case is currently being tried in Copenhagen
Municipal Court.

In that case a 35-year-old HIV-positive Haitian has been
charged with having endangered the lives of 28 women
by having intercourse with them without using a condom
and without telling them about the risk of infection.

FINLAND

Number of New HIV Cases Same for 1991, 1992

93WE0270A Helsinki HELSINGIN SANOMAT
in Finnish 19 Feb 93 p 16

[Article by Paivi Repo: “Over 500 HIV Cases Have Been
Found in Finland”]

[Text] Last year 89 new cases of HIV infection were
discovered in Finland, which is just as many as during
the record year of 1991. The number of cases in Finland
continues to be among the lowest in Europe. Sweden has
four times as many and Denmark 10 times as many
cases.

Thus far 518 persons in Finland have been identified as
HIV infected and 125 of these have developed to AIDS.
Eighty-five have died. The majority of HIV bearers live
in Uusimaa.

One-half of the infections have been transmitted through
homosexual intercourse, and less than one-third via
heterosexual intercourse. For 13 percent the source of
infection is unknown.

The majority of infections occur in the age group 20-39.
Two infants were infected by their mothers during
pregnancy or birthing.

JPRS-TEP-93-008
23 April 1993

Seventeen of the infections occurred in Africa, 10 in
Europe, and five in Thailand where there are half a
million bearers of the HIV virus.

In recent years about 20 foreigners per year have tested
HIV-positive here in Finland. In addition to this there
are several instances where a Finnish woman has been
infected by a foreigner that is her regular companion.

Test Is Compulsory

Health centers are obligated by the infectious diseases
law to test for HIV, even if the person does not reside in
the community where the health center is located.

The test costs about 80 markkas.

Approximately 700,000 Finns have been tested. One-
half million of them are blood donors who have had
blood tests since the fall of 1986. Before the blood
service began testing for HIV, nine persons were infected
during blood transfusions. Five of these cases have
developed AIDS.

“After tests began to be administered about | million
Finns have received blood and not one has been infected
with HIV in that way,” stresses docent Tom Krusius of
the Finnish Red Cross blood service.

Some 200,000 new blood donors were tested last year
and seven of them were found to be HIV-positive.

Blood Donors Have To Tell About Life-Styles

The blood service presently has donors sign a form that
asks them about their hygiene and possible high risk
behavior. Each year a couple of thousand donors are not
accepted for, among other reasons, low hemoglobin
values.

“Blood cannot be donated if one has had homosexual
relations, relations with a prostitute, or has ever used
intravenous drugs. In Belgium they have gone so far as to
not accept anyone as a blood donor for six months after
a sex partner change,” says Krusius.

Finland Having To Drop Out of Nordic HIV Research

Finland’s participation in the shared Nordic HIV-
vaccination research is being threatened by a shortage of
70,000 markkas and the cutbacks in the Helsinki health
office funds.

The mutual, 5-year research project will be launched in
Sweden either this week or next. Finland would join
during the latter part of the summer, at the earliest,
provided money can be found. At that time approxi-
mately 20 HIV-infected persons in the Aurora hospital
would participate. The majority of the 1,000 or so
infected persons participating in the entire project are
Swedes.

“We would need 70,000 markkas for the first year and
less during the years after that. Still it seems that the
money can be found nowhere. Even if the money were to



44 LATIN AMERICA

The way he describes his life, Ronaldo seems to see it
more as a fast-paced adventure than a profound tragedy.
“It is a source of pride to be regarded as a hero,” he said.
Given the positive results of the test done at FEBEM but
only now disclosed, Ronaldo raises the possibility that
the test results were wrong. He asks Ana: “Could we
really have AIDS?” Just in case, he prefers not to retake
the test. “I would rather believe the test could be wrong
than accept the idea that my whole family, even my
children, are sentenced to death,” he said. “So far, I
consider myself a winner because I am neither in jail nor
lead.”

Without the benefit of any doubt that he is really on the
road to death, Alexandre Vianna, 22, who is also in the
FEBEM files, is now in the Public Jail of Taubate, a city
in the interior of Sao Paulo State. “When I was at
FEBEM they took me to Emilio Ribas (the hospital for
contagious diseases, in Sao Paulo) to take the AIDS test.
So I took advantage of the opportunity, and escaped,”
said Alexandre. “I did not find out the results until, some
months later, I was sent back to FEBEM after being
caught in the act in a burglary. They notified my grand-
mother, but I got no medical treatment,” he added. The
same shock that fugitive Ronaldo got when he found out
he has AIDS may await people who shared intimacies
with Alexandre, if they find out about some of the things
he said. “I have already ruined the lives of a lot of
people” he said, feeling not the least guilt about having
infected innumerable partners, even though he knew he
had AIDS. “I could not count the number of women I
have had sex with. I lived in the red light district of
Santos (city on the coast of Sao Paulo State) for a long
time, but I only had two steady girlfriends,” said Alex-
andre. He never bothered to use condoms. “When the
time came, I would forget. I only used them with one of
my girlfriends. But she was very stupid. Some days she
wanted me to use them, then the next day she did not,”
Alexandre said.

Since he was jailed at Taubate in March 1990, convicted
of larceny and sentenced to 5 years and 7 months in
prison, Alexandre has seen his health deteriorate, espe-
cially since last September. Even so, he had to wait two
months before he was transferred to the hospital at the
Sao Paulo State Penitentiary. During that period his
condition was so serious that he could no longer eat.
“Besides aspirin, the jail doctors got me a little AZT,”
Alexandre said. However, he refuses to take the medi-
cine. “That medicine is like a drug. You become depen-
dent on AZT, and I do not want to die because of being
addicted to AZT.” Dark-complexioned, strongly built,
and 1.8 meters tall, Alexandre by no means fits the image
one gets from seeing photos of thieves in the newspapers.
Infected with the AIDS virus since the age of 17, he says
he was often taken for a mild-mannered and engaging
college student when he frequented the beaches in
Guaruja, one of the trendiest cities on the Sao Paulo
coastline.

“T always wanted to do well in life without making much
effort,” he said. In Santos, Alexandre was once hired as

JPRS-TEP-93-008
23 April 1993

manager at the Fluminense Bakery, near the port. He
made such a good impression when he applied for the job
that the owner of the bakery did not even ask to see his
references. For a long time, he lived up to expectations.
“That is, until one day when I drank too much and was
bent out of shape. So I took the bakery van and stole as
much as I could cram into it,” he recalls. “I took off and
never showed my face there again.” According to Alex-
andre, that was the best time of his life. The owner of the
bakery would sometimes lend him a Chevrolet Monza so
he could go to Guaruja for fun on the weekends. Besides
that, “I had an apartment with a color TV and a carpet
this thick,” he said, using the thumb and index finger of
his right hand to show how thick the pile was. Then he
lowered his voice and added: “But my paradise did not
last long. I got to know a group of Chileans who encour-
aged me to pursue my dream of seeing Atlantic City, in
the United States. That was when I started using drugs,
injecting 4 or 5 grams of cocaine into my veins every day.
I had to sell everything I had, even the TV and the
carpet. I became a beggar. Being a beggar is the only
thing in my life I am really ashamed of.

The FEBEM files reveal stories like that of Rosana and
her friends who live with AIDS in the center of Sao
Paulo, people like Ronaldo Santos who were not notified
by the institution of the positive results of their tests and
ended up marrying and having children, and former
inmates who went untreated and are now dying of AIDS
in the public jails as Alexandre Vianna is. The great
majority of the kids whose names are in the files,
however, are dead. They died either of AIDS, or had
their lives even further shortened by the police. Ill with
AIDS, Alexandre Candido died in March 1991, at the
age of 16—FEBEM knew he was infected when he was
13—while trying to escape the police after having robbed
a Sao Paulo steakhouse. That was only a few days after
he had skipped out of FEBEM for the 13th time. “In
1988, when he was in one of the FEBEM facilities, the
one at Tatuape, a social worker told our father that
Alexandre had AIDS,” said Candido’s sister (who would
not give her name out of fear of being discriminated
against at work). The worried family tried to find a bed
for him at the Hospital das Clinicas.

They found a bed. “But FEBEM would not release him
for treatment,” the sister says, bitterly. “The inspectors
did not take my brother to the hospital for treatment
even though a bed was ready for him. So we appealed to
a social worker and she explained that there must have
been some confusion, because the release had already
been requested.” Candido had only been taken from
FEBEM to the hospital twice when, one day, the people
responsible for him at the institution lost his Clinicas
admission card. The treatment had to be suspended
again. “My brother told me at the time that even when
he was complaining of extreme pain, no FEBEM worker
would give him any medicine. Medicines are given only
as a last resort. Not even the other AIDS-infected boys,
of whom there were quite a few, some with serious
symptoms, were released to go home to stay with their
families,” Candido’s sister said.



46 LATIN AMERICA

HAITI

AIDS Cases: 10,000; HIV Seropositivity: 200,000

FLO112223392 Port-au-Prince Radio Metropole
in French 1400 GMT 1 Dec 92

[Excerpt] [passage omitted including report on AIDS by
the World Health Organization on the sixth global anni-
versary of AIDS]

In Haiti, 10,000 cases of aids have been reported, and
200,000 cases of seropositivity.

HONDURAS

AIDS: 635 Dead, 3,632 Infected Nationwide

93WE0328A San Pedro Sula TIEMPO in Spanish
6 Mar 93 p2

[Text] Tegucigalpa—According to records from the
Health Ministry’s Control Program, a total of 635 Hon-
durans have died as a result of acquired immunodefi-
ciency syndrome (AIDS), and 3,632 are infected with the
human immunodeficiency virus (HIV), which causes the
disease.

Thus far this year, 40 new cases have appeared, bringing
the total number of persons suffering from the disease in
its terminal phase to 2,389. San Pedro Sula is the city
reporting the most cases: 960; followed by Tegucigalpa,
with 352; and El Progreso, with 67 cases.

The heterosexual population is the one most severely
stricken, with 1,868 cases; compared with 114 among
homosexuals, who were initially expected to be the ones
mainly affected by the disease.

The number of children under age 15 infected totals 88,
and there are reports of 570 cases involving Hondurans
aged between 26 and 30, followed by 448 victims among
those between ages 21 and 25.

JAMAICA

AIDS Committee Seeks Greater Community
Involvement

FL0312132792 Bridgetown CANA in English
1309 GMT 3 Dec 92

[Text] Kingston, Jamaica, Dec 3, CANA—Jamaica’s
National Aids Committee (NAC) is seeking greater com-
munity involvement in the fight against AIDS.
Chairman of the NAC, Dr. Peter Figueroa, says the
organisation would be working closely with the churches
with which it has enjoyed “a positive and fruitful”
relationship in community action to promote respon-
sible sex and parenting and age- old family values. And
according to Health Minister Easton Douglas, a “com-
munity commitment is extremely relevant to the urgent

SIPRS-TEP-93-008
23 April 1993

need for Jamaicans to change widespread and long-
standing cultural habits which can literally mean the
difference between life and death.”

Jamaica joined the rest of the world this week in orga-
nising numerous events including seminars, discussions,
and exhibitions to highlight the AIDS crisis.

According to the official news agency JAMPRESS, 394
cases of AIDS have been reported here. Some 270 people
have died from the disease, for which there is no known
cure. Douglas said it was “alarming and heart-rending”
to hear of the barbaric manner in which some AIDS
victims were being treated in their communities.

While some individuals, groups, and health care per-
sonnel had given commendable assistance and support,
he said, the majority of patients faced “raw hostilty and
overwhelming rejection in their hour of greatest need.”
Rejection often came from family members and even
from some health personnel as well as strangers, co-
workers, and neighbours, he remarked.

“The obvious answer to the double bogie of fear and
ignorance is education,” said Douglas.

NICARAGUA

AIDS Figures Reported

93WE0279A Managua BARRICADA in Spanish
13 Feb 93 pp 1, 12

[Article by Noel Irias]

[Text] MINSA [Ministry of Health] issued an announce-
ment yesterday that sent chills down the spines of the
most courageous among us: According to that institu-
tion’s calculations, some 10,000 Nicaraguans may be
asymptomatic carriers of the Human Immunodeficiency
Virus (HIV) that causes AIDS. The announcement came
from Deputy Minister of Health Federico Munoz
Fernandez.

According to MINSA statistical projections, the number
of asymptomatic persons infected with HIV is between
6,000 and 10,000. Experts calculate that roughly 100 to
125 persons are infected for every death recorded.

HIV was detected in Nicaragua for the first time in 1987.
A total of 31 patients have been recorded with clinical
manifestations of AIDS; 28 of them have died.

Munoz called AIDS “one of the health problems
assuming ever greater importance in Nicaragua.”
Despite that fact, Dr. Federico Aviles, head of MINSA’s
AIDS program, said it “has a budget of only $150,000,
when minimum needs are on the order of $.5 million.

Munoz said that “AIDS is already a health problem in
Nicaragua. The AIDS program has not received priority
for political and social reasons,” he added categorically.


IJPRS-TEP-93-008
23 April 1993

AIDS Cases Update

93P60074A Beijing RENMIN RIBAO in Chinese
25 Sep 92 p 4

[Article by Chen Ke (7115 0668]]

[Summary] At the Regional Conference for Impact of
AIDS on Social and Economical Development, He Jiesh-
eng, director of the State AIDS Control Center of the
Ministry of Health, reported that the total number of
AIDS virus-infected population in China is 932; 11 of
them are AIDS patients and 9 have died. The conference
was held in Kunmin, Yunnan on 22-24 September,
delegates were from the United Nations Planning and
Development Agency, WHO, the Ford Foundation,
China, India, Burma, Laos, Vietnam, Thailand, Hong
Kong, and Macao. He Jiesheng said that China has been
exerting great efforts on AIDS control, epidemiological
surveillance, legislation, education, research and inter-
national cooperation for AIDS prevention and has estab-
lished several AIDS prevention organizations.

970 People Tested HIV Positive

HK1903122193 Beijing ZHONGGUO XINWEN SHE
in English 0917 GMT 19 Mar 93

[Text] Beijing, March 19 (CNS)—The Director of the
Sanitation and Anti-epidemic Department of the Min-
istry of Public Health, Mr. Dai Zhicheng, briefing mem-
bers of the Health and Medicine Group of the Chinese
People’s Political consultative Conference, said that the
ministry had conducted tests on 1.5 million people since
the discovery of the first AIDS case in 1985. Some 970
people had tested HIV positive and 12 people had
developed full-blown AIDS, a number expected soon to
be much larger. The World Health Organization (WHO)
estimated that the actual number of people in China
infected with the deadly disease was likely to be three
times the known figure while many sufferers of the
disease have not yet been discovered.

AIDS-infected people are scattered over 18 provinces
and cities throughout the country with 13 areas most
badly hit in Yunnan and some of the coastal provinces
and cities.

Chinese AIDS Victims mainly catch the disease from
drug addiction, although sexual practices are also
responsible. Most of those infected are labour service
workers returning from abroad.

During a 3-year cooperative programme by China and
the WHO, China adopted measures to fight the disease
including a national association for the prevention and
treatment of AIDS and venereal disease, undertaking
and coordinating education on the disease, the boosting
of monitoring and scientific research on the disease, the
strengthening of publicity to make the public more aware
of the need for protection and employment of the legal
system in preventing and dealing with AIDS.

CHINA 9

Faster Way Developed To Identify AIDS Victims

54004803B Beijing CHINA DAILY (BUSINESS
WEEKLY) in English 8 Mar 93 p7

[Text] Asia-Lion Biotechnology Co. Ltd in China’s
southern coastal city of Zhuhai, near Macao, has devel-
oped a new diagnostic agent that can single out Aids
victims in only two minutes, according to sources from
the firm.

The test is being used at about 20 of China’s 56 customs
posts, Liu Jinhai, general manager and director of the
firm told CHINA DAILY in an interview. He added that
some samples of the whole blood rapid diagnostic agent
have been sent to the US and European and South-
eastern Asian countries at their request.

Liu explained that it used to take four to five hours to see
the test results. Therefore, when the results showed any
person suspected of carrying the Aids virus, it was often
very difficult to chase down the suspected carrier.

“Now it is simple and takes only the time to fill out some
forms,” said Liu. The people singled out by the test are
not necessarily all Aids patients, but have to go through
further examination.

The Asia-Lion company was set up two years ago with 7
million yuan in registered capital. With 150 employees,
it has become one of the largest Chinese manufacturers
in its field. Last year the firm produced 1.2 million yuan
($207,000) worth of diagnostic reagents. This year its
output value for that kind of products will be 40 million
yuan ($6.9 million), making it the country’s largest
producer of its kind, Liu predicted.

The firm also manufactures agents approved for hospital
use in diagnosing hepatitis A, B, C and E.

China’s research in biological engineering is not much
below highest world levels, Liu noted. However, its
manufacture lags behind.

Asia-Lion’s rapid development resulted mostly from its
broad co-operative ties with top research institutions in
the US, Australia, Singapore, Italy and China’s Taiwan,
Liu said.

As the firm’s business expanded, its sales and service
network has spread to Hong Kong, Macao and some
Southeast Asian countries in addition to its representa-
tive offices in Beijing, Shanghai, Guangzhou, Tianjin,
Shenyang, Xi’an, Nanning and Chengdu.

The firm has also set up two joint venture factories in
Shanghai.

Presently, the firm produces the following products:
The biological active peptide series: kallikrein,

proelastase, horseradish peroxidase (HRP), interleukin-
2, colong-stimulating factor and super oxide dismutase;