14 EAST ASIA

Adhyatma told a hearing of the Commission on Social
Welfare in the House of Representatives that the esti-
mate given by experts of the World Health Organization
was cause for alarm.

He recalled that a recent meeting with AIDS experts
from the Geneva-based WHO, he asked them their
estimate if Indonesia had 25 reported “sero-positive
cases.”

“The experts said the answer was simple. It’s one hun-
dred times that figure,” Adhyatma said.

“So we have 2,500 sero-positive cases; this should make
us even more alarmed,” said the minister who last
month appealed for concerted national efforts to curb
the spread of AIDS.

The campaign against AIDS was launched with health
officials running blood tests on prostitutes across the
country. The alarm bells were rung when it was found
that at least two prostitutes in Surabaya have tested
Positive.

Other recent reported AIDS cases included a Spanish
inmate in Malang and a couple in Bali.

Various government agencies gave different figures of
the number of people reported to have AIDS. The Health
Ministry last month said 19 have developed the symp-
toms of which 14 have died and 35 others have tested
positive for human immuno-deficiency virus (HIV)
which causes AIDS. [passage omitted]

SOUTH KOREA

Ministry Seeks To Deport Nigerian Testing AIDS
Positive

$K2112062091 Seoul YONHAP in English 0603 GMT
21 Dec 91

[Text] Seoul, Dec. 21 (YONHAP)—A Nigerian has
tested positive for the virus that causes AIDS [Acquired
immunodeficiency syndrome] and the Health and Social
Affairs Ministry has asked the Justice Ministry to deport
him, a ministry spokesman said Saturday.

The unidentified man, who came to Korea in November,
is employed by a local manufacturing company, he said.

He was tested at his employer’s request. It is not known
how he acquired the AIDS virus.

Of 10 foreigners found HIV-positive, nine have been
deported.

The ministry tests foreigners wanting to stay longer than
90 days for entertainment purposes when they enter the
country, but not tourists, journalists, diplomats or
people with work visas.

JPRS-TEP-92-003
12 February 1992

Number of AIDS Cases Reaches 169

SK0101062492 Seoul THE KOREA HERALD
in English 1 Jan 92 p 3

[Text] Two more Koreans tested positive for human
immunodeficiency virus (HIV) in December, the Health
and Social Affairs Ministry said yesterday.

One of them, identified only as a 30-year-old Choe, was
presumed to have contracted the deadly virus after
having sex abroad without taking precautionary steps,
the ministry said.

Another man, 24-year-old Ko, was known to have been
infected with the virus which causes AIDS inside the
country, the ministry said.

This has brought to 169 the total number of Koreans
who have been tested positive for HIV. Of them, 15 have
died and one has left the country.

LAOS

AIDS-infected People, Anti-AIDS Activities
Reported

BK0712113791 Vientiane KPL in English 0917 GMT
7 Dec 91

[Text] Vientiane, Dec 7 (KPL)—The result of blood tests
conducted during 1991 on 2,658 people in Vientiane has
indicated that among them 6 people were found with
HIV (“) [character with parentheses as received]. Of the
people, 3 were returnees from camps in Thailand and 3
are waitresses, confirmed the National Institute of
Hygiene and Epidemiology at a recent meeting here to
review its activities on HIV/AIDS control and preven-
tion.

1990 test revealed that only one person was HIV (“).
Therefore, so far there are 7 people with HIV (””) in Laos.

The institute has over the years launched several activi-
ties against AIDS.

Following the AIDS workshops for non formal trainers
held in Vientiane at the end of 1990, the NCCA [expan-
sion unknown] with the collaboration of those non
formal trainers who are representatives from the Lao
Women Federation in the five districts of Vientiane
municipality, high schools, colleges and universities has
organized discussions on the topic of AIDS and HIV
infection. Each discussion has included a pre and post-
test for the basic knowledge on AIDS/HIV of attendees.
The total number of attendees reached during these
discussions was approximately 11,000 persons.

In September and August 1991, the provincial station of
hygiene and (epidemiology discussed) HIV/AIDS for
2,089 students of provincial colleges. Several seminars
on AIDS and HIV infecton were also held for the
provincial health personnel.



JPRS-TEP-92-003
12 February 1992

According to the physician, this is the cutoff established
by the WHO regarding the model for data tabulation
adopted by Sao Paulo in 1981. If the rate goes above 10
percent, the entire system of mathematical calculation
and projection will have to be revised.

The CRTA epidemiologists themselves believe that the
major problem with the disparity between the official
figures and the real number of cases lies in the underre-
porting. Even though notification of AIDS cases is
compulsory, the CRTA estimates that 20 percent of the
cases were not entered in the official statistics. “The
figure should be much higher,” Debora said.

Last week, when the CRTA began distributing AZT,
donated by the Health Ministry to public hospitals for
free distribution to AIDS patients who were registered
and reported, there was an explosion of the demand in
several hospitals. Public health service officials supplied
the CRTA with lists of patients who had never been
reported, exceeding by 150 percent the number of cases
computed in the official data.

“Many of the civil servants responsible for reporting
cases don’t even know how to go about it,” Debora
declared. The computer which processes the epidemio-
logical data rejects files that are entered incorrectly, and
CRTA employees are obliged to recheck all the data.
These cases are invariably considered to be “under
investigation.” [passage omitted]

Government’s AIDS Prevention Campaign
Criticized

92WE0172A Sao Paulo ISTOE SENHOR in Portuguese
11 Dec 91 pp 50-51

[Text] Well, Brazil really did try to move closer to the
countries of the First World and make up for its lag in
terms of AIDS prevention campaigns. But the lineup of
activities promoted in Brazil on the occasion of the
World Day of Battle Against AIDS, celebrated on
Sunday 1 December, skidded into a series of memorable
gaffes caused either by lack of practice or by unfamil-
iarity with the subject. In leading cities of the world,
demonstrators took to the streets and filled sports sta-
diums, theater stages, and even art galleries. Leaders in
the health field joined artists and athletes at events
where the most important thing was to have the kind of
popular appeal that can induce the public to participate
and learn a little more about how to prevent the disease
and overcome prejudice against its carriers. In Brazil, the
Ministry of Health opted to employ the clout of televi-
sion, but weakened it with an old and not very con-
vincing approach, as if all it was doing was filling up free
political air time.

First it was President Fernando Collor who, during a
statement carried in prime time by all the radio and
television networks on Saturday evening 30 November,
let slip away a golden opportunity to score a decisive
point to change, once and for all, the image of an
administration that has yet to show worthwhile results in

LATIN AMERICA 35

the battle against AIDS. Collor spoke about the disease
for 18 minutes but never even mentioned the need to use
condoms, which are recognized as one of the key
weapons against the disease. The whole world talked
about condoms in order to explain, straightforwardly,
how educational campaigns should be conducted and
that using them is one of the safest ways to keep from
contracting AIDS through sexual relations. In New York,
condoms were distributed on street corners. In Brazil,
the word is still banned by a moralism that sees encour-
agement of the use of condoms as advocacy of birth
control.

The Ministry of Health’s educational program, in turn,
sinned—according to experts—by breaking a basic rule
of marketing. It was aired at 0900 on a Sunday morning,
an unfortunate hour on a day reserved for leisure and on
which most people give themselves the luxury of getting
up later. Another slipup starred Health Minister Alceni
Guerra himself. By using the term “AIDS sufferer” three
times in answering to live questions from viewers, the
minister ignored the guidance of enlightened world
authorities on the subject. The word “AIDS sufferer” is
now seen as stigmatizing and as evidence of prejudice;
the words AIDS “patient” or “carrier” of AIDS should
be used instead.

The involvement of a president in a campaign of this
nature was obviously well-received by all sectors of
society. “In no other country of the world has a president
spoken on this subject on national radio and television,”
boasted Eduardo Corte, director of the AIDS Depart-
ment of the Ministry of Health. However, some repre-
sentatives of the battle against AIDS found some contra-
dictions in Collor’s speech. “The president said it was
necessary to be clear, but he himself dodged the bullet by
avoiding any references to the use of condoms and
touching only generally on the infection of drug addicts
through syringes,” was the criticism leveled by Dr. Fabio
Mesquita of the health department of Santos, the city on
the Sao Paulo coastline where the incidence of AIDS
cases is the highest in Brazil.

Another poorly directed facet of the Brazilian campaign,
in the opinion of Jose Stalin Pedrosa, coordinator of the
Brazilian Interdisciplinary Association on AIDS, was the
introduction of former soccer star Pele in his brand-new
role as chairman of the High-Level Commission on
AIDS, “Pele’s participation is nothing more than gro-
tesque plagiarism of the American example,” Pedrosa
points out, In the United States, basketball player Magic
Johnson was invited by President George Bush to serve
on the National Commission to Combat AIDS after it
was announced last month that he is a carrier of the HIV
virus, “They wanted to make Pele the Magic Johnson of
Brazil,” said Pedrosa. “But he has no idea what this
epidemic represents and his appeal is fragile since he has
no connection with the disease.” True, Pele’s entry into
the battle against AIDS shortly after that of Magic
Johnson does smack of a lack of imagination. You have
to recognize, however, that world symbols such as Pele



IPRS-TEP-92-003
12 February 1992

BRAZIL

Free AZT Projected To Reveal Unreported Cases

92WE0123B Sao Paulo FOLHA DE SAO PAULO
(Fourth Section) in Portuguese 13 Nov 91 p 1

[Article by Aureliano Biancarelli]

[Text] A large number of AIDS patients—the number
may reach 1,000 in Sao Paulo State—are going to be
forced to come out of “hiding” within the next few
weeks. That is the prerequisite being imposed by the
Ministry of Health for supplying AIDS patients with
AZT survival pills. Physician Debora Barbieri, 40, of the
epidemiology section at the AIDS Reference and
Training Center (CRTA) says that the “hidden patients”
are middle-class men who have become impoverished
because of the disease and can no longer finance their
treatment on their own.

The race for AZT is bound to cause the number of
known and living patients in the state jump from about
4,300 to over 5,000. The CRTA’s epidemiology section
estimates that from 10 to 20 percent of AIDS patients do
not reveal their condition because they fear prejudice.
Debora claims that “another 5 percent are not reported
because of the shortage of officials and because physi-
cians are so overworked and earn so little that they do
not have time to fill out the form.”

The distribution of AZT will begin at five Sao Paulo
hospitals within the next few weeks.

The Wellcome Laboratory, which manufactures AZT,
sells about 2,000 bottles a month in this country. Each
patient consumes up to two bottles every 30 days. Each
bottle costs 83,000 cruzeiros.

Of the approximately 80 telephone calls now being
received by Disc-AIDS every hour, many are from
patients seeking information about what to do to receive
AZT. The director of the CRTA medical department,
Valquiria Pereira Pinto, says that “people who have the
virus but are not showing symptoms are seeking the
drug. There may not be enough medicine.”

It is not likely that infected persons who are drug addicts
and those living in destitution will report to the public
health services, says Dr. Maria Eugenia Lemos
Fernandes, director of the state’s AIDS prevention pro-
gram.

LATIN AMERICA 31

AIDS Incidence Through August

92WE0123A Sao Paulo O ESTADO DE SAO PAULO
in Portuguese 18 Nov 91 pp 10-11

[Article by Roldao Arruda and Neldson Marcolin: “Phy-
sicians Predict There Will Be One AIDS Case in Most
Families in Year 2000”; first paragraph is O ESTADO
DE SAO PAULO introduction]

[Text] The WHO [World Health Organization] says that
of the 10 million people already infected with AIDS, 75
percent are heterosexuals.

The recent announcement by basketball player Ervin
“Magic” Johnson that he was carrying the AIDS virus set
off an alarm clock with the power of a bomb. On waking
up, the world discovered that contrary to what had been
imagined for a decade, it was no longer possible for
anyone to consider himself free of danger. According to
estimates by the World Health Organization (WHO), 75
percent of those already infected throughout the world
are heterosexuals,

In the year 2000, according to the WHO, the number of
infected persons will total 40 million, and heterosexuals
will account for the same percentage that they do today.
“Just as almost every family has a case of cancer or heart
disease in its midst, so most of them will have a carrier
of the HIV virus by the end of this decade,” predicts
oncologist Drauzio Varella of the Syrian-Lebanese Hos-
pital. “AIDS will become the biggest killer among the
world’s diseases,” confirms Dr. James Chin of the WHO.

It was a slow awakening. From 1980, when the first cases
of a disease that destroys its victim’s immune system
were reported among American homosexuals, until the
announcement by Johnson, the risks facing heterosex-
uals had never been revealed in their true dimension. In
1985, American actor Rock Hudson, who by then had
fallen ill, was the first celebrity to draw attention to the
spread of AIDS. But because he was a homosexual, his
case did not heighten the awareness of heterosexuals.

But thanks to the basketball hero, who made it clear that
he had been infected through a heterosexual relation-
ship, the discussion took on new life. In Varella’s
opinion, Johnson’s announcement has been the most
important single event in the history of the epidemic.
“Johnson has done more for the fight against AIDS than
all the campaigns carried out to date,” he says. “He
showed the world the true dimension of the disease,”

agrees psychologist Jose Roberto Peruzzo, who has lived
with the virus for four years and heads the Incentive to
Life Group (Givi) in Sao Paulo.

In Brazil as of the beginning of September, the Ministry
of Health had counted 21,023 AIDS cases. It is estimated
that for every patient, there are 30 infected individuals—
nearly 700,000 Brazilians—who may develop the disease
in coming years. According to the WHO, 418,000 people
have already died throughout the world. Varella says:
“The cases of those infected by that first generation of
the disease are now beginning to appear.”



IJPRS-TEP-92-003
40 LATIN AMERICA 12 February 1992
GUATEMALA (AIDS) victims. The epidemiological figures indicate

AIDS Deaths Total 86

92WE0209B Guatemala City DIARIO DE CENTRO
AMERICA in Spanish 26 Nov 91 p 2

[Excerpts] Public Health and Social Assistance Minister
Dr. Miguel Angel Montepeque Contreras stated that as
of last September 182 cases of AIDS had been detected
in Guatemala for a total of 86 deaths, that is, 44 percent.

The greatest incidence of the disease occurs among
males, and sexual transmission is the most common, at
least in our country.

Following we present an overview of Dr. Montepeque
Contreras’s statements: [passage omitted]

AIDS in Guatemala

The AIDS problem in Guatemala began with the diag-
nosis of the first case in December 1984, followed by five
cases in 1985, ten cases in 1986, 13 in 1987, 18 in 1988,
78 in 1990, and as of the month of September 1991, 182
cases of AIDS had accumulated, 195 people were asymp-
tomatically infected, and 32 were infected with chronic
lymphadenopathy, for 86 deaths (44 percent). With
respect to gender, of the total AIDS cases, 81 percent are
males and 19 percent females, with a ratio of 4 to 1, and
the ages most heavily affected are between 15 and 49,
comprising 95 percent (174 cases).

With respect to the forms of transmission of the AIDS
virus, sexual transmission is the most common, since of
the total asymptomatic, AIDS, and chronic lymphaden-
opathy cases, 89 percent correspond to sexual transmis-
sion,

The rate of risk of the Guatemalan population is 4.32 for
every 100,000 inhabitants, if we take into account this
year’s population and the variable infecting capacity of
people infected with the disease, with or without clinical
signs, and of those who have already died, who could
have infected other people by any of the known means of
transmission.

The primary causes of death of AIDS patients are
opportunistic infections not related to Kaposi’s sarcoma
or pneumonia from Pneumocystis carinii (54 percent);
12 percent of the deaths result from Pneumocystis cari-
nii, and 9 percent from Kaposi’s sarcoma.

HONDURAS

Eighty-two New AIDS Victims
92WE0184A Tegucigalpa EL HERALDO in Spanish
9 Nov 91 p4

[Text] Honduras is continuing to see an increase in the
number of its acquired immune deficiency syndrome

that 82 new cases of the disease were reported in just this
month.

The Epidemiology Division submitted a report on the
AIDS cases in the country yesterday. From the time the
first patients suffering from the disease were reported in
1985 through 1991 thus far, 1,502 Honduran citizens
have been infected.

Given the spread of this disease, the Epidemiology
Division estimates that 50,000 of our compatriots would
test positive for the human immunodeficiency virus
(HIV), the difference being these people do not show any
symptoms, but are indeed able to infect others,

Honduran epidemiologists have studied 2,320 individ-
uals, of whom 478 are asymptomatic carriers (they do
not have the AIDS symptoms, as such), while 340 are
patients with AIDS-related diseases.

The infectious upsurge in the disease leads professionals
to believe that for each person infected, there are 40 or
50 more who have the virus.

AIDS has taken the lives of 52 Honduran children. The
majority were infected with the disease from their
mothers, and the others were the victims of sexual abuse.

To date, 520 women have been reported with AIDS (33
percent), while the 982 male patients constitute the other
67 percent. Of all of the victims, 71 percent are between
21 and 40 years of age.

The spread of AIDS is the result of sexual relations
between heterosexuals (multiple partners), in particular,
so that it has been concluded that 75 percent of the
patients acquired the disease through sexual promis-
cuity.

When the “20th century disease” began to affect Hon-
duras, it was said that only homosexuals had the virus,
because the first cases were seen in this group. However,
only 5 percent of the cases being reported now come
from this group.

The city of San Pedro Sula has had the largest number of
cases, with 602 reported victims (40 percent). Teguci-
galpa is in second place, with 192 cases (13 percent),
followed by El Progreso with 48 (3.3 percent), Comay-
agua with 43 (2.8 percent), and La Ceiba, with 39 cases
(2.6 percent).

Of the patients studied, 1,374 have lost weight, 1,198
report chronic fever, and 1,083 are suffering from
chronic diarrhea.

The Epidemiology Division has reported that 620 of the
AIDS patients are still alive, while 415 have died, and
the fate of 407 other Honduran citizens is not known.

Given the great upsurge of AIDS in Central America, the
heads of the epidemiology departments in the six nations



8 SUB-SAHARAN AFRICA

superintendent Dr. Jack Norman-Smith said the
increase in the number of patients suffering from full-
blown AIDS had been “dramatic”.

It is estimated that there are close to 200,000 HIV-
infected people in South Africa and this number is
increasing by about 300 every day.

In the light of increasing statistics, the department had
increased its resources devoted to AIDS prevention.

A nationwide AIDS information campaign was launched
at the beginning of this month and was the forerunner of
a major community campaign, the department said.

An aspect of this campaign would be to ensure that
children remained free from HIV infection as they
passed through adolescence.

A Life Skill programme, incorporating relevant AIDS
prevention education, is being formulated and a number
of different modules will be available in all secondary
schools at the beginning of next year.

New Process Found To Identify HIV-2 AIDS
Virus

MBI1712152691 Johannesburg South African
Broadcasting Corporation Network in English
1100 GMT 17 Dec 91

[Text] A second strain of the AIDS virus, HIV-2 which
has been sweeping parts of Africa, may be curbed in part
from spreading to the United States and other countries,
by new blood tests.

The American Food and Drug Administration recently
approved a test kit which can identify in a single process
blood tainted by both types of the AIDS virus. Recom-
mendations are being made that all blood organizations
should screen donated blood for both viruses.

Health Department Releases AIDS Data for 1991

MB1401142892 Johannesburg SAPA in English
1348 GMT 14 Jan 92

[SAPA PR wire service issued by SA [South African]
Communication Service: “HIV-Free Children and
Youths]

[Text] 1011 cases of AIDS have been reported by the end
of 1991.

South Africa has now joined the ‘club’ of the 14 African
countries which have reported at least 1000 cases of
AIDS.

The first cases of AIDS in South Africa were in men who
had sex with men. The numbers of AIDS reported in this
group last year (59) is the lowest prognoses since 1987.
This suggests that self- initiated education has been
successful and the worst of the pandemic may be over.

JPRS-TEP-92-003
12 February 1992

For heterosexuals the news is much less optimistic and
there is little sign of the pandemic slowing down. Two
thirds of the 345 persons with AIDS diagnosed in 1991
became infected heterosexually and most were young
adults in the prime of life.

The next most numerous groups being diagnosed with
AIDS in 1991 were very young children who made up
one sixth of all new cases. They became infected from
their mother before or during birth.

These figures draw attention to those people who are not
affected, namely children and youths. It is absolutely
essential to maintain their HIV-infection free status. An
educational programme has been developed over the
past year.

This involved research by three separate academic
bodies in different parts of the country. Various educa-
tional schemes were tested out. The findings of this
research have become available.

These have been incorporated into a number of modules,
which includes materials for both pupils and teachers.
These, and an educational video film will be available to
all secondary schools throughout the country.

Because AIDS transmission and sexual activity are an
integral part of life and not a separate function, the
modules will try to integrate AIDS prevention into
everyday life and provide children and their parents with
the skills to make further transmission of HIV unlikely.

This package will be launched next month. It is essen-
tially a working or pilot model. The various components
of the educational community, including teachers, par-
ents, administrators and the pupils themselves, will be
encouraged to make contributions to this working
model. At the end of the day the working model may
look quite different from the proposed draft model.

This process of active involvement will enable the draft
model to become a fully functional educational tool.
Although perhaps less dramatic than the discovery of a
wonder drug or a vaccine, educational programmes such
as this will eventually provide the answer to the scourage
of AIDS in South Africa.

Issued by: Subdirectorate Liaison and Publications

Department of National Health and Population Devel-
opment

Pretoria 14 January 1992
SWAZILAND

Health Ministry Official Gives AIDS Statistics
MB2201180692 Mbabane Radio Swaziland Network
in English 1600 GMT 22 Jan 92

[Text] The Ministry of Health has reported that five
people have died of AIDS in the country during the last



68 WEST EUROPE

similar group where we gave heated concentrates. In
hindsight, you could think now that we put at risk the
group who were given noninactivated blood. Keep in
mind though, that with what we knew then it could have
seemed at worst that we had put at risk the subjects to
whom we had given the heated inactivated blood. Many
said, in fact, that heating blood could denature the
proteins, especially in the VIII and IX factors—those
that we had to transfuse into the hemophiliacs—and thus
give rise to complications.”

Continuing, Prof. Mannucci said: “Anyhow, to cut it
short, we saw almost at once that in the group treated
with unheated blood, seropositive cases came to light,
while in the other group they did not show up at all. For
obvious reasons of caution, our study was conducted
with a small number of persons, but the results were
statistically so significant that we suspended the test so
as not to harm the “untreated group, and we immedi-
ately gave all the data of our experiments to the
LANCET for publication.”

Ferrieri: At this point, Prof. Mannucci, charges were
made that the Ministry had “wasted time” before ban-
ning distribution of the noninactivated blood. You obvi-
ously informed the Health Ministry of Montagnier’s and
your findings, did you not?

Mannucci: Obviously I informed the Ministry immedi-
ately. And I have to say they dealt with the problem
without delay. Just look at the dates: The LANCET
published the article on 28 February 1985; the new
ministerial legislation came on 15 July. Now the Min-
istry obviously had to absorb this completely new scien-
tific data, check it out, examine it closely, and then make
its decision. Given ministerial bureaucracy, I don’t think
the time from March to July had been too long.

Ferrieri: There are, however, those who hold—like Mr.
Magrini, president of the Italian Association of Recipi-
ents of Multiple Blood Transfusions—that infected
blood was distributed even after July 1985.

Mannucci: This does not call into question either us or
the Ministry. Theoretically it can well be that individual
industries left noninactivaied blood in circulation. I
don’t believe so. As far as regards our Hemophilia
Center, we immediately informed the multinational
companies that supply us with blood: they withdrew the
old blood from circulation, substituting it with inacti-
vated blood. If others have proof that some industries
did otherwise—that is leaving in circulation “untreated”
blood, as in fact happened in France—and that would be
very serious—they should submit the evidence and seek
appropriate punishment for those responsible.

Ferrieri: Anyway, professor, even in Italy there were
certainly seropositive cases that came to light between
March and July of 1985; like others had before March
1985 when, without knowing, you transfused blood that
potentially could transmit the infection.

SJPRS-TEP-92-003
12 February 1992

Mannucci: These two objections are correct: I’m con-
vinced that there have been HIV infections between
March and July 1985—not at our Center, where we
immediately modified the transfusion method, but else-
where in Italy. It is unfortunately an inevitable paying of
the price for a margin of time between the discovery of a
remedy and its mass employment.

As to the possible infections between 1984 and 1985,
let’s go back to the situation then: We knew so little of
AIDS, even if there were some elements that indicated
how it was transmitted into the blood. But the point is
that the untreated hemophiliacs risked death by hemor-
thage. A sure risk, of course, against a risk that was then
uncertain. We were faced with that dilemma in those
years: renounce transfusing hemophiliacs, thus leaving
them to die of hemorrhage, or continue with the trans-
fusions. That was our choice—a common choice, on the
other hand, made at that time by all hematology and
hemophiliac treatment centers throughout the world—to
run that risk. It was understood that we did these
transfusions always and only with the consent, case by
case, of the patients.

The positive fact remains that Italian hemophiliacs have
a seropositive rate enormously lower compared with any
other country—starting with France. In an interview two
years or so ago that fortunate difference was defined to
us by Prof. Mannucci as “unexplainable.”

Ferrieri: Is it still unexplainable, professor?

Mannucci: No, I would say that today we understand the
reasons that were unexplainable then. Just think that in
France and Germany half of the hemophiliacs are serop-
ositive, in the United States it is even 90 percent. I had
even supposed that a different genetic predisposition
was at stake. With Prof. Scorza, an immunologist at
Milan University, we had noted that there were some
differences which, however, were not important enough
to call for persuasive explanations. We were just groping
around in the dark. Nowadays, at least as far as France is
concerned, it’s just the infected blood transfusion
scandal that could give us the precise explanation of that
phenomenon.

Ferrieri: Do you confirm, professor, that after 1985 there
were no seropositive cases among hemophiliacs in Italy?
Others deny this, referring however to a pooling of
multitransfusion recipients with hemophiliacs.

Mannucci: It was the Disease Control Center of Atlanta
that said it, not I. There they register all onset stage
seropositive cases, and for Italian hemophiliacs the fig-
ures were precisely that there were none in the past six
years. There were, unfortunately, six cases in Germany,
in the wake of an accident in the treatment of plasma; a
batch of infected blood was poured by error into a
container that had no chemical additives that would
have guaranteed the death of the AIDS virus. It’s certain
that a similar accident can’t happen again.



50 NEAR EAST & SOUTH ASIA

AIDS, has been implementing a wide-scale campaign to
spread education among young people against the killer
disease and ways to protect themselves from it.

The committee, which directs most of its attention to
school graduates, conducts lectures and documentary
film shows and distributes leaflets featuring ways to
provide people with protection. According to the com-
mittee, AIDS is mainly transmitted through sexual con-
tact among men and women and among homosexuals. It
is also passed through the use of infected needles by
addicts.

The committee, in cooperation with the Ministry of
Education and other concerned parties, conducts its
work at schools and youth centres, with the main target
being those planning to go abroad for study.

Dr. Muna Hamzah, director of the ministry’s Health
Education Department, said health officials and workers
have compiled 20 documentary films for the purpose of
promoting the fight against AIDS. The department pub-
lishes pamphlets and booklets which are distributed to
community colleges, universities and secondary schools
and conducts lectures on the causes of the disease and
ways of protection.

According to the statement, the Health Ministry has
conducted studies on AIDS in Jordan through 7,500
samples of people, aged between 15 and 60, 50 percent of
whom were women.

A recent study in the United States showed that AIDS
was spreading rapidly among American women and
cases contracted through heterosexual contact were rap-
idly increasing.

The WHO has been issuing warnings of a dramatic
increase in AIDS among women noting that the virus,
called HIV, was rising fast.

The WHO says that AIDS was pandemic unlike other
so-called international health problems such as malaria
and small pox, AIDS strikes the developing and devel-
oped world with equal vengeance and forces all nations
to consider their common interest in the solution of
international health problems, the statement said.

It said that the AIDS epidemic provides a new opportu-
nity to view health as an international phenomenon, one
that is best addressed by policies with international
dimensions.

MOROCCO

‘Alarming’ Increase in AIDS Cases

92WE0206A Rabat L’OPINION in French 5 Dec 91
pp 1,3

[Article by Ali Benadada: “AIDS: A Scourge That Hides
Many Others”)

[Text] Several days ago, on 1 December, the interna-
tional community “celebrated” the fourth International
Day of Struggle Against AIDS.

IPRS-TEP-92-003
12 February 1992

The theme of the event was “Let us all meet the
challenge,” i.e., the challenge of a malady that is
becoming more and more widespread owing to the
inability of science to find a treatment, develop a vaccine
to stem the epidemic, or even limit its destructiveness.

The only way to avoid it is prophylaxis. And that means
it is necessary to sensitize the public to the nature and
gravity of the disease. But given the demographic profile
of AIDS victims in Morocco, the citizenry alone cannot
assume all responsibility for protection and prevention.

Examination of national or worldwide statistics shows
first of all that the disease, at first seen as an illness of
homosexuals and drug users, has gone beyond that stage:
It is now a scourge that can attack everyone, which
anyone can contract—and may have contracted already.

Next, the figures show the disease is taking on such
alarming proportions that it threatens to become a
holocaust.

Thus while at present there are some 1,500,000 cases of
AIDS worldwide, the figure will rise to 15 or 18 million
by the year 2000—in eight more years—assuming no
effective vaccine is developed. And there is little likeli-
hood such a vaccine will be ready by the end of the
century, according to Dr. Michael Merson, head of the
world anti-AIDS program. Dr. Merson adds that every
day the virus attacks 5,000 more victims.

According to the World Health Organization (WHO), 75
percent of those infected with the AIDS virus (9 to 10
million throughout the world) live in Third World coun-
tries.

Morocco’s Case

As paradoxical as it may sound, according to official
statistics the number of AIDS cases in Morocco is
“relatively low.” As of 30 September 1991, there were 90
cases of AIDS, 24 cases of AIDS related complex, and 86
asymptomatic carriers.

A total of 200—albeit such round numbers must some-
times be viewed with suspicion!

However that may be, and as small as the caseload may
seem, a comparison of these statistics with those for last
year proves the disease is on the increase here.

The number of AIDS cases reported has grown from 60
as of 30 September 1990 to 90 a year later—a 33-percent
increase. And the number of persons infected with the
HIV virus has grown from 135 to 200. In other words, a
40-percent increase over the previous year.

Regarding the modes of transmission of HIV virus in
Morocco, according to figures provided by the Health
Ministry’s National Program for the Struggle Against



48

Solomon and Dr. M. Ganapathi of the Madras Medical
College said here today that the detection of sero positive
cases in Madras and elsewhere in the State was
increasing.

Testing of random samples of serum from tuberculosis
patients and those visiting the surgical and medical
out-patient departments and antenatal clinic, besides the
STD wards was increasingly proving that the HIV infec-
tion was not confined to prostitutes and other high-risk
groups, but was prevalent even among men and women
belonging to well-to-do families, because of various
factors such as unhealthy sexual practice, improper
blood transfusion and use of contaminated syringe.

Addressing a press conference, they said the random
sampling of serums under the ICMR-sponsored sentinel
surveillance project, which began a year ago, had so far
shown that while four percent of those visiting the STD
ward, one percent of Tuberculosis patients and 0.5
percent of pregnant women had the HIV infection.

World AIDS Day: The need of the hour was to create
public awareness about the various aspects of the infec-
tion, including the preventive measures needed. It was in
that context that ARFI and the Tamil Nadu Govern-
ment, through its Health Department, have planned for
a series of programmes on the occasion of the World
AIDS Day on December 1.

The agenda includes a meeting to be inaugurated by the
Health Minister, Mr. S. Muthusamy, at the Madras
Medical College, a western music-cum-dance concert, a
sound and light programme by students of the Film
Institute, a puppet show, and a “therukutthu,” all focus-
sing on the theme of AIDS prevention.

The highlight of the activities will be a five-day exhibi-
tion of a 400 sq.m. “AIDS memorial quilt,” containing
the names and other details of AIDS victims the world
over. The quilt was formed by stitching together panels
contributed by friends and relatives of the victims under
the “NAMES project” of a voluntary group in San
Franciso.

Increase in Gujarat

92WE0215D Calcutta THE STATESMAN in English
20 Nov 91 p9

[Article: “Spurt in HIV Cases in Gujarat”]

[Text] Ahmedabad, Nov 19—There has been an increase
in the number of human immuno-deficiency virus cases
in Gujarat causing anxiety in Government and medical
circles, reports UNI.

Official statistics revealed that the HIV cases which
stood at 90 in July 1990, had presently increased to 715.

According to data available at the surveillance centre at
the B. J. Medical College here, of the 715 HIV carriers in
the State, 455 belong to Surat, three each to Bulsar,

AR EAST & SOUTH ASIA

JPRS-TEP-92-003
12 February 1992

Baroda, Jamnagar and Rajkot, two to Nadiad, and one
each to Mehsana, Godhra and Bhavnagar.

Ahmedabad has 233 HIV carriers of the AIDS virus and
among these eight are children aged between three and
11, all patients of thalassemia requiring repeated blood
transfusion. Most of the other HIV carriers in the city are
professional blood donors.

The cases of all the eight children were detected by the
Indian Red Cross Society, Paldi branch, which was the
first among the voluntary organizations in the State to
screen blood samples to detect HIV infection.

Each of the children had received at least 30 bottles of
blood from professional blood donors in private labora-
tories before their samples were screened by the society.
They are undergoing treatment at the Thalassemia
centre of the society.

An 11-year-old girl, who had acute thalassemia and
received 80 bottles of blood from professional donors,
died last year. A private laboratory in Lal Darwaza
found at least 12 of its professional blood donors HIV-
infected.

According to Dr. H. S. Shah, superintendent of the V. S.
Hospital, so far 2,000 blood samples have screened and
27 people were found to be carriers of the HIV infection.

AIDS Now Biggest Threat to Narcotics Users

BKO0412135191 Hong Kong AFP in English 1223 GMT
4 Dec 91

[Excerpts] Calcutta, India, Dec 4 (AFP)—Participants in
a just-concluded International Conference on Drug
Abuse here believe the spread of acquired immune
deficiency syndrome (AIDS) is now a bigger problem
than drug abuse itself. [passage omitted]

Kl Goyal, general secretary of the anti-narcotics cam-

paign in the Indian state of Rajasthan, said the spread of
IDS had emerged as the biggest threat to drug addicts
in India.

“It is turning into dangerous proportions,” he said,
citing a World Health Organisation report which said 51
percent of global AIDS cases had been detected among
intravenous drug users.

In India he said the problem was most acute in the
country’s northeast and cited an Indian Council of
Medical Research report which said 51 percent of HIV-
positive cases have been detected in the region.

According to one estimate the state of Manipur on the
Burmese border, which has a high concentration of
intravenous drug users, may have 60,000 carriers of the
HIV virus that leads to AIDS.

Raj Bothra, an American physician from the Kansas
Medical Center, also warned against the growing AIDS
menace in India, predicting that by the year 1995 India
will have more AIDS cases than anywhere in the world,



54 CENTRAL EURASIA

HIV Infection in Children

92WE0104A Kiev VRACHEBNOYE DELO in Russian
No 7, Jul 91 pp 11-17

{Article by Prof V. I. Dmitriyev, Leningrad, Scientific
Research Laboratory of Immunology, Virology and
AIDS (Chief—Senior Scientific Associate V. G. Moro-
zov), Military Medical Academy imeni S. M. Kirov]

UDC 616-053.2/.5-097

[Text] According to retrospective analysis, which
revealed antibodies against the agent of the acquired
immune deficiency syndrome (AIDS) in surviving blood
sera from patients, the first cases of human infection
were observed in Africa in 1959, and in the USA
beginning in 1977. However, a sporadic increase in
incidence of pneumocystic pneumonia (15 cases) and
Kaposi’s sarcoma (26 cases) accompanied by severe
deficiency of cellular immunity among young homo-
sexual men in major cities of the USA was not noted
until spring 1981. Such pathological states were encoun-
tered previously among senile patients with severely
suppressed immunity almost exclusively. Beginning in
1982, AIDS was revealed in inhabitants of Western
Europe [5].

French researchers were the first to report on the AIDS
virus in 1983 [27]; a year later it was isolated in pure
culture, and a test system by which to detect it was
created [24,25]. The AIDS agent was found to be a
T-lymphotropic retrovirus, which later came to be called
HIV—human immunodeficiency virus (in Soviet litera-
ture, VICh—human immune- deficiency virus). HIV
belongs to the retroviruses—a family of RNA- con-
taining viruses possessing the enzyme revertase (reverse
transcriptase) necessary for synthesis of DNA on a
matrix of viral RNA, after which the newly formed DNA
is incorporated into the genome of the host cell.

Two serological variants are known reliably today—
HIV-1 and HIV-2. Within the framework of the family
of retroviruses, HIV belongs to the subfamily of lentivi-
ruses, which also include cat T-lymphotropic virus,
monkey and cow lentiviruses, Visna and medi viruses,
and others. The possibility is not excluded that HIV is an
African monkey virus that has adapted itself to man.
However, significant differences in their structure indi-
cates that this happened as a result of genetic recombi-
nation (gene exchange) between monkey viruses [3,13].

AIDS agent selectively afflicts cells possessing an
external SD, receptor, related to the sheathe structures
of the virus (glycoprotein gp 120 in the case of HIV-1,
and gp 105 in the case of HIV-2). Such “targets” prima-
rily include immunocompetent cells—the principal “sol-
diers of immunity” [17]: T,-lymphocyte- helpers (induc-
tors), macrophages and monocytes. Among
nonimmunocompetent cellular elements, astrocytes—
glial cells of the central nervous system, epithelial cells of

IJPRS-TEP-92-003
12 February 1992

the rectal mucosa and vascular endothelium—are car-
riers of the SD, receptor, and are consequently HIV
reservoirs [5]. The earliest stage of development of HIV
infection is affliction precisely of T,-lymphocyte-
helpers, which are responsible for interaction between
the numerous cells that protect the individual from
microbes, viruses and mutated cells of the organism
itself.

As we know, migration processes assumed global scope
in the second half of the 20th century. HIV began to
migrate from small isolated regions (reservoirs of dor-
mant viruses) in Africa to the cities, where all forms of
life and sexual contacts were different than in tropical
rural settlements. When the HIV genome is incorporated
into the genetic apparatus of an afflicted cell, the
organism becomes a lifelong virus carrier. The latent
period of HIV infection (it may last 8 years or more)
proceeds asymptomatically in the infected individual,
and yet he is still capable of transmitting the virus to
other persons during this time.

In accordance with WHO recommendations, we distin-
guish between the stage of carrying the virus asymptom-
atically and four clinical stages of HIV infection—initial
(acute), persistent generalized lymphadenopathy (PGL),
associated complex (AIDS-AC or pre-AIDS), and clini-
cally developed (full-scale) AIDS, the final stage of HIV
infection. Clinically developed AIDS is a disease of viral
etiology proceeding with affliction of the immune system
(chiefly the cellular component) and the nervous system,
manifesting itself through development of serious infec-
tious (parasitic) diseases and (or) malignant neoplasms,
as well as through signs of encephalomyelopathy
[2,5,10,11,19].

In our country, a new clinical classification of HIV
infection was proposed on the basis of experience in
working with infected children [9]: incubation; the stage
of primary manifestations (acute infection, asymptom-
atic infection, generalized lymphadenopathy), the stage
of secondary diseases (stages A, B and C); the terminal
stage.

Clinical specialists, including pediatricians, must view
the course of a new, slowly proceeding retrovirus infec-
tion in its entirety. A knowledge of these principles is
necessary for early detection of HIV infection, because
preventive measures are most effective in the period
when the virus is carried asymptomatically. This will
make it possible to prevent transmission of the virus
from one person to another, and for medical workers to
promptly prescribe the optimum treatment prior to
development of lethal infectious complications, inva-
sions and cancers.

HIV infection was diagnosed in children in 1982. In the
opinion of Dzh. Modlin [transliteration], of the Johns
Hopkins Medical School [6], “children and adults are
completely different hosts for HIV, and age may have an
effect on the course of illness.”



58 CENTRAL EURASIA

dlya vracha)” [Acquired Immune- Deficiency Syndrome
(AIDS) (Recommendations for the Physician], Lenin-
grad, Mezhvuz. tipografiya (3) SPPO-2 Lenuprizdata,
1989, 118 pp.

9. Rodionov, A. N., Korolkova, T, N. and Chayka, N. A.,
“Sarkoma Kaposhi i SPID (rekomendatsii dlya
vrachey)” [Kaposi’s Sarcoma and AIDS (Recommenda-
tions for Physicians)], Leningrad, Mezhvuz. tipografiya
(3) SPPO-2 Lenuprizdata, 1989, 44 pp.

10. “AIDS: Review of CDC/WHO Definitions of Dis-
ease Cases Carried Out in 1987,” BYUL. VOZ., Vol 66,
No 2, 1988, pp 104-110.

11. Uchaykin, V. F., “AIDS in Children (Lecture),”
PEDIATRIYA, No 8, 1989, pp 71-79.

12. Khaitov, R. M., “AIDS: Problems and Accomplish-
ments as of 1987,” IMMUNOLOGIYA, No 2, 1988, pp
4-16.

13. Chayka, N. A. and Klevakin, V. M., “SPID: chuma
XX veka” [AIDS: The Plague of the 20th Century],
Leningrad, Lenizdat, 1989, 107 pp.

14. Chayka, N. A., “SPID v voprosakh i otvetakh
(rekomendatsii dlya naseleniya)” [AIDS in Questions
and Answers (Recommendations for the Public)], Len-
ingrad, Mezhvuz. tipografiya (3) SPPO-2 Lenuprizdata,
1989, 64 pp.

15. Shirobokov, V. P., Yevtushenko, A. I. and Kovaleva,
N. M., “SPID” [AIDS], Kiev, Zdorovya, 1988, 232 pp.

16. Brook, M. kG., Cor, D., Forster, S. et al., “Anti-HIV
Effects of Alpha-Interferon,” LANCET, Vol 1, No 8628,
1989, p 42.

17. Bruckmann, C., Rosendahl, C., Neumann, J. et al.,
“HIV-Infektionen in der Padiatrie: eine Ubersicht,”
AIDS-FORSCH., Vol 3, No 12, 1988, pp 651-670.

18. Desgrandes, C., Boyer, V., Souche, S. et al., “HIV.
Monoclonal Antibodies Against HIV Antigens,” J.
CELL BIOCHEM, Suppl. 138, 1989, p 250.

19. Gallo, R. C., Salahuddin, S. L., Popovic, M. et al.,
“Frequent Detection and Isolation of Cytopathic Retro-
viruses (HTLV-II) From Patients With AIDS and at
Risk for AIDS,” SCIENCE, Vol 224, No 4648, 1984, pp
500-503.

20. Gallo, R. C., Fischinger, R. J. and Bologneri, D. P., in
“Mechanism of Viral Leukaemogenesis,” London, 1985,
pp 89-134,

JPRS-TEP-92-003
12 February 1992

21. MMWR, Vol 36, No 1S, 1987, pp 3s-14s.

22. Montagnier, L., “AIDS Priority (Letter),” NATURE,
Vol 310, No 5977, 1984, p 446.

23. Pizzo, Ph., Eddy, J. and Faloon, J., “Acquired
Immune Deficiency Syndrome in Children: Current
Problems and Therapeutic Considerations,” AMER. J.
MED., Vol 85, No 2A, 1988, pp 195-202.

24. Veber, F., Blanche, S. and Griscelli, G., “Infection a
VIH de Venfant,” IMMUNOL. MED., Vol 5, No 2,
1988, pp 77-82.

COPYRIGHT: Izdatelstvo “Zdorovya”, “Vrachebnoye
delo”, 1991

Another AIDS Carrier Found in Lithuania

OW 1212055891 Moscow BALTFAX in English
2111 GMT 11 Dec 91

[Following item transmitted via KYODO]

[Text] According to the AIDS Prevention Center at the
Lithuanian Health Care Ministry, one more carrier of
the AIDS virus, a foreigner, has been recently revealed in
Lithuania. He voluntarily passed an anonymous test for
the virus at the center. He told medics that he had had
sexual contacts in Lithuania. All the people close to the
carrier are now being tested.

Earlier, 10 AIDS carriers have been registered in Lithua-
nia.

It was recommended to the man to get registered in the
AIDS Prevention Center in his native country.

Medical Experts Alarmed at Spread of AIDS

LD2312092291 Moscow Radio Moscow World Service
in English 1300 GMT 20 Dec 91

[Text] Medical men in the country are very much
alarmed about the possible spread of AIDS, and want to
ask the Parliament of Russia to sharply increase
spending on producing effective drugs against that
deadly disease.

In their opinion, the money can come from disarmament
and conversion of the arms manufacturing industry.

According to a forecast made by a computer, there could
be up to 2,500,000 bearers of the AIDS virus by the end
of the decade, and the peak of the epidemic could be in
the year 2030, when the number of virus bearers will
increase many times over.



46 NEAR EAST & SOUTH ASIA

from whose walls a blown-up Balagopala looks askance
at a scruffy lawyer trying to impress a client too drunk to
bother.

The smooth-talking, gold-watched Sharmaji was recently
ousted by the Sangh’s president, the large and loud
Rukminibai, who now promotes charity shows statedly
to collect funds for retired prostitutes. “Bahisaheb,”
however, did manage a four-month AIDS study tour,
covering Amsterdam, Rotterdam, New York, London,
Belgium and Tokyo.

The anguish of the real victim hasn’t been alleviated at
all. Those found positive are sold off to decreasingly
fussy, increasingly sordid “establishments,” and finally
abandoned when the AIDS Related Complex establishes
its emanciating stranglehold. The $650 million World
Bank grant or even the Rs 60 crores sanctioned for
Maharashtra shouldn’t end up creating more AIDS
“experts” instead of reaching the lowest levels where it
matters most. The ICMR’s rehabilitation plan waits
upon someone willingly to take responsibility for the
allotted money.

In Kamathipura’s most desperate ghetto, Yellamma’s
discarded handmaidens spill over to occupy every inch
of filthy, unpaved alley space. In a grotesque parody of
canopied four-posters, rows of iron beds line up in the
open, fully curtained in black plastic. Umabai sits within
spitting distance of an overflowing garbage dump, and
spurns any offers of getting it shifted. “If it is removed,
the goondas will put up their jhhopdis in its place, and
people feigning concern will not be kept away by its
stink. This garbage heap protects my izzat. In any case
we have been thrown on a kachra ka dhug. Just leave us
alone on it.”

But benign neglect is too hazardous a luxury in an
imminent epidemic that will not disappear with the
season.

[2 Dec 91, pp 1, 3}

[Text] Bombay, December 1. There have always been
two sides to the AIDS coin. One, the aseptic conference
hall with earnest researchers projecting slides and plati-
tudes; the other, sleazy Falkland Road where HIV
crouches in claustrophobic hovels and the pallor of death
is already visible through the garish paint on faces.
What’s new is the increasingly unbridgeable chasm
between the two.

The ICMR surveillance centres and the Bombay Munic-
ipal Corporation might argue that “testing of high-risk
blood samples must continue so that future services can
be planned,” others in the field insist that no more time
and money should be wasted on this sterile exercise,
especially since more lives are ruined rather than helped
with the discovery of HIV positivity. As it is, after
spending Rs 25 lakhs on a special AIDS ward at the JJ
Hospital, it has now dawned on officialdom that isola-
tion is clinically unnecessary and psychologically unde-
sirable.

SJPRS-TEP-92-003
12 February 1992

The exemplary surveillance on blood bank supplies
needs to be maintained, but on HIV’s other, still-defiant
route, it is imperative to make a policy shift to an
aggressive promotion of safe sex. The main target must
now be the direct user. Not the prostitute, but her client
who multiplies infection in high-risk groups and then
takes it home to wives and children yet unborn. The
campaign must be intensified among those who attend
clinics for Sexually Transmitted Diseases (STD).

Dr. Jacob John of the CMC, Vellore and among the
foremost researchers in the field, identified the dramatic
increase of HIV among these cases as a marked trend in
the national AIDS epidemiology. Dr. J. K. Maniar, who
recently revealed the entry of HIV-2 into India, colour-
fully describes STD and HIV as “brother-sister”, noting
that sero-positivity in STD patients has spiralled from
five percent to 25 percent in just the last two years.
Aggravating the situation is, both, the decreasing age of
those affected by STD (most are between 18 and 25) and
the high rate of “dafaulters” who don’t return to the
clinic for a check-up.

Expectedly, Dr. Maniar demands a structural change,
taking the programme “out of the hands of the microbi-
ologist, who cannot speak the “language of those
affected, and putting it into those of STD specialists,
general practitioners and community health workers.”

In Bombay there were twice as many full-blown AIDS
cases in November (52) as there were in April. In
Maharashtra, sero-positivity through the heterosexual
route accounts for 4.9 percent of samples screened,
compared to only 0.6 percent in recipients of blood and
serum products. In Gujarat, HIV-positivity multiplied
from 70 in July 1990 to 715 in November 1991 (all blood
donors). Today, no state is free of the scourge, and
national figures have spiralled from 63 in 1986, when
surveillance began, to a tip-of-the-iceberg 5,880 docu-
mented cases. All this points to promiscuity as a fact of
Indian life. High-risk behaviour isn’t obviously simply
the aberration of not-me groups; as the base widens, the
dangers multiply exponentially.

The safe-sex message is being passed on by doctors and
medical social workers and “Kama Sutra’s” erotic adver-
tisement does stand out amidst blander posters at the
Bombay Municipal Corporation’s STD clinic. But AIDS,
five years after the control programme’s launch, is still to
get on the medical, nursing and community-work cur-
ricula, The ad hoc lecture and seminar is all. “We
haven’t even learnt to talk freely about sex with these
patients. We dole out thousands of ”Nirodhs“ and
»Maharajahs;“ but we have no way of ensuring that they
are used.” Besides, as Fatima, who has now sub-
contracted her Kamathipura brothel, will inform you,
“Some respectable men may bring along a barsati coat,
or buy one from the gharwalli, but usually they are too
drunk to bother. At one time, men showered us with
gifts, today there are too many girls, too few clients.



18 EAST ASIA

Mr. Niwat said that Hat Yai District is coming under
strong criticism from abroad concerning the AIDS situ-
ation. It is essential that all sides cooperate in solving the
problem in order to bring about order and improve our
image. This is because we want Malaysian tourists to
come to Hat Yai as in the past. Prostitutes are coming
under attack concerning the AIDS problem. Thus, it is
essential that everyone cooperate in controlling this
disease. Also, steps must be taken to ensure that tourists
are not exploited and that they do not exploit us.

“All parties must formulate measures and cooperate,
because business in Hat Yai is now very depressed. Even
though prostitutes are violating the law, prostitution is a
fact of life in every society. We must be willing to
compromise. It’s impossible to eliminate prostitution.
Thus, measures must be implemented to control AIDS.
Our policy is to place condoms in every hotel room, but
that creates a problem with respect to our image. And
hotel owners have not cooperated. We must help each
other and not act like that. If an official takes a bribe
from a brothel, please inform me immediately so that we
can get rid of that individual.”

Dr. Channarong Kuakowitchai, a medical control expert
with the Zone 12 Venereal Disease Center, Songkhla
Province, said that the AIDS situation in Songkhla
Province is very serious. There are now 33,822 people
with the AIDS virus, and of these, 172 are full-blown
AIDS cases. AIDS has spread to 24 families. Most of
those who contract the virus do so through sexual
encounters.

“Nationwide, approximately 300,000 people have the
AIDS virus. The way to solve this problem is to coop-
erate in preventing this disease. Prostitutes must use
condoms, and they must require their customers to use
condoms. Everyone must operate in the same way,
particularly the brothels.” [passage omitted]

Health Official Discusses AIDS Vaccine Tests

92WE0150C Bangkok DAO SIAM in Thai 1 Nov 91
pp 1,8

[Excerpt] [passage omitted] Dr. Thira Rammasut, the
deputy undersecretary of public health, talked with
reporters about the reports that the World Health Orga-
nization will use Thailand as one of the countries to test
an AIDS vaccine. He said that before this vaccine can be
tested on Thais, this must be first be discussed by the
Ministry of Public Health. The first step will be to test it
on animals. Laboratory tests have shown that this vac-
cine can prevent AIDS. Once the vaccine has been tested
on animals, it will be tested on Thais. This vaccine has
already been tested among various groups of people in
the United States, and the results of the tests have been
good. Thus, the drug must be tested on people in other
countries in order to see if the drug can prevent AIDS.

Dr. Thira said that before this vaccine can be tested on
Thais, there must be clear data showing the results of the
tests conducted in the United States. Once we have the

JPRS-TEP-92-003
12 February 1992

various data, there must be criteria, These must be
presented to the ministry’s committee for consideration.
It must determine if things were done properly and in
accord with the criteria that we set. Only then will we
permit the vaccine to be tested on Thais. Our first
consideration must be the safety of Thais. We must
monitor the tests closely and protect the rights of those
on whom the drug is tested. We won’t simply allow tests
to be conducted and allow Thais to become guinea pigs.
The ministry has various criteria. We won’t allow Thais
to be guinea pigs who don’t know that they are being
used to test the drug.

Dr. Thira said that if Thais discover an AIDS vaccine,
the drug will have to go through the same series of tests.
It will have to be tested by various committees just like
foreign drugs. If a Thai discovers an AIDS vaccine, he
should contact the Department of Communicable Dis-
ease Control in order to determine if the drug really can
prevent AIDS, It will have to be tested on animals. Those
who say that they have discovered an AIDS vaccine
cannot simply advertise its effects. If they really have
found an effective drug, they should have it tested to
ensure that it is safe for use by people with AIDS.

Dr. Thira said that the World Health Organization has
already contacted Thai officials. This matter has been
submitted to the National AIDS Coordinating Com-
mittee for consideration. It will consider the results of
previous tests and decide whether the drug can safely be
tested on Thais. The matter will then be submitted to the
prime minister, the chairman of the National AIDS
Committee, who will consider whether the drug should
be tested on Thais. We are monitoring things very
closely. People can’t simply come here and test drugs.
The testing of this AIDS vaccine will probably take 10
years before the results are known. It will probably take
about a month to make a decision on whether to allow
testing on Thais. This must be considered very carefully.
If it is decided to allow the vaccine to be tested here,
various programs will have to be submitted. We can’t
rush to test this drug. The Ministry of Public health
won’t allow that. This is just the initial step. Nothing has
been done yet. We must first decide whether to allow
them to conduct the tests. Those who are tested must
volunteer to be tested. No one can be forced. And this
must be done in accord with international human rights.

Epidemiologist on AIDS Vaccine Experiment

92WE0121C Bangkok SIAM RAT in Thai 3 Nov 91
pp I, 16

{Excerpt] [passage omitted] In his capacity as chairman
of the National Epidemiology Committee, Dr. Prawet
Wasi talked with reporters at the Asia Hotel on 2
November about the “testing of an AIDS vaccine in
Thailand.” He said that the U.S. Military Medical
Research Institute has presented concrete data on AIDS
prevention and wants to test the vaccine in Thailand.
The Military Medical Research Institute is now testing
this vaccine in the United States. This requires going



36 LATIN AMERICA

are extremely effective in educational campaigns, and
they don’t have to be experts on the subject or have any
connection with AIDS.

If it is not easy to weigh the positive and negative effects
of the mistakes and successes racked up by the Brazilian
Government, it is certainly true that the two television
programs did not have an impact anything like, for
example, the blackout staged in several U.S. cities for 15
minutes on the night of 1 December. In an atmosphere of
national solidarity, the lights on buildings and monu-
ments were turned off in cities like Miami, Austin,
Chicago, and San Francisco. In New York, even the
Manhattan skyline, one of the best-known postcard
views in the world, was dark. Only the Empire State
Building, the most famous in the city, was kept lit in
homage to those who have died because of the AIDS
virus. Television, the same means used by the Brazilian
Government to publicize its message, spent a lot less
time but yielded a lot more shock value: 31 American
cable TV stations aired an eight-minute documentary
showing that during that exact interval one person was
dying of AIDS in the United States.

Equally dramatic demonstrations took over the rest of
the world on Sunday. In Bombay, India, children of
prostitutes organized a procession to alert the public on
the realities of the epidemic and asking, for the sake of
their mothers’ health, that Bombay men use condoms
when having relations with them. In Bangladesh, it was
the doctors themselves who took to the streets to warn of
imminent danger. In Italy, immunologist Ricardo Aiuti,
one of the leading specialists on AIDS, kissed a carrier of
the AIDS virus on the mouth to show that kissing is not
contagious. In Paris, Act Up, an association of the
AIDS-infected and homosexuals, organized a march
along the streets of the city in which the main slogan was
“AIDS: Time to declare a state of emergency.” And in
England, as was bound to happen, Princess Diana turned
out to be the central character in the commemoration of
the date.

Back in Brazil, in Porto Alegre, the AIDS Prevention
Support Group (GAPA) set up a kind of cemetery by
placing 724 headstones near the Monument to the Expe-
ditionary Force. One mark of progress in the Brazilian
campaign, according to Dr. Arnaldo Etzel of the Santos
Department of Health, was the shift in the theme of the
propaganda against spread of the disease. From now on
it is to be based on solidarity and an appreciation for the
value of life. Etzel hates messages such as: “You have
AIDS and you’re going to die,” which have encouraged
discrimination against carriers of the disease.

Often the victim of that prejudice, Sao Paulo native
Carlos Aparecido da Cruz, 31, a former drugstore clerk,
summoned the courage to reveal his illness during the
video that was broadcast on Sunday. To him, the ter-
rorist health policies originally adopted regarding AIDS
must also be blamed for the cavalier behavior of AIDS
sufferers. “I even invented a slogan: If you’re not careful,
the Ministry of Health will get you,” he said.

SJPRS-TEP-92-003
12 February 1992

It is estimated that there are now about 700,000 people
in Brazil who are infected with the HIV virus. However,
the latest notification reported 21,023 cases, which puts
the country in fourth place behind the record-setters, the
United States, Uganda, and Tanzania. The Brazilian
figure is underreported, largely because of prejudice,
which is thought to be making many patients conceal
their condition as carriers of the virus from the author-
ities. Now, the requirement to report the disease in order
to receive the AZT medicine free of charge (a bottle costs
104,000 cruzeiros and lasts about 15 days) may help to
boost the official statistics. Then it will be up to public
health campaigns to keep those figures at acceptable
levels or even reduce them. Otherwise, the dire predic-
tion made by Collor in his speech could come true: that
by the year 2000 there will be eight million carriers of the
AIDS virus in Brazil.

Drug Use Spreads AIDS in Sao Paulo Interior

More Use Than Imagined

92WE0179A Sao Paulo O ESTADO DE SAO PAULO
in Portuguese 16 Dec 91 p 10

[Article by Daniel Hessel Teich: “AIDS Following the
Drug Traffic Route in the Interior’”]

[Text] AIDS has changed the interior of Sao Paulo.
Cities proud of their agroindustrial wealth and ofa
quality of life much superior to that in the capital are
now compelled to live with a problem that is growing by
the month, reflected in the statistics of the State Secre-
tariat of Health: the increase in AIDS cases provoked by
intravenous drug use.

Following in the wake of the drug traffic routes that
crisscross almost throughout the interior of the state, this
form of infection is attracting the attention of the pro-
fessionals in the Department of Education and Preven-
tion, of the CRTA (AIDS Referral and Training Center),
in the Secretariat of Health. “We are trying to implement
a specific program for each region,” said Elizabeth
Arevalo, a social worker with the CRTA.

“As cases are reported, we are discovering that drug
consumption is much greater than we imagined, prima-
rily among the poorer people,” declared Ireneu Luiz
Maia, chief of the Department of Infectious Diseases of
the Sao Jose do Rio Preto Faculty of Medicine.

Strategically located in the northern part of the state, Sao
Jose do Rio Preto is close to two of the primary drug
pipelines: the Euclides da Cunha and Washington Luiz
highways (SP-320/310). The drugs which reach the
region enter by way of the Bolivian border and proceed
across all of Mato Grosso do Sul.

Open Road

According to Alberto Corazza, delegate of the Division
of Prevention and Education, of the State Department of
Narcotics Investigation, the Sao Paulo interior is a fertile



JPRS-TEP-92-003
12 February 1992

Many More Cases Alleged

92WE0178A Dublin IRISH INDEPENDENT
in English 28 Nov 91 p 15

[Article by Stephen O’Brien: “AIDS Toll ‘Twice that
Revealed by Statistics””]

[Text] The number of Irish people who have died from
AIDS could be double the official government figure
because it does not include those in the large Irish
community in Britain, President Mary Robinson was
told yesterday.

The Positively Irish Action on AIDS (PIAA) group told
Mrs. Robinson that many Irish people become involved
in “high risk activity” in London and other British cities
with little awareness of the dangers involved, because of
“the lack of HIV prevention initiatives in Ireland.”

PIAA representatives met Mrs. Robinson in London one
year ago, when the president travelled to meet Irish
emigrants during her election campaign.

On their return visit to Aras an Uachtaran yesterday the
London-based group outlined the measures needed in
this country to help the Irish at home and abroad:

—Accessible, explicit, non-judgmental” education on
HIV and sexual health issues should be available to
everyone in Ireland through schools, youth clubs,
statutory and voluntary services.

—Free condoms and needle exchanges to prevent the
spread of HIV should be available to all parts of
Ireland, not just one Dublin location.

—HIV policies and resources in Ireland must take into
account the large Irish community in Britain affected
by HIV and AIDS.

Spokeswoman Siobhan Riordan said a survey of AIDS
help centres throughout London showed that between 5
and 10 percent of their regular clients were Irish,
although just 2 percent of the population in Britain was
Irish. And she believed that while officials figures
showed that 1,122 HIV positive cases had been detected
in Ireland, there were at least that many Irish people
affected with HIV in Britain.

A report presented to the president contained a claim by
an Irish priest that there could be as many as 3,000 HIV
positive cases in Ireland—nearly three times the official
figure—because of the large number of intravenous drug
abusers here.

Father Sean Cassin of the Dublin Merchants’ Quay
Project said the Irish College of General Practioners
(ICGP) estimated that there were 7,000 intravenous
drug abusers in Ireland—mostly in Dublin—and the
number who are HIV positive might not be far behind
the 64 percent figure among drug abusers in Edinburgh.

WEST EUROPE 67

SPAIN

Safety of Country’s Blood Supply Examined

Health Risk Low

92WE0116A Milan EUROPEO in Italian 8 Nov 91
pp 80-82

[Interview with Pier Mannuccio Mannucci, Milan Uni-
versity hematologist, by Giuliano Ferrieri; place and
date not given: “Risky Transfusions? Not in Italy”]

[Text] In France, 460 persons have been contaminated
by many types of viruses (those of the various hepatitis
and the HIV of AIDS) following transfusions of infected
blood distributed “to save on expenses.” Can something
similar have happened in Italy too?

Hematologist Pier Mannuccio Mannucci, one of the top
experts on the subject, firmly denies it. “Statistics con-
firm it,” he says, “look at the hemophiliacs (who,
needing continuous blood transfusions, constitute a cat-
egory that can serve as reference). In Italy there are 700
seropositives compared to 3,000 hemophiliacs. That is
still a lot, but it is the lowest percentage of all European
countries. They have not increased in recent years. And
there has not been even one seropositive case among
them after 1985, that is, since Italy by law distributes
only blood and plasma ‘treated’ with heat and with
chemical processes to kill viruses, and especially the
fragile HIV of AIDS, which is destroyed at as low as 60
degrees Centigrade.” Prof. Mannucci is the director of
the Second School of Specialization in Hematology at
Milan University and of the Angelo Bianchi Bonomi
Center of Hemophilia and Thrombosis at Milan’s Poly-
clinic.

Mannucci knows what he’s talking about: It is not a mere
coincidence that he, together with Prof. Luc Montagnier
of the Pasteur Institute of Paris (the discoverer of the
AIDS virus) conducted the world’s first clinical research
on the destruction of the HIV virus through the use of
heat. It was because of that study published in Britain’s
“Lancet” (signed by both Mannucci and Montagnier)
that countries were only allowed to give transfusions
with “treated” blood.

It is worthwhile to hear this story told by Prof. Mannucci
himself. He says: “Up to 1984 it was not even certain
that AIDS was caused by a virus. In 1984 Montagnier
discovered the virus (followed then by Gallo) and at the
end of that year Dr. Evatt of the Center for Disease
Control in Atlanta, experimentally demonstrated, in
vitro, that heat destroys the HIV. In vitro: but it was
clear it was necessary to demonstrate that the destruction
of the HIV virus could also be accomplished in vivo. I
was fortunate enough to know beforehand the results of
Dr. Evatt’s research. It was at this point that Montag-
nier’s and my decision,” continued Prof. Mannucci,
““was to accomplish the first experimentation on man.
We chose a group of hemophiliacs who had been treated
with blood concentrates not inactivated by heat, and a


JPRS-TEP-92-003
12 February 1992 4 AIDS

GUATEMALA

AIDS Deaths Total 86 {Guatemala City DIARIO DE CENTRO AMERICA, 26 Nov 91]
HONDURAS

Eighty-two New AIDS Victims /Tegucigalpa EL HERALDO, 9 Nov 91] ....

Thirty-three Additional AIDS Cases /Tegucigalpa EL HERALDO, 17 Dec 91]
ST. LUCIA

Majority of AIDS Cases Contracted Heterosexually /Bridgetown CANA, 20 Jan 92) ......

NEAR EAST & SOUTH ASIA
EGYPT

Officials Support Law Against AIDS Carriers /Sabir Shawkat; Cairo AL-WAFD, 3 Jul 91] ....
INDIA

AIDS Reported Spreading Rapidly in Goa /Madras INDIAN EXPRESS, 10 Oct 91]
Papers Report Continuing Spread of AIDS...
Cases in Bombay, Madras, Manipur /Bombay THI
Spread in Gujarat /Bombay THE TIMES OF. INDIA, 20 Nov 91) ..
Better AIDS Treatment Urged, Bogus Treatment Scored
[Bachi J. Karkaria; Bombay THE TIMES OF INDIA, 1, 2 Dec 91]
Continuing Reportage on Fight Against AIDS ..
AIDS Prevention Bill Withdrawn /Bombay THE TIMES OF INDIA, 4 Dec 91]
More Cases in Calcutta [Amit Ukil; Calcutta THE TELEGRAPH, 3 Dec 91]
Tamil Nadu Statistics /Madras THE HINDU, 29 Nov 91] ...
Increase in Gujarat [Calcutta THE STATESMAN, 20 Nov 91]
AIDS Now Biggest Threat to Narcotics Users {Hong Kong AFP, 4 Dec 91]

TRAN
AIDS Patients Identified by 10 Nov Total 182 /Tehran IRNA, 15 Nov 91]
Official Details AIDS Cases /Tehran ABRAR, 18 Nov 91] ..
JORDAN

Article Reports Total of 66 AIDS Cases /Amman JORDAN TIMES, 28 Nov 91] .....
MOROCCO

‘Alarming’ Increase in AIDS Cases /Ali Benadada; Rabat L’OPINION, 5 Dec 91]
NEPAL

AIDS Cases Increase as Prostitutes Return {Kathmandu THE MOTHERLAND, 2 Dec 91]
PAKISTAN

Number of Individuals With AIDS Increasing Steadily
[Peshawar THE FRONTIER POST, 12 Nov 91] ...
Government Said ‘Doing Nothing’ To Prevent AIDS [Karachi AMN, 17 Nov 91]
Ten Million AIDS Victims Forecast by 2000 /Karachi AMN, 18 Nov 91] ...
Government Accused of Criminal Neglect Regarding AIDS
[Ikram Hoti; Peshawar THE FRONTIER POST, 20 Nov 91]
Over 100 Said Infected With AIDS [Lahore NAWA-I-WAQT,

CENTRAL EURASIA

HIV Infection in Children /(V. Dmitriyev; VRACHEBNOYE DELO, Jul 91]
Another AIDS Carrier Found in Lithuania [Moscow BALTFAX, 11 Dec 91]
Medical Experts Alarmed at Spread of AIDS {Moscow Radio Moscow World Service, 20 Dec 91] .



70 WEST EUROPE

thoughtlessness with which doctors do transfusions even
when they aren’t necessary,” says Pasquale Angeloni, 64,
director of the National Blood Transfusion Center of the
Red Cross in Rome. And all the campaigns to influence
people to donate blood? “There’s an annua! deficit of
200,000 containers. Orthopedic operations and trans-
plants call for large amounts of plasma. But if every time
a surgeon operates he pours out one or two units of
plasma, that is a practice without good grounds.”

While censuring, without mincing words, the waste of
plasma and the ill-fated consequences brought about by
a mistaken medical culture and by a foolish health
system, Prof. Angeloni outlines for EUROPEO the
maneuvers and interests that rotate around blood trans-
fusion centers.

“Let me cite a typical reality: In England there are 12
transfusion centers, in France a few more, in Italy we
have now reached 360. The money generally spent by a
regional health system—between medical personnel,
paramedics, equipment, etc.—for the classic 400 milli-
liter pocket hovers between 700,000 and 900,000 lire.
Such high costs are born of the dispersion and prolifer-
ation of health structures that certainly do not favor the
collection and management of blood. We'll see the
absurdity of it within a few months when local health
units open outside hospitals dozens of transfusion cen-
ters. Let’s say it clearly: The State will be paying hun-
dreds of persons for a service that will have no practical
usefulness for the community.”

Rome stands out as far as waste of public money for
transfusion centers is concerned. Ermanno d’Erme,
regional president of Avis, the biggest association of
blood donors, confirms that: “In Rome there are already
too many transfusion centers. In spite of the logic and
experience gained in other cities, millions are being
spent for useless, if not damaging, structures that cost
millions and millions.

Yet Law 107 of May 1990 decrees that transfusion
centers should be one for every 400,000 users, an average
that is applied in provinces like Viterbo and Latina,
which thus can claim a correct proportion. In Rome the
ratio is one every 100,000 inhabitants. Even in this case,
however, there exist two Italys: The North, with 45
percent of the total populations, garners 64 percent of
the national supplies. In the South it does not go over 17
percent. The reason is “very simple,” replies Professor
Angeloni. “In numerous southern cities there is a
thriving market in blood controlled by unscrupulous
persons. Unfortunately, people turn to them because
transfusion centers don’t have even enough supplies for
the daily needs of hospitals. It’s the classic mechanism of
the black market: There’s never any blood available, but
if you pay, it’s always possible to find some.”

The game is simple, the Red Cross in Rome says: You
buy in the North—the Veneto and Friuli Regions have a
very high number of regular donors-—through courteous
requests, and the blood is then resold wherever it is more

SIPRS-TEP-92-003
12 February 1992

convenient, With the chronic lack of reserves, no one
wastes time to make scrupulous checks. Thus, that is the
way the game is played. Talk about blood-suckers!

PORTUGAL

AIDS, Hepatitis Among African Trainees

92WEO1I4A Lisbon O JORNAL in Portuguese
31 Oct 91 p5

[Article by Herminio Santos]

[Excerpt] Five members of the military contingent from
Portuguese-speaking countries in Africa [PALOP]
assigned to the Amadora Commando Regiment on the
basis of the cooperation agreements signed between
Portugal and its former colonies are infected with AIDS
or the hepatitis-B virus. An authorized Army General
Staff source has confirmed the existence of these cases to
O JORNAL, going on to say that, of the five sick
individuals, three have hepatitis and two have con-
tracted AIDS.

These individuals arrived in Portugal on 14 September
as members of a group of 13 sergeants and commis-
sioned officers. The majority began attending the course
for commando monitors and instructors taught by a
sergeant and a commissioned officer in the permanent
professional Army cadre. Some days later, they were all
given various medical tests, consistent with the normal
procedure for soldiers from PALOP.

After the test results reached the regiment on the 16th of
this month, the infected individuals were immediately
excluded from the course and taken to the Belem Mili-
tary Hospital (formerly the Military Hospital for Infec-
tious-Contagious Diseases). At least one of the sick
individuals used the regimental premises only for
sleeping, spending time in another Army unit. Although
the Ministries of Defense and Foreign Affairs are spon-
soring a cooperative effort, which will have the last word,
it is almost certain that these patients will be sent back to
their native countries,

According to the Army General Staff, the regimental
commander called an immediate meeting of the teaching
staff as soon as the results of the tests were known. The
purpose was to put ar. immediate end to the rumors that
were beginning to circulate about the cases of AIDS and
hepatitis in the unit. Duri: > this “explanatory session,”
at which a doctor was prese*t, the instructors were told
about the situation and aiso were given information
about the symptoms of the diseases and how they are
transmitted,

According to medical sources with whom 9 JORNAL
has talked, hepatitis-B is transmitted in the .: ne way as
AIDS—that is, by means of blood or spern. “here is
only one difference between the hepatitis virus and the
AIDS virus, and that is that the former is more resisiant.



SJPRS-TEP-92-003
12 February 1992

Ferrieri: On the other hand, the scandal of the “so-
as-not-to-waste” infected blood transfusions broke in
France, the land of Montagnier. It is a harsh fact, don’t
you think?

Mannucci: Certainly, and I was upset about it myself;
after all, as I told you, the first clinical study on the safety
of the recourse to heated blood was a Franco-Italian
research project that also carried Montagnier’s name.

Naturally its’ clear that Montagnier and the Pasteur
Institute are not involved in that mess. Involved are the
people in the ministries: that Dr. Garretta, who has the
Teputation of being a good manager but certainly not a
great scientist. It’s true that a good manager can direct a
transfusion service...we are lucky ourselves that heading
that job we have a great manager who is also a great
scientist—Prof. Girolamo Sirchia.

Organization Criticized
92WE0116B Milan EUROPEO in Italian 8 Nov 91
Dp 83-84

[Article by Sergio Canelles: “Very Expensive Blood:
Small Quantity and Not Used Very Well]

[Text] Angelo Magrini is a marketing sector professional.
A transfusion he received four years ago gave him a
hepatitis infection. “It’s a miracle I didn’t run up against
the AIDS virus,” he told EUROPEO. “Dozens, hun-
dreds of persons in fact, let’s say less fortunate than I,
find themselves saddled with tragedies without ever
having done anything wrong.”

The origin of the drama that has involved a high number
of multitransfusion receivers, hemophiliacs, micro-
cythaemics, and other sick persons subject to frequent
blood transfusions, is set between April 1985 and Feb-
tuary 1987. “In Italy during that period,” charged
Angelo Magrini, currently president of the multiple
transfusion recipients association, “use of blood and
hemoderivates was effected without being specifically
tested to verify immunity to the HIV AIDS virus.” For a
period of about two years, hospitals, clinics, and other
health. structures could thus have used blood and its
derivates. without knowing the risks of AIDS infection.

Already years ago, Magrini charged that “the require-
ment to check blood from so-called nonregular donors
goes back to April 1986; the order to withdraw the
hemoderivates that were not specifically tested only
came in February 1987, while.we had to wait until 15
January 1988 before tests bearing on these diseases were
introduced for every sample of donated blood in Italy.”

It was not long before the consequences emerged. The
statistics of the Superior Health Institute speak for
themselves: 1,200 persons have been infected by the HIV
virus. As time went by, the picture outlines itself
unequivocally. There are 149 deaths; of the 1,051 still
alive, 120 by now definitely have AIDS; 931. others are
seropositive.

WEST EUROPE 69

A law suit initiated for “biological damage” by more
than 400 persons, members of the multiple transfusion
recipients association, calls for 300 million lire in com-
pensation for those infected by the transfusions, and 600
million for the families of those already dead. Other
benefits are sought for orphans and widows of heads of
families who died on the job.

“A few days before the World Congress on AIDS that
took place in Florence a few months ago, ’we received,“
they say scornfully at the association of multiple trans-
fusion recipients ’the counter offer of the Health Min-
istry: compensatory damages of 50 million lire for fam-
ilies which have lost a relative; 18 million for those
infected by AIDS.“

But how is one to act in such a delicate area as blood
transfusions, and what is to be done starting immedi-
ately?

Immunologist Fernando Aiuti covers several points for
EUROPEO: avoid the easy transfusions, do them only in
cases of real necessity. Go with the rule of double tests
with two control kits, The risk cannot be totally elimi-
nated, but one hypothetical infection is reached for every
100,000 transfusions. And again: dispense with taking
blood samples for subjects at risk, and work with a
doctor to draw up interview patterns. The reason? It is
well known that replies of individuals are rarely truthful
if the person is not offered the assurance that the data
given is useful and not discriminating.

Finally, transfusion centers should not be allowed to do
specific and sophisticated analyses (as in the case of the
HIV): In very many cases, people turn to these centers so
as not to lay themselves open to risk in a specific center
dealing with AIDS, thinking they are substantially the
same when in fact they carry out completely different
procedures.

What is the real danger any of us can risk? A probability
in 40,000 is the cold statistic calculated in hospitals of
the risk of contracting sickness following blood transfu-
sions. But the unmentionable sickness, of ‘course, is
AIDS.

“Anyway, the high-risk phase is at an end,” asserts
Antonio Zanini, resident doctor of the transfusion center
at Bologna’s Ospedale Maggiore. “At the present time we
are able, through so-called ‘windows of observation’ to
establish with an extremely limited margin of error the
presence of infective elements in the blood. The
problem, however, doesn’t disappear. The risk of infec-
tion can never be eliminated 100 percent. The solution
could come through an increase in regular blood donors.
Checks and identifications are enormously facilitated by
persons who continuously donate plasma on a regular
basis.”

In reality a simple solution does not exist. Blamed are
the carelessness and superficiality with which blood
donations and transfusions are handled. “The problem
which must finally be dealt with seriously is the excessive



17) WEST EUROPE

“The investigation is in progress. I do not exclude an
indictment by the end of the month,” said Ake Olsson.

Among physicians, opinion is strong that an HIV-
infected person who knowingly exposes another to risk
of infection should be punished pursuant to the criminal
code, not according to the Disease Control Law.

HIV-Positive Individual Incarcerated

A Finnish man was sentenced to two years’ imprison-
ment for having infected his male partner with the HIV
infection. The municipal court of Helsinki condemned
the man for the infliction of grave bodily harm which
caused his death.

Monthly HIV Increase Stable

92WE0082G Stockholm DAGENS NYHETER
in Swedish 23 Oct 91 p 6

[Article by Kerstin Hellbom: “No Increase of HIV;
Spreading Via Heterosexual Intercourse in Sweden” —
first paragraph is DAGENS NYHETER introduction]

[Text] Between two and four people a month are infected
by the HIV virus through heterosexual intercourse in
Sweden. This has been the trend in recent years. Indig-
enous heterosexual spreading has neither increased nor
diminished,

This is the finding of the latest statistics from the
National Bacteriological Laboratory [SBL], on newly
reported HIV positive individuals during the third
quarter of this year.

In contrast to the high numbers of HIV positives newly
detected in the first years, the numbers in more recent
years, starting in the mid 1980’s when the capability of
testing for it began, have stabilized at about 30 people a
month. This tendency has not changed, according to
SBL’s latest statistics.

In all, 83 new cases were reported in July, August, and
September of 1992. The spread of the disease breaks
down as:

Homosexual intercourse, men: 25, women: 0.
Needle-users, men: 5, women: 2.

Heterosexual intercourse, Men: 18, women: 30.
Blood and blood products, men: 0, women: 1.
Mother to child: 2.

The table shows that spreading of the infection through
heterosexual intercourse continues to be greater than
spreading through homosexual intercourse or through
needles.

Of the total of 48 who were heterosexually infected, half
were of foreign origin. Of the approximately 20 individ-
uals remaining, about half of those were infected abroad.

This leaves about 10 who were heterosexually infected in
Sweden, between two and four individuals a month.

SJPRS-TEP-92-003
12 February 1992

Since the first HIV positive cases were detected in
Sweden in the mid-1980’s, a total of 2,890 individuals
infected with HIV have ben reported to SBL. Of these,
2,338 are men and 552 are women. The spread of the
infection breaks down as follows:

Homosexual intercourse, men: 1,372, women: 0.
Needle-users, men: 422, women: 172.
Heterosexual intercourse, men: 371, women: 325.
Blood and blood products, men: 150, women: 45.
Mother to child:16.

Unknown cause, men: 14, women: 3.

Of the 2,890 reported HIV positive cases in Sweden, at
least 800 are of foreign origin, most of whom were
infected through heterosexual intercourse.

Tighter Blood Checking From HIV Concern

92WE0082C Stockholm DAGENS NYHETER
in Swedish 1 Nov 91 p 5

[Article by Lena Axelson: “Stricter Control Over
Blood”—first paragraph is DAGENS NYHETER intro-
duction]

{Text] The possibility of spreading the HIV virus in
Sweden through blood transfusions is still not excluded.
Therefore the National Board of Health and Welfare has
recommended that the nation’s hospitals be extremely
careful when they administer blood to their patients.

“The risks cannot be swept under the rug,” said pro-
fessor Claes Hogman of the Academic Hospital in Upp-
sala. He participated in compiling the national board’s
general advice on replenishment of blood loss.

According to Claes Hogman, the situation for blood
transfusions in Sweden has changed a great deal since the
beginning of the 1980’s. The risk of being infected with
HIV in this manner is today much diminished.

“By 1983 safety measures were already in place for blood
donation. Doctors warned people in risk groups about
donating blood. And in the summer of 1985 it became
possible to test blood for the HIV virus. By autumn of
the same year, the test was performed throughout the
country. The same year, a method of heating blood from
donors began to be used in order to kill any HIV virus
present.

During the last six years no one in Sweden has been
infected with the HIV virus through blood transfusions.

A week ago, the worst health scandal in France’s history
was discovered. Of the nation’s 2,300 hemophiliacs,
1,200 have been infected with the HIV virus through
blood transfer. Of those infected, 185 have died of AIDS.
The virus was transmitted during the years 1980-1985.
The cause appears to have been negligence on the part of
the authorities.

Three bureaucrats at France’s National Blood Transfu-
sion Center have been charged with having neglected to



JPRS-TEP-92-003
12 February 1992

At present, many countries have spent a great deal of
money to set up anti-AIDS funds in an effort to stop the
disease.

Vietnam formed the National Anti-AIDS Committee
with WHO’s assistance. On 30 November in Hanoi, the
Anti-AIDS Committee held a meeting to welcome the
World Anti-AIDS Day.

“Speaking at the meeting, Professor Pham Song, presi-
dent of the National Anti-AIDS Committee spoke about
latest information on AIDS in Vietnam. He said that out
of 67,600 blood tests, they discovered one Vietnamese
and 49 Thai fishermen living in the provinces of South
Vietnam infected by HIV. The professor expressed his
desire for cooperation in AIDS prevention with all
national sectors and levels and international organiza-
tions.”

Representatives of the UNDP [United Nations Devel-
opment Programs] and WHO at the meeting stated that
they wanted Vietnam to cooperate with the international
community in preventing AIDS. They also promised to
continue providing financial assistance to the anti-AIDS
work in Vietnam.

EAST ASIA 29

French Medical Equipment for Institute in HCM
ity

BK0412161991 Hanoi VNA in English 1226 GMT
4 Dec 91

[Text] Hanoi VNA Dec 4—The Pasteur Institute in Paris
has presented the Pasteur Institute in Ho Chi Minh City
with medical equipment, materials, chemicals and bio-
logical products for tests regarding HIV and other
viruses.

With the donation, the capability of the AIDS laboratory
of the local institute will increase considerably. More-
over two experts from the Paris Institute have come to
cope with the AIDS problem for two years.

The local institute so far has tested 4,000 blood samples
for HIV. One was positive.

HIV can be a potential threat to the Mekong River Delta
provinces due to broadening trade with other countries.
Medical groups are now covering the region to conduct
tests for highrisk groups.



JPRS-TEP-92-003
12 February 1992

In October 1991, 3 meetings on AIDS and HIV infection
were organized by the NCCA in Savannakket Province,
with a total number of 422 participants, NCCA in
collaboration with the member of the AIDS subcom-
mittee from the military health department has con-
ducted meetings to discuss HIV/AIDS topics among 656
military recruits and soldiers. The seminar was assisted
by the embassy of the United States of America in Laos.

In August 1991, a 2-day workshop was organized in the
National Institute of Hygiene and Epidemiology to pre-
pare a questionnaire for the rapid assessment of KABP
[as received] and conduct a pretest. The number of
participants was in total 22.

The Lao radio and television broadcasts have aired
programmes on AIDS/HIV information. And the Lao
leading newspapers have also published 8 articles on
AIDS and HIV infection.

Since the mid of 1991, the NCCA and the laboratory
services of the National Institute of Hygiene and Epide-
miology have adopted an anonymous testing system for
voluntary persons, a pre and post test counselling and a
reasonable follow-up for the HIV positive person.

On the 17th September 1991, the NCCA had a discus-
sion with policemen and immigration officers of the
Ministry of Interior in order to avoid a tendency of
prejudice and discrimination isolation of HIV positive
people identified among the illegal returnees from Thai-
land.

The laboratory-responsible for HIV antibody testing has
actively participated in the programme of quality control
of WHO collaborating laboratories in Australia and
Switzerland in order to increase the performance and
accuracy of the testing methods used. Since we have no
confimatory test for HIV, the initial positive samples
found in our laboratory were sent to Australia and
recently to Thailand for the confirmation.

TAIWAN

Health Department Requires AIDS Tests for
Engaged Couples

OW0612093791 Taipei CNA in English 0819 GMT
6 Dec 91

{Text] Taipei, Dec. 6 (CNA)—A test for the HIV virus
will be part of the tests for men and women before they
get married, and any one who wishes to get a clean bill of
health can go to the 75 authorized hospitals across the
country for free tests, the Department of Health (DOH)
said Thursday.

Currently around 14,000 men and women have a
package of pre- nuptial health tests made every year, and
the department is planning to provide a 1,508 NT [new
Taiwan] dollar subsidy for each test so human immuno-
logical deficiency virus (HIV), B type hepatitis and blood
cell tests can be included.

EAST ASIA 15

DOH said that the number of HIV virus carriers con-
tinues to rise, and AIDS patients are no longer restricted
to such high-risk groups as homosexuals, it is time for
more active measures to be adopted to prevent the
spread of the deadly disease.

THAILAND

Use of Troops as AIDS ‘Guinea Pigs’ Discussed

92WE0066A Bangkok KHAO PHISET in Thai
7-13 Oct 91 pp 24, 25

[Article by Uaiphon Taechutrakun: “Thai Recruits,
AIDS Guinea Pigs: The Risks Overshadowed by Inter-
ests”)

[Text] One section in the bible states that the towns of
Sodom and Gomorrah, which were located along the
Nile River, were inhabited by sinful people and so God
punished them by destroying them. A statement heard
today is that the disease that is annihilating people is
AIDS. People have not yet found a way to stop this
scourge. All that those who contract AIDS can do is wait
to die. Researchers are looking for a drug to treat this
disease, and people throughout the world are waiting,
hoping that they will succeed. But before that day
arrives, many tests will have to be done. And this time,
the testing ground has turned to the Thai Army.

It’s said that the first name thought of by researchers
looking for a testing ground for their drug is “Thailand.”
This is because Thailand now has many things, and it is
very attractive to these people. That is, Thais are easy-
going. As a result, tests can be conducted here both
openly and secretly. Dr. Redfield, who is with the U.S.
Army, has expressed a desire to test the drug Protein GP
160 in Thailand, particularly in the Thai Army. Last
year, he made contact through the Army Medical
Department. But this came to light only after General
Narudon Detchapradiyut asked why they had to test this
drug using Thai soldiers. He asked why they didn’t test it
on American soldiers in view of the fact that this drug
was developed by an American. The answer given by one
human rights activists was that Thailand’s human rights
standards or laws are not as tough as those of the United
States. Using Thais as “guinea pigs” is much easier. To
date, many tests have been done. It’s just that the people
involved were not aware that they were being used as
guinea pigs, because those conducting the tests did not
tell them.

“They told them that they were injecting them with a
vaccine to protect them against malaria and that they
had to get another shot in a month. That was all it took
to conduct the tests. And another important attraction
was the compensation paid these people,” said a person
who was involved with this project to KHAO PHISET.

But KHAO PHISET has learned that Dr. Redfield
contacted people here around the middle of last year.
The director of the Army Medical Department at that



JPRS-TEP-92-003
12 February 1992

newspapers and all branches of the mass media. These
would help with the people. Individuals would be asked
to help also. Mr. Michai Wirawaithaya would have the
Universities and schools engage in a poster contest
displaying the dangers of AIDS.

As for the budget for AIDS prevention, in its 1992
budget the government provided 3 million baht to
Bangkok, 28 million baht to the Local Administration
Department, 1.6 million baht to the National Police
Department, 3 million baht to the Department of Cor-
rections, 2 million baht to the Department of Labor and
1.7 million baht to the Office of Policy and Planning.

Mr. Michai Wirawaithaya said of the reports about
volunteers testing a vaccine to cure and prevent AIDS
that in another two years there would be experiments
with people but that it would take 10 years for a vaccine
to be developed. [passage omitted] He asked the Min-
istry of Interior to issue a letter requesting the coopera-
tion of brothels and asking them to close for one day.

Chiang Mai AIDS, Condom Use, VD Rates

92WE0149C Bangkok THAI RAT in Thai 11 Nov 91
pp 1,17

[Excerpt] [passage omitted] We had the opportunity last
week to prove whether this project was just good in
theory or was actually effective. Those who ran the test
made a list of “brothels” in Chiang Mai as well as how
much business they did and without knowing how far we
had gotten they asked to cover the area of the project
beforehand.

Dr. Wiwat Rotnaphityakon, the director of the Office of
Communicable Disease Control for area 4 in Ratburi
saw clearly that prostitutes were the most important
carriers of the AIDS virus. Since it was not possible to
prohibit this profession, the way to slow the spread of
AIDS was by working hard to have condoms used every
time at all brothels, or as this was called, “the project for
100 percent condom usage”.

Dr. Wiwat had achieved 100 percent condom usage in
Ratburi and had expanded this battle to 10 other prov-
inces, for example in Phitsanulok condom usage had
increased a great deal.

In Chiang Mai a survey by the Chiang Mai Province
Public Health Office (SSCh.ChM.) indicated that 70
percent of those contracting the AIDS virus contracted it
through sexual encounters, and half these contracted the
disease from prostitutes. It was also found that 40
percent of the prostitutes in the city of Chiang Mai had
the AIDS virus.

Since so many prostitutes had the virus, the Chiang Mai
Province Public Health Office worked hard to promote
100 percent condom usage in the province. Dr. Chairat
T. Charoen, the assistant to the head public health
doctor, said that public health officials and officials of
Chiang Mai University, the municipality, the police, the

EAST ASIA a

mass media as well as the governor had cooperated in the
100 percent condom usage project. The project began in
34 out of 109 brothels in the municipal district of Chiang
Mai in the areas of Kamphaengdin, Santitham, Loikhro,
Tonpho, the sports stadium and the airport. There were
500 prostitutes who participated in the project.

The procedure was to go to the brothels and inform the
Prostitutes and brothel owners that condoms should be
used every time with all customers. It was emphasized to
brothel owners that they should be very strict with the
Prostitutes. And the public health service provided about
100,000 condoms per month free.

During this effort it was discovered that the incidence of
venereal disease, which is an indicator of whether con-
doms are being used or not, fell from 600 cases per
month to 200 cases per month or 70 percent. In addition
the public health office sent teams of hunters, or rather
teams of visitors to check to see if they could persuade
Prostitutes or induce them with money to have sex
without a condom. It was found that 92 percent were not
willing to have sex without a condom even though it was
demanded and no matter how much of a tip was offered.
As for the brothels which did not require condoms, the
police were asked to make them understand.

In any case after we had listened to how effective this
project was, we went to see for ourselves at the brothels
in Kamphaengdin—an area of Chiang Mai well-known
to night visitors—to see if they complied and to see what
they thought of the 100 percent condom usage program.

Mr. Yaisi, the owner of a brothel in Kamphaengdin who
had improved the atmosphere by selling drinks in front
of his brothel, allowed himself to be interviewed and said
that he had 11 prostitutes and charged 50 to 100 baht per
time. He made sure that they all had their guests use
condoms each time. There were four to five a day who
were not willing to use condoms. They were generally
drunk. Yaisi calmed them by asking them to come back
another day because today they could not speak clearly.
[passage omitted]

Officials React to Malaysian AIDS Fear
92WEOI50B Bangkok SIAM RAT in Thai 16 Nov 91
pp 1, 16

[Excerpt] [passage omitted] A report from Songkhla
Province stated that a Malaysian daily newspaper that is
published in Malaysia recently published a special article
on the front page. This article was written by Mrs. Liang
Choeng Lan. The article discussed the state’s policy,
saying that the Malaysian Government has ordered the
ministers and deputy ministers of various ministries, the
members of the House of Representatives, Senate, and
Council of State, and government officials not to travel
to Thailand unless necessary. This is because of the
AIDS situation in Thailand.

“This report mentioned the government’s policy of for-
bidding people from visiting Thailand. It said that the



SJPRS-TEP-92-003
12 February 1992

Epidemiology Division of the Ministry of Public Health.
A rather low estimate is that approximately 200,000
people will have the AIDS virus by the end of this year.
This number is expected to increase to 1.3 million by the
year 2000. And by the year 2000, the number of people
with full-blown cases of AIDS will increase to 350,000.

The economic effect of this will be very great. Estimates
based on data from the Epidemiology Division show that
in 1992, Thailand will have at least 5,000 people with
full-blown cases of AIDS. If each of these people is
treated from the time he contracts the disease until he
dies, it will cost at least 5 billion baht, or approximately
one-third of the total budget of the Ministry of Public
Health. This does not include the other costs of pre-
venting and controlling AIDS. This will definitely have
an impact on the ministry’s ability to monitor and
control other diseases.

An effect on the economy that cannot be seen but which
is still very important is the “opportunity cost” of those
who have this disease. Besides the fact that they will not
be able to work and earn money, they will use huge
amounts of public funds. [passage omitted]

Then there is the issue of mothers and children. In
Chiang Mai Province, which is the province where the
spread of AIDS is the most serious, it has been found
that one out of every 25 women who are pregnant have
the AIDS virus. (In the rural areas of the north, one in 10
men has the virus.) This means that huge numbers of
infants will be born with the AIDS virus, because there is
a 20-40 percent chance of infants contracting the virus.
[passage omitted]

There have been reports that youths with AIDS-infected
needles are stabbing villagers with these needles at the
markets. These reports are causing much concern among
the people. Senior people from various units have had to
come forward and tell the people not to worry, because
there is little chance of them becoming infected. When
trying to control AIDS, they tell people not to use dirty
needles to inject drugs, because they will become
infected with the AIDS virus. But when people are
stabbed with needles, they tell them not to worry, that
their chances of becoming infected are very small. [pas-
sage omitted]

I am not really worried about people being stabbed by a
needle and contracting AIDS. What worries me is that
those with the AIDS virus will become mentally dis-
turbed and become resentful toward society because they
contracted AIDS. They may react in various ways. Even
though these people are to be pitied and even though
they should not be punished, in practice, if a person is
suspected of behaving differently like this, they should
not be allowed to mix with other people. Steps should be
taken to detain them and change their behavior.

Malaysia, a neighbor of ours, has an AIDS problem, too.
For the most part, this stems from the fact that Malay-
sian men have sex with prostitutes in Thailand and take
the virus back home. It’s my guess that if it wasn’t afraid

EAST ASIA 17

of the political consequences, Malaysia would have
closed the border and forbidden Malaysians from
entering Thailand. Those people come here for the
purpose of visiting a prostitute. The Malaysian minister
of public health is seeking measures, such as requiring
those with the AIDS virus or those in high risk groups to
carry an ID card. One stern measure is to build a
detainment center for people with AIDS. The president
of the Malaysian Medical Association has publicly
opposed the measures proposed by the Malaysian min-
ister of public health. He thinks that the best way to fight
AIDS is to educate people and provide advice. [passage
omitted]

I don’t understand why the subcommittee considering
the AIDS control law still feels that Thailand doesn’t
need a law. When will they think that this is necessary?
Probably when their family members contract AIDS.

Army Officer on Northern Conscripts’ AIDS
Incidence

92WE0120A Bangkok BANGKOK POST in English
31 Oct 91 p3

[Article: ‘200 Army Conscripts Found To Be AIDS
Carriers”}

[Excerpts] More than 200 conscripts in the Third Army
Region have tested positive for the AIDS virus.

Third Army Region public relations officer Lt.-Col.
Banyong Sirasunthorn said yesterday that more than two
percent of about 10,000 conscripts in the 17 northern
provinces have the Human Immuno-deficiency Virus,
the initial stage of AIDS.

Five percent of privates in Chiang Rai and Phayao alone
tested HIV positive, he said, adding most of these had
sexual intercourse with prostitutes in their local prov-
inces. [Passages omitted]

Third Army commander Lt.-Gen. Pairote Chantaurai in
Phitsanulok tomorrow will chair a meeting of local
authorities on AIDS dangers and how to prevent the
virus spreading. [Passages omitted]

Songkhla Officials View AIDS Economic Impact

92WE0121A Bangkok SIAM RAT in Thai 1 Nov 91
pp 1, 16

[Excerpt] [passage omitted] A report from Hat Yai
District, Songkhla Province, stated that on 31 October,
Police Colonel Manot Kraiwong, the provincial police
superintendent in Zone 2, Songkhla Province, and Mr.
Niwat Sawatkaeo, the district officer in Hat Yai District,
held a meeting with brothel owners in the district. This
meeting, which was held in the auditorium of the district
headquarters, was attended by approximately 140
brothel owners.



30 EAST EUROPE

CZECHOSLOVAKIA

‘Several Hundred Thousand’ HIV Cases Expected
by 2000

AU2012160791 Bratislava PRAVDA in Slovak
19 Dec 91 p 3

{CSTK report: “Threatened by AIDS”]

[Text] Prague—‘I appeal to all people of goodwill to
renew their respect for life, morality, and fidelity and
decency in human relationships and to also encourage
respect for moral standards in their children. This is the
only way we can ward off the tragic vision of the grave
danger facing the Czechoslovak population from the
AIDS disease.” This is what Czech Health Minister
Martin Bojar emphasized in a statement just released.
Minister Bojar refers to a statistical forecast according to
which we can expect several hundred thousand people in
the CSFR to become infected with the HIV virus by the
year 2000. The virus will mostly occur among young
people born between 1970 and 1980. The greatest risk of
infection comes from promiscuity, prostitution, and
intravenous drug abuse. M. Bojar also condemns all
attempts to propagate prostitution and promiscuity and
to liberalize the sale of drugs.

JPRS-TEP-92-003
12 February 1992

ROMANIA

First Congress on AIDS Ends

AU0912085291 Bucharest ROMPRES in English
0841 GMT 7 Dec 91

[Text] Bucharest ROMPRES, 7/12/1991—After three-
day debates, the first National Congress on HIV Infec-
tion and AIDS concluded in Bucharest on Friday,
December 6.

The expositions and addresses made during the congress
enlarged upon methods to investigate and prevent the
disease, education of the people and of the youth in
particular, clinical manifestations in HIV infection and
AIDS, methods to protect the medical and nursing staff,
efforts to discover a treatment allowing the extension of
the span of life of the sick.

The congress ended with an appeal launched by the
“Doris” Foundation, a humanitarian society that orga-
nized the congress’ to all government and non-
government institutions urging them to contribute to the
application of an AIDS control programme in Romania
and to assist the sick.

Data supplied by the Health Ministry show there are
1,557 AIDS cases in Romania, most of them in Con-
stanta County and in Bucharest City.



12 CHINA

Forum Discusses AIDS Situation

HK1412024291 Beijing GUANGMING RIBAO
in Chinese 1 Dec 91 p 2

[Article by correspondent Fan You (5400 0642): “AIDS
in China Spreads Unabated”]

[Text] Beijing, 30 Nov (GUANGMING RIBAO)—As
revealed by Public Health Minister Chen Minzhang at the
“World AIDS Day” forum convened today, from 1985 up to
now, the Ministry of Public Health has received reports from
15 Chinese provinces, autonomous regions, and municipali-
ties on incidences of exposure to the HIV-virus. Six hundred
and fifteen people have tested positive for the HIV-virus
antibody, eight have developed full-blown AIDS. Of these
eight, three are mainland residents; one had been a returnee
from an overseas aid mission and had died this July.

The theme of this year’s “World AIDS Day” is “Jointly
Meet the Challenge.” To prompt various social circles of our
country to participate in AIDS prevention and control, the
Chinese People’s Political Consultative Conference Med-
ical, Health, and Sports Committee; State AIDS Prevention
and Control Committee; State AIDS Prevention and Con-
trol Expert Committee; and the Beijing Municipal Public
Health Bureau jointly held this forum one day before the 1
December “World AIDS Day.”

This correspondent learned from the forum that AIDS is
spreading globally at an alarming rate of 5,000 new cases of
exposure each day. So far, 8-10 million people worldwide
have caught the HIV- virus; there are 1.5 million AIDS
patients, 500,000 are children below the age of five.

Medical experts at the forum said: Though a dreadful disease,
AIDS is preventable. They believe that our country should
strengthen prevention in the following areas: 1. preventing
AIDS from spilling over into the country from neighboring
countries where AIDS is rampant; 2. strengthen health edu-
cation to labor and service personnel to be sent to countries
with high AIDS incidences; 3. cracking down severely on
illegal behavior, such as drug-taking and patronizing prosti-
tutes with the aim of eliminating infection through these
paths; 4, tighten the sterilization procedure of medical instru-
ments (such as syringes, needles, and dental instruments) and
monitoring donors’ blood and stopping infection from med-
ical sources; and, 5. closely monitoring the signals from
fetuses within mothers’ wombs, and interrupting pregnancy if
necessary.

Experts also advise people that while we should guard
against AIDS, we should also dispel unnecessary panic
toward it, saying that there is no danger of catching AIDS
from general contact with AIDS carriers or patients, such as
eating at the same table, hand shakes, using the same
telephone, riding on the same transport, or working
together. Scientific research has proved that mosquito bites
cannot spread the AIDS virus either.

China Seen Alert and Active on World AIDS Day

40101011A Beijing CHINA DAILY (National)
in English 2 Dec 91 p 3

[Text] China is keeping a close eye on the spread of AIDS in
the country and is taking stringent measures to control it,
according to a senior health official.

JPRS-TEP-92-003
12 February 1992

Addressing a forum held on Saturday in Beijing to com-
memorate “World AIDS Day,” which was yesterday, Chen
Minzhang, minister of Public Health, said that out of
300,000 people who have had serum examinations in the
past 11 months in China, 122 have been found to be HIV
positive and three of them have contracted AIDS.

Since 1985, Chen said, China has found eight AIDS
sufferers and 607 infected by the AIDS virus in 15
provinces, cities and autonomous regions.

Among them are three mainland AIDS sufferers, one of
whom had just returned from abroad. He was found to have
been infected by the AIDS virus in 1989 and died in July this
year.

The AIDS-infected are mainly drug addicts in the south-
western border regions, people in inland provinces who
have returned from abroad where they have been
working as members of an exported workforce, people in
coastal areas who have returned from visits abroad, and
prostitutes in the big cities.

Statistics for the past five years show that 22 HIV
carriers are living in Guangdong, 13 of whom were found
this year. And in Shanghai, altogether 14 HIV carriers
have been discovered since 1985, four of whom were
found this year. A hotline number 4742615 offering
AIDS consultancy services was opened yesterday in
Shanghai, according to the local Wenhui Bao.

At the forum, Roy D. Morey, UNDP resident represen-
tative in China, said China has an almost unique oppor-
tunity to prevent the spread of AIDS, as the epidemic is
still in its infancy in China. He said he hopes China will
succeed in its fight against AIDS.

AIDS Victims’ Health Conditions Improve

0W0301064292 Beijing XINHUA in English
0548 GMT 3 Jan 92

[Text] Beijing, January 3 (XINHUA)—The health con-
ditions of three of the first four AIDS victims found in
China have taken a favorable turn after treatment,
though the other died not long ago.

According to sources close to an appraisal meeting on
AIDS detection and prevention techniques held in Zhe-
jiang Province, the immunity of the three victims has
improved during the past few years.

In 1985, Zhejiang medical researchers found that the four
AIDS victims had been affected after receiving injections of
imported blood products.

Soon after, an AIDS research and co-operation group
was set up in the province, mobilizing scores of scientists
and doctors across the country for the study of clinical
diagnosis, Chinese herbal medicine treatment, virus sep-
aration and pathology.

They combined Western medicine and Chinese traditional
herbal medicine in the treatment of the victims; their
“China no.1 AIDS therapy” proved to be effective in
improving and adjusting the immunity of HIV carriers.

The researchers also separated the AIDS virus from imported
contaminated bloods, for the first time in the world.



JPRS-TEP-92-003
12 February 1992

Hepatitis-B has permanent effects and can even cause
serious liver damage, as well as being fatal in extreme
cases,

The other African military personnel serving with the
Commando Regiment are not in direct contact with the
soldiers doing their compulsory military service. One
reason, among others, is that they are of higher rank;
they are all sergeants or commissioned officers. These
individuals are chosen in their native countries by a
Portuguese Army team made up of a physician and an
instructor. Those selected are given basic medical exam-
inations before departing for Portugal. However,
because of the cost and the complicated procedures in
the analyses required to establish the existence of infec-
tions caused by the AIDS or the hepatitis-B virus, these
tests can only be given in our country. The African
soldiers who have taken courses in Portugal have
achieved satisfactory technical results, and many have
become instructors in their home countries.

This is not the first time that African soldiers being
trained in Portugal have proved to be carriers of AIDS or
hepatitis-B. Almost every year since the cooperative
actions with PALOP were initiated, some sergeants or
commissioned officers have been sent back to their
native countries because they are infected with one of
these diseases. [passage omitted]

SWEDEN

Law Tested After Rape Victim Gets HIV

92WE0082B Stockholm DAGENS NYHETER
in Swedish 16 Oct 91 p 8

[Article by Carin Stahlberg and Bo Westmar: “HIV-
Infected Through Rape; Law Suit Tests Disease Protéc-
tion Law”—first paragraph is DAGENS NYHETER
introduction] .

[Text] An HIV-infected man risks being sentenced to up
to 10 years’ imprisonment for having raped and infected
a woman. Everything depends upon whether the woman
feels well enough to testify in a trial—otherwise the man
will go free.

Kristina is the first Swedish woman to be HIV-infected
by a rapist. Her fate has raised a number of questions:

—Does Sweden’s Disease Protection Law, which is
designed to prevent the spreading of infectious dis-
eases, work?

—Should those who knowingly spread life-threatening
diseases be punished?

—Does the victim get support and reasonable damages?

The events which changed Kristina’s life occurred the
day before the summer solstice in 1990. She went home
with an acquaintance to his apartment. For the first
quarter hour he was pleasant, but then he changed.

WEST EUROPE nm

“Suddenly he came in from the hall and said: ‘Do you
know that I am HIV positive?” Kristina recounted in a
radio program on “The Channel” earlier this year.

Held Locked In

The man assaulted Kristina, held her locked up for 20
hours, and raped and violated her repeatedly. Finally she
was able to flee when the man borrowed cigarettes from
a neighbor.

The week after the brutal rape, Kristina fell ill with a
high fever. She remained in bed for three weeks and was
taken care of by her 11-year-old daughter.

On the third visit to the doctor, she received her sen-
tence—she had succumbed unusually rapidly to a very
aggressive HIV infection.

Since then Kristina has lived in a state of shock, and her
marriage is now definitively broken up.

The rapist’s sentence thus far has been a mere three
months’ compulsory quarantine in a hospital. He was
sentenced pursuant to the Disease Protection Law in
order to prevent him from repeating the behavior.

Still Not Sentenced

He has yet to be sentenced even for his actions—rape
and spread of the life-threatening HIV virus.

Now, more than a year after the event, Kristina has for
the first time felt able to report the rape to the police. A
judicial hearing is a prerequisite for enabling her to
receive damages for her suffering.

At the same time, the rules for confidentiality under the
Disease Protection Law are being questioned. According
to'the law, HIV-infected individuals have the right to
anonymity as long as they do not commit a crime that
leads to imprisonment for more than two years. The
paragraphs of the law considered at this point to be
applicable to the spreading of the HIV virus—including
“posing a danger to others” and “infliction of bodily
injury”—carry a maximum of two years’ imprisonment.

But some legal experts, among them Olle Hoflund,
professor emeritus of criminal law at Stockholm Univer-
sity, have asserted that the current criminal code already
offers the opportunity for stiffer sentences.

10 Years’ Imprisonment

Ake Oisson, district attorney of Stockholm’s municipal
court, who is currently investigating the Kristina rape
concurs.

He maintains that the man can be sentenced to up to ten
years’ imprisonment on the basis of the criminal code.
The category of crime can be violent rape or serious
assault—“serious” on the basis of the spreading of the
infection—with a scale of punishment from 4 to 10 years
or 1 to 10 years of incarceration respectively.


56 CENTRAL EURASIA

in adults predominantly on the limbs, and almost exclu-
sively in senile persons, Among other cancerous pro-
cesses associated with AIDS in children, primary cere-
bral lymphoma, Burkitt’s lymphoma, immunoblastic
sarcoma, macrocyte lymphoma etc. are encountered
[12].

Thus development of not less than two basic symptoms
in children may be said to be the first clinical manifes-
tation of HIV infection: weight loss or slow growth;
chronic diarrhea, lasting over 1 month; protracted fever.
The two basic symptoms must be accompanied by not
less than two secondary clinical signs: generalized lym-
phadenopathy; oropharyngeal candidosis; recurring
infection of general nature (otitis, pharyngitis etc.); per-
sistent cough; generalized dermatitis, HIV infection of
the mother.

The developed clinical pattern of HIV infection in
children is distinguished from that of adults by more
highly expressed psychoneurological symptoms, by fre-
quently developing lymphoid interstitial pneumonia,
and by rare combination with hepatitis B, Kaposi’s
sarcoma and lymphomas. Bacterial sepsis and lym-
phopenia occur rarely in children; in some children, a
normal helper-suppressor coefficient is noted (although
the number of T-helpers and suppressor lymphocytes
may be simultaneously reduced in the late stages of the
disease), hypergammaglobulinemia is more pronounced,
and so on.

The problem of timely laboratory diagnosis of HIV
infection in children is complicated by the fact that
antibodies against the AIDS agent may sometimes not
appear in blood until 15 months after infection, and in
the first 6 months of life, the antibodies that are deter-
mined are maternal [29]. Antibody synthesis may be
suppressed due to affliction of B-lymphocytes. In con-
trast to adults, not only T-cells (helpers) but also B-
lymphocytes suffer in children, which in a number of
cases promotes development of opportunistic bacterial
infections and sepsis [5,16,22,28].

Revealing immune-deficiency virus, and not antibodies
to it, has important significance to dependable diagnosis
of HIV infection in children. Detection of genetic mate-
rial of the virus by molecular hybridization (revelation of
HIV nucleic acids), determination of the activity of
reverse transcriptase—the marker enzyme of retrovi-
ruses, and of HIV core antigens (for example p24 pro-
tein) by heterogeneous immunoenzymatic analysis, and
isolation of pure virus culture play a priority role in this
case, Laboratory analyses frequently do not permit sero-
logical detection of HIV infection in children with a high
degree of probability, and therefore the diagnosis must
be based on determining risk factors in children and the
clinical signs of a disease that serves as an indicator of
AIDS.

According to the CDC/WHO definition of disease cases
[11,14,26], definite specific diagnosis of one out of the
12 AIDS-indicating diseases in category I permits a

JPRS-TEP-92-003
12 February 1992

clinical diagnosis of AIDS in the absence of a serological
blood test, or even if the latter is negative (!). For
children, these diseases include candidosis of the esoph-
agus, tracheae, bronchi and lungs; extrapulmonary cryp-
tococcosis; cryptosporidiosis coupled with diarrhea
lasting more than 1 month; cytomegaloviral afflictions of
any organs (except for or besides the liver, spleen and
lymph nodes in a patient older than 1 month); infection
caused by herpes simplex virus and persisting over a
month in a patient older than 1 month; lymphocytic
interstitial pneumonia in children up to 13 years old;
pneumocystic pneumonia; toxoplasmosis of the central
nervous system in patients older than 1 month, etc.

According to WHO recommendations, dependably dem-
onstrated presence of AIDS-indicating diseases of cate-
gory I in children in the absence of other causes of
immune deficiency, such as prolonged treatment by
immunodepressants, radiation therapy, oncological and
hepatological diseases, and absence of congenital or
acquired immune deficiencies in connection with lym-
phogranulematosis, myeloma and lympholeukosis
allows a diagnosis of AIDS.

There are also 12 category II AIDS-indicating diseases,
presence of which permits an AIDS diagnosis only in the
case of HIV-seropositive (!) repeat reactions in immu-
noenzymatic analysis and in the immunoblot [translit-
eration] test [11]. They include bacterial infections that
are combined or recurrent to up to 13 years (more than
two cases in 2 years of observation)—septicemia and
pneumonia caused by hemophilic bacilli and strepto-
cocci; disseminated (extrapulmonary) coccidioidomico-
sis; HIV encephalopathy (HIV dementia); isosporosis
coupled with diarrhea persisting for over a month;
Kaposi’s sarcoma in children of different ages; cerebral
lymphoma; other B-cell immunoblastic sarcomas at any
age; extrapulmonary tuberculosis; recurrent salmonellar
septicemia (not by Eberth’s salmonella); HIV dystrophy
(emaciation, dramatic deterioration), etc.

In the absence of AIDS-indicating diseases, the following
diagnoses are established in HIV seropositive children
according to WHO recommendations: asymptomatic
carrying of HIV, persistent generalized lymphadenop-
athy (PGL), and AIDS-associated (or related) complex
(AIDS-AC or AIDS-RC). In accordance with the Soviet
classification, HIV infection may be referred to: in the
incubation stage; in the stage of primary manifestations
(acute infection, asymptomatic infection, generalized
lymphadenopathy); in the stage of secondary diseases
(stages A, B, C); in the terminal stage. As we know, only
cases of clinically developed (full-scale) AIDS are subject
to WHO registration. All cases of HIV infection are
registered in the USSR [9,11].

Prescription of therapeutic drugs against HIV infection
in children must follow a particular succession. Antiviral
drugs should be used first: azidothymidine, which blocks
revertase and suppresses synthesis of viral nucleic acid;
after that duplication of “reservoirs” (T-helpers, mono-
cytes, macrophages etc.) in which the viruses live and



4 SUB-SAHARAN AFRICA

The clinical and biochemical investigations of the blood
were carried out in all patients. Anemia was observed in
53%; lymphopenia in 45%; hypergammaglobulinemia, in
98%.

Thus far there is no specific treatment for the immuno-
depression. The presence of an accompanying sapro-
phytic infection governs the use of specific treatment.
After the establishment of the agent of three opportu-
nistic infections (tuberculosis, cryptococcosis, and can-
didiasis), treatment was effective. The remaining
patients were treated symptomatically.

As as result of treatment, improvement commenced in
142 patients (77%) with opportunistic infections, intes-
tinal parasitoses and salmonellosis; 29 (15.8%) died.
Severe meningoencephalitides of various etiologies and
pneumopathies with established or nonestablished cause
were the principal causes of death. Marked cachexia was
observed in 91.6% of the deceased. Twelve patients
(6.5%) were hospitalized repeatedly because of relapses
of the disease.

COPYRIGHT: Izdatelstvo “Zdorovya”, “Vrachebnoye
delo”

DJIBOUTI

Increase in HIV Positive Cases ‘Disturbing’

92WE0I55A Djibouti LA NATION DE DJIBOUTI
in French 3 Oct 91 p 4

[Article by Aramis Houmed Soule: “AIDS: Disturbing
Increase in Djibouti”)

[Text] AIDS is increasing at a disturbing rate in our
country: 683 seropositive individuals (individuals
infected with the virus but without clinical symptoms of
AIDS) and 104 cases of AIDS have been diagnosed by
the country’s medical services, especially at the Peltier
general hospital, since 1986 when the human immuno-
deficiency virus (HIV), which causes AIDS, appeared for
the first time in the Republic of Djibouti. Some of the
people affected eventually died.

“These figures are just the tip of the iceberg; to have an
idea of what is going on, you should multiply them by
five. Projections are gloomy,” officials in charge of the
national AIDS control program pointed out.

Actually, there is cause to worry if we consider the
context that characterizes the situation in our country
(strong population concentrations in towns, massive
inflow of impoverished people from neighboring coun-
tries, garrison troops, etc.) and the current increase in the
number of cases. Thus [text illegible] cases in 1988, we
have reached 51 cases in 1990. And 46 cases were
reported during the first half of this year only.

It is therefore high time to increase awareness of the risks
of AIDS at all levels, especially considering that, in spite
of intensive research, there is currently no vaccine or

JPRS-TEP-92-003
12 February 1992

treatment of proven effectiveness. Hence the importance
and urgency to implement an adequate prevention
strategy. And this should be the responsibility of the
media and sociologists far more than that of doctors.
This truth deserves being brought again to the attention
of PNLS (National Program for AIDS Control) officials,
as efforts at prevention have shown their limitations.

The current practice of publishing certain messages that
are sometimes the mere transposition of messages used
in Europe or elsewhere is of no use in making the
Djiboutian people truly aware of the AIDS threat.

Some of these messages may even result in a mispercep-
tion of AIDS. This is true, for instance, of the message,
“A faithful couple is safe from AIDS,” which can be
interpreted in a different manner. It may prove right
those who say that AIDS is a disease invented by the
West to combat infidelity. Similarly, to say that “AIDS
kills” does not prove anything.

The reason is that death is infinitely more commonplace
than in the West and that a flexible concept of the length
of life softens death’s tragic character.

In our opinion, a far greater impact could be achieved by
using shock images or information disclosing the truth
about the number of deaths. In addition, pointing out
that young subjects would be deprived of descendants
would be effective.

Besides, billboards are far from the best communication
media for prevention messages in a country with a high
rate of illiteracy.

ETHIOPIA

Estimates of 4,000 AIDS Cases in Country
EA0512094691 Addis Ababa Voice of Ethiopia

in Amharic to Neighboring Countries 1600 GMT
2 Dec 91

[Excerpt] [passage omitted] A statement issued by the
Ministry of Health on the occasion of World AIDS day
reveals that while six years ago there were only two
reported AIDS patients in the country the number of
reported AIDS cases or patients up to October 1991 has
reached 1,534, These are only reported cases and there
are estimated to be more than 4,000 AIDS cases or
patients in our country, the statement concluded.

GHANA

Daily Examines Women Dying of AIDS in Ivory
Coast

AB1912120691 Accra Ghana Broadcasting Corporation
Radio Network in English 0700 GMT 15 Dec 91

[Text] Writing under the heading: Our Dying Women,
the WEEKLY SPECTATOR expresses concern about
reports in Cote d'Ivoire that Ghanaian women there are
dying daily from the killer disease AIDS.



IPRS-TEP-92-003
12 February 1992

deep-rooted cultural aspect which he identifies as the
primary factor in the spread of AIDS—the “Thai male’s
sexual behaviour.” He admits, it is a very difficult task.

“We have to make people understand that they should
reduce the number of sexual partners, and that they
should use condoms when they have sex,” Mechai said.
“We also have to check the rate of venereal diseases
because a person with VD has five times greater chance
of contracting AIDS.

“We also have a long-term plan to educate primary
students to adopt more positive sexual attitudes. If we
can’t educate the adults, perhaps we can educate the
children.”

His most immediate concern, however, is how to ensure
that the programme will survive political changes fol-
lowing each change of government. In other words, how
can he ensure that future governments attach the same
degree of importance to the issue of AIDS and carry on
the programme to its timely conclusion?

His strategy, the minister said, is to create an “‘inter-
ministerial body” which will coordinate work of all
ministries at the administrative level, away from the
uncertainty at the political level, to ascertain that the
programme moves on despite political changes.

To ensure any kind of permanency, it seems he will need
a legislation specifically authorising the setting up of
such a body. The only problem is that the time he has left
in office in fast running out, too short to even initiate
legislation, let alone get it passed. [passage omitted]

Drug Addiction on Increase in North

BKO0712021191 Bangkok THE NATION in English
7 Dec 91 p A4

[Text] Chiang Mai—The number of drug addicts in the
country’s northern region this year has recorded an
increase with hilltribes people heading the list.

The Director of the Northern Drugs Treatment Centre,
Dr. Annop Wisuttimak disclosed yesterday that this year
about 60,000 people or about an 18 percent rise com-
pared with last year, had registered at the Department of
Medical Services to undergo treatment for addiction.

Among the 1,876 under care of the northern centre,
1,018 are hiltribes people, Dr. Annop said, adding that
over half of them, 822, are being treated for opium
addiction. However, the doctor said, the total number of
opium addicts at the centre declined by about 12 per-
cent, compared with last year. This was because the drug
abusers had switched to heroin instead, especially the
hilltribe people. These addicts have also turned to intra-
venous injections instead of smoking as before.

Although the total number of heroin addicts at the centre
was 803, lower than that of opium, it is calculated they

EAST ASIA 27

have risen to 30 percent from the last year. Six hundred
and seven of them were those from the plains area while
196 were hilltribe villagers.

According to Annop, consumption of amphetamines,
alcohol and inhaling volatile solvents is gaining popu-
larity among young northern people aged under 24 as
shown by the 28 percent increase in those seeking
treatment for the addiction compared with last year.

Among the heroin addicts, 13 were found to have
contracted HIV (the human immunodeficieny virus)
which leads to the AIDS disease.

The centre had to work harder as it not only has help
them to quit consuming drugs but also to provide
counselling services to prepare them to return to society.

Nineteen AIDS-infected Babies Die; Hospital
Gives Abortions

BK1612022991 Bangkok THE NATION in English
16 Dec 91 p A2

[Text] Almost half of the 40 babies born with the AIDS
virus in the state hospital in Chiang Mai province during
the past two years have died, a doctor said.

Dr. Wirat Sirisanthana, head of pediatrics at the
Maharat Nakhon Chiang Mai Hosptial, said on Saturday
that 19 of 40 babies who tested positive to the virus after
birth had died of AIDS-related diseases.

Four of the infected children where abandoned by their
mothers, she said.

The mothers of all infected babies told doctors that they
had contracted the virus through sexual contact.

This was an alarming sign of AIDS transmission from
fathers, who visited prostitutes, to the mothers and their
children, Wirat said.

Most of the infected children died about eight to nine
months after birth.

The doctor said the abandoned children were taken into
custody by a Public Welfare reception house.

Wirat also begged infected parents not to abandon their
newborn chidlren because there was still chance the
infants might not contract the virus.

The doctor cited a recent tragedy when a woman com-
mitted suicide by drinking poison after her husband died
of AIDS. The woman also fed her baby with the poison
but doctors saved the child who later tested negative to
the virus.

Wirat said she believed more children would be born
with the fatal virus next year if abortions were not
allowed for infected mothers.

Abortion is illegal in Thailand unless it can be proven
that the pregnancy is endangering the life of the mother,
or if the mother has been impregnated in a rape.



JPRS-TEP-92-003
12 February 1992

October and the beginning of November there were
160-170 patients in the Aurora Hospital who exhibited
some form of symptoms caused by HIV. There were
about 20 actual cases of AIDS.

According to Timo Rostila, the City of Helsinki’s epide-
miologist, AIDS is under control in the capital region.
Since 1987 a so-called AIDS strategy has been carried
out in Helsinki. It means that detailed plans have been
prepared for AIDS patients. Rostila says that “AIDS
patients need many different kinds of treatment services
and these have to be ready in advance.”

The AIDS strategy is examined yearly. “In the beginning
the predictions were too pessimistic, but now they have
changed to become more realistic,” Rostila stated.

The first man to become ill with AIDS in Finland was a
homosexual living in Helsinki. His illness was confirmed
in 1983. The relative number of heterosexuals with
AIDS has increased since the early years and that of
homosexuals has decreased. The proportion of women
has also increased. Likewise the virus has infected ever
younger people: 20 to 25-year-olds are carriers of the
virus to a greater extent than before. On the other hand
there are very few carriers under 20 years of age in
Finland. The mean age of HIV carriers is about 30.

30,000 Mothers Tested

There are two children in Finland who are carriers of
HIV. In Helsinki expectant mothers are tested in mater-
nity centers in order to prevent infection of the newborn.
Only 1. percent have refused [testing].

Facts about HIV are taught in the schools of Helsinki.
Not one grammar school student in Helsinki leaves
school without an understanding of how HIV is trans-
mitted or how to prevent infection from it.

AIDS is still a fatal disease. When the virus is discovered
it may take nine or ten years before the symptoms of the
actual disease break out.

Altogether 419 people in Finland have been identified as
infected with HIV, and of these 94 have been determined
to have AIDS.

GERMANY

AIDS Rampant Among Medicated Hemophiliacs

92WE0118 Hamburg DER SPIEGEL in German
No 47, 18 Nov 91 pp 126-133

[Unattributed article: “Death From the Syringe”]

[Text] Half of German hemophiliacs, more than 2,000
men, have become infected with the AIDS virus from
drugs. Several hundred have died, there is little hope for
the rest. The scandal is still being hushed up by a grand
coalition of health authorities, insurance companies,
doctors and functionaries.

WEST EUROPE 63

In France the government is tottering. It tolerated the
infection of thousands of Frenchmen with AIDS in the
years 1983 to 1985. Every second hemophiliac is
infected; 205 have already died. Opposition leader
Jacques Chirac calls the “affair” barely “imaginable, it is
so awful.” The Montpelier committee of hemophiliacs is
bringing suit for a “crime against humanity.”

“It is terrible,” says Jean-Louis Bianco, the minister for
social affairs currently holding office, “that now thou-
sands of people have to die because of the transmission
of AIDS.” The scandal has been mirrored for weeks in
the headlines in the French press.

In Germany the government is standing steady and solid.
It tolerated the infection of thousands of Germans with
AIDS in the years 1983 to 1987. Every second hemo-
Philiac is infected: officially 180 have already died. In
contrast to France, the opposition has never spoken out
on the affair. The association of those hemophiliacs
affected urges: “Quiet! Quiet! Quiet!” In Germany
scandal is not a topic for discussion.

The biggest catastrophe involving medicine in the his-
tory of the FRG remains swept under the rug. Yet it is
much worse than the infamous “Contergan” scandal of
the 1960’s. Then almost 4,000 children were born with
severe deformities as a result of the sleeping aid Con-
tergan which had been prescribed for their mothers.

This time it is the hemophiliacs who are affected. This
group of from 4,000 to 6,000 male patients suffers from
a congenital coagulant factor deficiency, hemophilia.
Because the hemophiliacs were treated with AIDS con-
taminated preparations in the 1980’s, every second
patient is now threatened with death.

Exact numbers are lacking. That is part of a strategy that
has helped to keep the scandal secret, for years. A grand
coalition of doctors, medication manufacturers, insur-
ance companies and hemophiliac functionaries is
involved in the maneuvers. The Ministry of Health and
its subordinate Federal Health Office (BGA) are
assisting in the deceit, the minimizing and delay, as best
they can. For they all have a lot to conceal.

“After 1983 no one else should have been allowed to be
infected,” says Elsbeth Gnade. She is the widow of
Wolfgang Gnade, until 1989 deputy chairman of the
German Hemophilia Society (DHG). Her husband died
in July of this year of AIDS, only 47 years old. “For me
that is murder.”

“The men were knowingly infected,” is also the judg-
ment of Ingeborg Koester, 72 years old. She is, still,
second chairman of another patient association,
“German Hemophiliac Counselling.” Ingeborg Koester
lost her son Harald, 37, to AIDS in the fall of last year.
Now she assists the (still) living. “Many of Harald’s old
friends are already in very poor condition.”

Tim Gabbert’s father remembers “a competitive athlete
in peak condition.” Looking at him, his illness was not



JPRS-TEP-92-003
12 February 1992

Mountain climber and fitness fan Geissler had no time
for drugs and the prophylaxis of epidemics.

Unfortunately, Geissler’s successor in office, Rita Suess-
muth, appointed in September 1985, proved to be only a
show star. A qualified French teacher, Catholic by voca-
tion, and soft women’s libber, she misunderstood the
disease AIDS as a psychosocial problem. She wanted,
according to the title of her book on the subject, to show
“Ways Out Of Fear,” not ways out of danger.

Rita Suessmuth ensured that Germany (along with the
Netherlands) is one of the few countries in the world that
has no requirement for a doctor to report a case of AIDS.
The number of persons infected with the sickness-
generating HIV virus is as unknown as that of those
suffering from AIDS or who have died from AIDS. In
Germany harmless gonorrhea must be examined, glan-
ders and influenza must be reported—the fatal disease,
AIDS, is, in the best instance, reported voluntarily. The
obscure area is large.

Hemophiliacs estimate that at least 400 or 500 of their
fellow sufferers have so far died of AIDS; the Federal
Health Office quotes their number at only 180. Death
certificates are issued by the therapists at the hemo-
philiac centers (where the patients contracted their
deadly infection); any report to the “AIDS Center of the
Federal Office of Health” is voluntary.

The Bavarian minister Peter Gauweiler, who became
known across Germany as the result of his anti-
Suessmuth position in the matter of AIDS, calls the
behavior of the responsible health officials in Bonn quite
simply a “crime.” He finds totally “incomprehensible”
the “delay in the application of existing, protective legal
regulations” and the “absence of any willingness to
devote the necessary attention to the early recognizable
dangers.” In Gauweiler’s words: “Hemophiliacs were
infected over a period of many years with a fatal viral
illness.”

One of the principal guilty parties in this drama is the
Berlin Federal Health Office, a giant authority that
maintains 2,750 workers, among them 850 academics.
The BGA did not listen to its alert Professor L’age-Stehr.
Instead, the problem of AIDS infection from blood
products—when every day counted—was dragged out
with a nonchalance as though it were a matter of the
sniffles. Mrs. L’age-Stehr is no longer permitted to be
involved with AIDS and is not allowed to give interviews
on the subject.

The lethargic tempo of the BGA was established at the
time by its drug company-friendly president, Karl
Ueberla, whom his subordinates mockingly called
“Karlchen Ueberall” [Karl Everywhere] or “Di-Mi-Do”
[Tu-Wed-Thu], because he frequently lasted only three
days in the office, but was busy otherwise looking after
all types of secondary business, and for this reason he
had to step down from the president’s office in April
1985,

WEST EUROPE 65

The dates of the chronique scandaleuse [chronicle of
scandal] of the Ministry of Health and its senior
authority, the BGA:

—At the beginning of September 1983, the Ministry in
Bonn goes to the public for the first time in the matter
of AIDS and claims it had “introduced accelerated
measures to effectively suppress a possible spread of
the illness through blood and plasma preparations.”

—On 25 October 1983 a panel of experts from the
Ministry of Health recognizes that “no cause exists for
the fear” that the fatal immune deficiency could be
“transmitted by means of coagulant products.”

—About 120 experts gathered in Berlin at the invitation
of the BGA on 14 November 1983 in order to com-
plete a Factor VIII hearing. The tenor of the industry:
There is no danger; AIDS is not an infectious disease.
Ueberla says in his concluding statement: “The BGA
will make its decision about Factor VIII preparations
by the end of March 1984.”

—That did not happen until 8 June 1984. The BGA
imposes a few restrictive measures, but decides against
a possible immediate enforcement, asks the drug com-
panies for “rebuttal,” and grants a generous “period of
adjustment” until 31 December 1984.

—The period extends until 1 October 1985. Starting on
this day, only AIDS-safe (“deactivated”) coagulant
factor preparations may be offered for sale.

But this official decision by no means marks the end of
the risk. The Ministry of Health, now headed by the
veterinarian Dieter Grossklaus, abandons all energetic
measures. It declared, four years after the problem
surfaced, the lethally dangerous drugs to be “no longer
marketable.” This empty phrase now shifted the respon-
sibility for checking to the 11 land “Main Authorities.”
What happened with the preparations still in existence at
the manufacturers, wholesalers, clinics, and drug stores
is not known. Their storage life in most cases was two
years—until the fall of 1987.

In any event, there was no official “recall action” any-
where, usually announced through the unmistakable
“Red-Hand-Letters” to all German doctors.

What the bumbling meant for the hemophiliacs can be
seen from the numbers: At the Heidelberg hemophiliac
center in 1981 all the patients tested were free of AIDS,
as the later test of frozen blood samples showed; in 1984,
67 of the 160 patients were already infected with the
fatal disease. No surprise: Munich virologist Gert
Froesner has proved that all the plasma pools tested that
were shipped from the United States to Germany in
1984-1985 contained HIV antibodies and were “‘proba-
bly infectious as a result.”

The Swiss hemophilia expert, Professor Alfred Haessig,
not involved in the delays in Germany, has calculated
that up to 90 percent of all serious hemophiliacs in the
FRG became AIDS-positive by 1986. It was not an


66 WEST EUROPE

unavoidable fate, as the example of the GDR proves:
When the Wall fell two years ago, there were exactly two
hemophiliacs with AIDS in this nation of 16 million.

In West Germany hemophiliacs and newly operated
patients were being infected with the AIDS virus even at
the end of the 1980’s—from coagulant preparations
from Biotest, which had now been subjected to a clearly
inadequate “cold sterilization.” The company, which is
located in Dreieich near Frankfurt, did not withdraw the
preparation from the market until April 1990.

Until the bitter end, the prominent hemophilia thera-
pists put off and deceived their patients. When DER
SPIEGEL—accurately—put the number of infected and
therefore fatally threatened hemophiliacs at as many as
3,000, Egli and six colleagues rejected the connection
between a positive test for AIDS and the AIDS illness as
“speculation” in a letter to the editor. Supposedly,
therapy with the contaminated drugs had a “unseen
immunization” effect, so it was as good as a “protective
vaccination.”

Professors Barthels (Hannover), Egli (Bonn), Landbeck
(Hamburg), Lechler (Cologne), Scharrer (Frankfurt),
Schimpf (Heidelberg), and Schramm (Munich) stated
with one voice: “It would be regrettable if hemophiliacs
refrained from treatment with factor concentrates
because of the fear of AIDS.” Egli patient Oliver Koep-
pchen on the situation in Bonn: Following the articles in
DER SPIEGEL, “hundreds of hemophiliacs had to be
reassured for hours by doctors from the Hemophilia
Center in Bonn, before they continued the treatment
with Factor VIII, which is essential to their life.”

But only those who withdrew [from treatment] in good
time had a chance for survival. The others had been
“finally and completely” paid off by the drug manufac-
turers’ insurance companies in 1987-88. The average for
a lost life was DM60,000; younger patients had to be
satisfied with less. The numbers are being kept secret by
agreement, and it is also secret how many AIDS-infected
hemophiliacs were still alive then and participated in the
deal. Harald Koester and Wolfgang Gnade, the two
negotiators for the hemophiliacs, are dead.

All in all, say survivors in the patient associations, the
insurance companies got off with about DM110 million.
So far no hemophiliac has dared to bring suit against his
doctors, the authorities, or the manufacturers of the
lethal preparations. That would mean entering the bright
light of publicity and—in spite of reduced health—facing
years of judicial fighting, the end of which no infected
patient would be likely to survive. “We hemophiliacs
will keep our mouths shut for 10 or 20 thousand marks,”
says Carl Caspari from the DHG in Northrhein-
Westfalia.

There is also peace between the Association of the
Pharmaceutical Industry and the Association of General
Local Health Insurers. With regard to the hemophiliacs
with AIDS, the two financially powerful giants agreed:

JPRS-TEP-92-003
12 February 1992

“We are holding to our agreement not to discuss assign-
ment of fault publicly.” The insurers, so goes the cynical
argument from drug representatives at internal discus-
sions, were now saving a ton of money because fewer and
fewer hemophiliacs were requiring medication.

Those who are still alive have long since used up their
DM60,000 in the last four years. Their marriages, says
Ingeborg Koester, are “for the most part broken.”
Because the infection with AIDS was concealed from
many hemophiliacs for a long time, about 150 wives
have been infected. No one is paying them a penny. Still,
says one of those affected, “a human life cannot be
compensated with money.”

In France, a court in Paris put just the mental anguish
caused by an AIDS infection in the summer of this year
at 1.5 million French francs [Fr] (about DM500,000).
The American Kimberly Bergalis, infected by her dentist
with the HIV virus, received an award of $1 million.

From the “pittance with which the German hemophil-
iacs were paid off” (Koester), the survivors, according to
the terms of the agreement, even have to pay “funeral
costs” in “the event that the medication damage is so
great that the injured party dies.”

IRELAND

AIDS Statistics Given, Figure In Dispute

AIDS Coordinator’s Statement

92WE0178A Dublin IRISH INDEPENDENT
in English 20 Nov 91 p 14

{Article by Don Lavery: “Heterosexuals Alert on AIDS
Risk]

[Text] The medical profession, and the whole commu-
nity, should now be aware that AIDS is a heterosexual
disease, the National AIDS Coordinator, Dr. James
Walsh said yesterday, as the latest figures showed that 93
people have died from AIDS.

But he said medical care now kept people alive longer
and they had a better chance of being alive when a
breakthrough came and a cure for AIDS was found.

He said initially people lived three to four years with the
disease but this had now been pushed to ten or 11 years.

The National AIDS Coordinator said that, given the
amount of research into AIDS, by the end of the decade
“we may be a long way down the road to effective
treatment and a vaccine.”

Dr. Walsh said a publicity campaign and a major sem-
inar will be centered on World AIDS Day on 20
November.



24 EAST ASIA

and strict description of the test procedures as well as
directions on how to handle patients if the project
happens to produce bad results.

“They should not only announce the good side of the
test, but also any bad effects the vaccines might have,”
said Chantawipa Apisuk, a representative from
Empower, an organization concerned about AIDS in
relation to prostitution.

“Furthermore, family members of the volunteers must
also be brought in for moral support. And there is still
the question of how to test the vaccine’s effectiveness for
those volunteers in the non-infected group. Will they be
asked to test the vaccine’s effectiveness by committing
high-risk acts? All that will have to be answered and
shown to the public,” Chantawipa said.

But not all NGOs give the project a positive assessment.
Jon Ungphakorn, another representative from an NGO.
concerned with the AIDS problem said he feels con-
cerned about the Army project, since it would be con-
ducted in an environment where orders are not ques-
tioned.

“Tt makes me wonder why such a project would have to
be carried out in the Army, where recruits must take
orders without questioning them. And I also question the
proposal to test the vaccine on non-infected people,
because it might encourage such people to commit
high-risk acts, thinking that they are now protected by
the AIDS vaccine,” he said.

Another expert, meanwhile, said he saw no disadvantage
for Thailand from participating in either the WHO or
the Army programme.

Said Dr. Prapan Panupark, director of the Programme
on AIDS, Thai Red Cross Society: “If the test proves
successful, Thailand stands a chance to benefit from the
technology transfer involved and even a chance to have
a free“ vaccine or, at least, low-price vaccines.”

On the other hand, Dr. Nat Pamornprawat, Mahidol
University’s Rector and a member of the WHO AIDS
programme steering committee, said he sees a benefit
that most others have overlooked.

“The vaccine trial programme must involve the country
in which the experiment takes place, WHO and the firm
developing the vaccine. And, in reality, the WHO itself
will only take the role of coordinator, to guide the staff of
the host country to conduct the test themselves. I think
this role is crucial, since there are now firms conducting
vaccine experiments in developing countries without the
government’s knowledge. This is the guinea pig problem.
But if WHO comes in and takes the role of coordinator,
it would help bring the test into the open and prevent
those foreign firms from doing it undercover,” he said.

Dr. Nat might have reason to fear, Rumours have been
circulating in medical circles that some European drug
firms have already started their own clandestine experi-
ments in developing countries in Africa. And Thailand,

JPRS-TEP-92-003
12 February 1992

with its high HIV infection rate, could easily be among
those targetted by such firms.

On Threshold of an Epidemic

According to official Health Ministry figures, Thailand
now has about 33,800 people infected with the Human
Immunodeficiency Virus (HIV), which leads to AIDS.
An unalarming figure when compared to the Thai pop-
ulation of 55 million.

However, most medical experts feel that this figure only
hints at how bad the situation has become in Thailand,
which now ranks second only to India in the severity of
the AIDS epidemic in Asia.

Medical experts, all of whom asked not to be quoted,
agreed that instead of the 33,800 figure, the number of
people infected with HIV in Thailand might be more in
the region of 500,000. That number would probably
grow to 2-4 million by the year 2000 if nothing is done by
the government to contain the spread.

“The AIDS epidemic in Thailand is going through a
critical phase. In 1988, we found the epidemic to be
confined mostly to the drug addict group. It then spread
to commercial sex workers and their clients in ’89 and
°90, and now, the epidemic is gaining a hold in the
general population,” one said.

Telling Figure

One figure, rarely published but telling, is the percentage
of newly-pregnant women who have tested HIV-positive.
In the past six months, this figure climbed up from 0.6
percent to 0.8 percent of all pregnant women in Thai-
land, and a stunning 6 percent in the northern provinces
of Chiang Rai and Chiang Mai.

“It might seem a very small number,” said the same
expert. “But consider that it took three years [since 1988]
to reach 0.6 percent, and now in six months it went up to
0.8. Basically this shows that AIDS is being transferred
from sex clients to their wives. And that means the
general population,” he said.

Another figure, the percentage of sexually-active people
who contract the HIV virus, gives an even more alarming
signal.

“This figure for Thailand is only a little over one percent.
This may seem small to most people. But as medical
experts, we know from past experience in other countries
that one percent acts as a kind of threshold marking the
stage-at which the epidemic will spread very quickly and
become very hard to control, For Thailand it is possible
that we will see this figure jump to 5 percent by the end
of next year,” he said.

Many of the experts, however, are still reluctant to say
whether Thailand would experience an AIDS explosion
on the level of Africa, where 30 percent of the population
in some countries has already contracted HIV.



WT1S 2
ATTH PROCESS. 103

S2e8 PORT ROYAL RO
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SJPRS-TEP-92-003
12 February 1992

ANGOLA

Health Official Notes Steady Increase in AIDS
Cases

MB0312164591 Luanda Radio Nacional Network
in Portuguese 1900 GMT 2 Dec 91

[Excerpt] The number of AIDS cases in Angola is rising
steadily. Deputy Health Minister Dr. Martim Avalanga
has disclosed in Luanda that 250 national citizens suf-
fering from that disease have already been registered. He
was speaking on the occasion of AIDS Day on 1
December. [passage omitted]

BENIN

HIV Positive Figures Call For Urgent Action

92WE0192A Cotonou LA NATION in French
13 Nov 91 p4

[Article by Ferdinand Houehou: “Approximately 1 Bil-
lion CFA Francs To Fight AIDS in Benin”]

[Text] A total of 803,320,000 CFA [African Financial
Community] francs will be the financial contribution of
the development partners toward strengthening Benin’s
efforts to prevent and combat AIDS.

It was at the conclusion of a conference to mobilize
resources held last 28 and 29 October at the Hotel Aledjo
PLM in Cotonou that the intergovernmental institu-
tions, multilateral and bilateral organizations, and non-
governmental organizations represented at these meet-
ings undertook this commitment.

Their contribution will make it possible to implement—
over a period of two years—the medium-term national
plan to combat the epidemic.

This plan obviously places the emphasis on informing
and educating the different sectors of the population
with a view to helping them assume responsibility for
their own health and that of others. Adherence to this
basic principle of the fight against AIDS is an effective
way to curb the spread of the epidemic, inasmuch as the
prospects for an early discovery of a vaccine and a
therapy for use against the disease are not very prom-
ising.

This is why—in recognition of the insidious character of
the disease—Minister of Public Health Veronique Law-
son, who presided over the proceedings of this coordi-
nated effort against AIDS, made a point of saying:
“Never in the history of the world has any disease had
such a serious impact on individual human beings simul-
taneously in their body and in their relations with others
and with their social milieu.”

In fact, the Acquired Immune Deficiency Syndrome
(AIDS) has given rise to not just one but three interde-
pendent worldwide epidemics: the epidemic of infection
with the HIV (Human Immunodeficiency Virus), the

SUB-SAHARAN AFRICA 1

medium for the transmission of AIDS; the AIDS epi-
demic properly speaking; and the “epidemic” of social-
,cultural, economic, and political reactions to the other
two epidemics,

It is well to remember that because AIDS is primarily
transmitted sexually, it also strikes mothers and their
children. The rise in infant mortality attributable to
infection with the HIV could cancel out the progress
anticipated from the child health programs supported by
UNICEF [UN International Children’s Emergency
Fund] in the developing countries.

This is the occasion to pay tribute to the progress made
in primary health care (SSP) as part of the public health
program under way in Benin. The work of the SSP
depends on the exercise by government officials, public
health personnel, and the media of their responsibility to
inform the public of the acute health problems that are
afflicting the nation as well as the ways to prevent them
and combat them. This means that with respect to
maternity, for example, one should explain carefully the
potential risk to which the mother and child are exposed.
The decision to avoid pregnancy when a woman runs the
risk of infection with the HIV and possibly to terminate
a pregnancy depends, of course, on national policy, on
our beliefs, and on our cultural values. A total of 134
AIDS cases and 15,000 seropositive cases were reported
last year, and as of 30 September 1991 a total of 185
AIDS cases and 20,000 seropositive cases had been
reported. Perhaps these figures—when compared with
Benin’s total population of more than 4.5 million—are
not sufficiently expressive to galvanize individual effort
for the fight against this scourge. Especially if one
considers the figures for the disease that have been
recorded in some African countries: for example,
Uganda, which had 21,719 AIDS cases as of 31
December 1990 and 1.3 million seropositive cases as of
April 1991, in a population estimated at 17 million, and
Zaire, which had recorded 14,762 AIDS cases as of 31
January 1990 in a population of approximately 30 mil-
lion.

Actually, the statistics concerning the AIDS epidemic
(185 AIDS cases and 20,000 seropositive cases) recorded
in Benin should instead be analyzed in terms of new
contaminations that they are in the process of gener-
ating. Hence the urgent necessity of intensifying and
strengthening health education with a view to inducing
the different sectors of the population to change their
sexual behavior in an efficacious and timely fashion, and
especially by reducing the number of their partners and
by using condoms. This is because—according to the
WHO [World Health Organization]—for every case of
AIDS detected in a given country one must assume the
existence of 100 seropositive cases.

Moreover, the spread of the HIV can also be prevented
within the specific framework of the national public
health system by ensuring the safety of blood and blood
products and by avoiding the reuse—without carefully



JPRS-TEP-92-003
12 February 1992 5 AIDS

WEST EUROPE
AUSTRIA

Experts Criticize AIDS Policy; 696 AIDS Cases To Date
[Vienna WIENER ZEITUNG, 22 Jan 92] ....

DENMARK

Minister Approves AIDS Vaccine Funding /Copenhagen BERLINGSKE TIDENDE, 26 Oct 91] .. 59
AIDS Deaths Traced to Contaminated Blood Supply

59

[Louise Fleischer; Copenhagen BERLINGSKE TIDENDE, 28 Oct 91] ..... 60
Agency Studying Employer Policy on HIV

[Bodil Jessen; Copenhagen BERLINGSKE TIDENDE, 4 Nov 91] .... 60
‘Safe-Sex’ Habits of Homosexuals, Bisexuals Studied

[Copenhagen BERLINGSKE TIDENDE, 28 Nov 91] .. 61

Figures for HIV Infections in Early 1980's Revised

[Soren Kassebeer; Copenhagen BERLINGSKE SONDAG, 8 Dec 91] ....
AIDS Infection Threat Seen Adding to Jail Sentence

[Copenhagen BERLINGSKE TIDENDE; 18 Dec 91] ..
Government’s AIDS Funding Discussed

[Pernille Stensgaard; Copenhagen BERLINGSKE AFTEN, 24 Dec 91 - 2 Jan 92] ...

FINLAND

Fewer Helsinki HIV Cases in 1991 [Helsinki HELSINGIN SANOMAT, 2 Dec 91]
GERMANY

AIDS Rampant Among Medicated Hemophiliacs /Hamburg DER SPIEGEL, 18 Nov 91] .....
IRELAND

AIDS Statistics Given, Figure In Dispute ..

AIDS Coordinator’s Statement /Don Lavery; Dublin 4 lo “
Many More Cases Alleged Stephen O’Brien; Dublin IRISH INDEPENDENT, 28 Nov 91] ...

63

66
66
67

SPAIN

Safety of Country’s Blood Supply Examined .....
Health Risk Low [Milan EUROPEO, 8 Nov 91] ..
Organization Criticized [Sergio Canelles; Milan EUROPEO, 8 Nov 91]

PORTUGAL

AIDS, Hepatitis Among African Trainees [Herminio Santos; Lisbon O JORNAL, 31 Oct 91] ....... 70
SWEDEN

Law Tested After Rape Victim Gets HIV

[Carin Stahlberg and Bo Westmar; Stockholm DAGENS NYHETER, 16 Oct 91]
Monthly HIV Increase Stable [Kerstin Hellbom; Stockholm DAGENS NYHETER,
Tighter Blood Checking From HIV Concern

[Lena Axelson; Stockholm DAGENS NYHETER, | Nov 91] ....
HIV Incidence Among Pregnant Women Increases

[Stockholm DAGENS NYHETER, 14 Nov 91]
Paper Views Quarantine Law, AIDS Danger (Si
Thirty New HIV Cases Registered Each Month

[Carin Stahlberg, Karen Soderberg; Stockholm DAGENS NYHETER, | Dec 91]...

TURKEY
Army Takes Measures To Prevent Spread of AIDS [Istanbul MILLIYET, 4 Dec 91] ..

‘ENS NYHETER, | Dec 91]

14



IJPRS-TEP-92-003
12 February 1992

CAMBODIA

Health Official Calls for Anti-AIDS Campaign

BK0812062491 Phnom Penh SPK in English
0423 GMT 8 Dec 91

[Text] Phnom Penh SPK December 8—A doctor from
the Ministry of Public Health in Phnom Penh has called
on people to contribute to fighting AIDS which may
have affected some persons in the country.

In an interview with local media workers on the occasion
of the world anti-AIDS day, December 1, Dr. Mom
Bunheng, who is head of the Epidemic Department of
the Ministry, said two HIV carriers had already been
reported in Cambodia.

These two AIDS victims were found during the screening
of blood donors in Cambodia, according to the Ministry.

They tested HIV-seropositive during recent tests made
on 2,500 blood donors, it said.

The doctor quoted the World Health Organization
(WHO) as estimating that from 8-10 million people in
the world carried HIV by mid-i991 and that 1.5 million
of them already developed AIDS.

“About 5,000 people in the world are infected with HIV
everyday”, he said.

After explaining that AIDS could develop in HIV car-
riers within 10 years, Dr. Mom Bunheng expressed his
concern over the spread of HIV in Cambodia as well as
in the world.

HIV virus may be transmitted through sexual relations,
blood transfusion and hypodermic injection, he said.

The doctor recommended the use of condoms as a
preventive measure.

HONG KONG

Positive HIV Tests Reach ‘Record High’ in Nov

HK2812062191 Hong Kong SOUTH CHINA
MORNING POST in English 28 Dec 91 p 2.

[Article by Helen Signy]

(Text] The number of positive tests for the HIV virus
leapt to a record high in November as local people surged
to clinics after basketball star Magic Johnson admitted
he has the virus and superstar Freddie Mercury died
from AIDS.

Eleven new cases were detected by the Government last
month, head of the special preventive unit, Dr. Lee
Shui-shan, said.

The number of telephone calls to the Government’s
information hotline last month has double the October
figure.

EAST ASIA 13

The Government has now recorded 203 people as car-
rying the HIV virus which leads to AIDS, although Dr.
Lee estimated 3,000 to 5,000 people were actually
infected.

“In November so many things have happened like Magic
Johnson, Freddie Mercury, the establishment of the
AIDS Foundation and our training course for nurses,
which resulted in more people becoming aware of HIV
infection and coming forward for testing,” he added.

“T also believe teenage idols can help a lot. Here we don’t
have Magic Johnson or Freddie Mercury, so if we have
some singers who come forward and say they are con-
cerned, it’s probably going to help,” he said.

The new cases were eight Chinese and three non-Chinese
adult men, six of whom contracted the virus through
heterosexual sex.

Four were homosexual and the cause of infection in one
case was unknown.

One more heterosexual developed full-blown AIDS last
month, bringing the total number of patients to 59, of
whom 39 have died and six have left Hong Kong.

Dr. Lee said twice as many Chinese people were now
being infected as non-Chinese, although many Locals
still thought AIDS was a foreign disease.

Local awareness would increase as neighbouring coun-
tries continued to see more cases, he said.

It is thought two of the new cases could have caught
AIDS in Thailand, where more than half of the prosti-
tutes and drug addicts are widely known to be infected.

“What will affect people is what happens in other
countries. Even what happens in Thailand has an impact
on us, because people who go there for sex are beginning
to worry,” he said.

Co-ordinator of local charity AIDS Concern, Ms. Lisa
Ross, said awareness about AIDS had risen dramatically
during 1991 in Hong Kong.

“Somehow the message is getting through and people are
starting to ask questions, but the general knowledge level
is still pretty horrific among the local population,” she
said.

INDONESIA

Health Minister—2,500 Possibly Infected With
AIDS

BK1812131091 Jakarta THE JAKARTA POST

in English 12 Dec 91 p 1

[Excerpt] Jakarta (JP)—The number of people infected
with the deadly aquired immune deficiency syndrome
(AIDS) in Indonesia may be as high as 2,500 or 100
times the reported cases, Minister of Health Adhyatma
said here yesterday.



IJPRS-TEP-92-003
12 February 1992

activity. Of the 184 women examined by us, 72 were
widows, divorcees, or unmarried; 85% were residents of
the capital, primarily of the poor areas.

The cause of the disease was blood transfusion carried
out in connection with massive blood losses during birth
up through 1987, in 18 patients; in 1987 the investiga-
tion of donor blood for the presence of the virus had not
yet been carried out. The sexual route of infection was
Presumed in 125 (68%) patients. Traditional treatment
(scarification) had been carried out at various times in
41 of the patients, as a rule using nonsterile instruments.
When the medical history of 31 of the patients was
studied, tuberculosis of the lungs was found in 31 of the
patients, herpes zoster in 22, and venereal diseases in 39
in the 1981-1985 period. Twenty-five of the patients
abused alcohol.

The diagnosis of AIDS is established in the presence of
not less than two main and one secondary features, in the
absence of other causes of immune depression. The main
features are: loss of body weight of more than 10%;
chronic diarrhea for one or more months; persistent
fever (38-39°); asthenia and anorexia. The secondary
features include the following: chronic persistent cough
of more than one month; itching of the skin, widespread
skin diseases; herpes zoster; herpes simplex with chronic
course; candidiasis of the oral cavity and the nasophar-
ynx; adenopathy, polyadenopathy; reduction of memory
and intellect; infection of the central and peripheral
nervous system.

Loss of weight of more than 10% was observed in 70% of
the patients examined; prolonged fever in 66%; asthenia
with loss of appetite, in 78%; nocturnal sweats, in 47% of
the patients. Chronic diarrhea was noted in 96 (52.2%)
patients; in 64% this was in combination with helm-
inthoses or intestinal amebiasis.

The main symptom of involvement of the lungs is
chronic cough (66%), accompanying tuberculosis of the
lung in 30 patients (16.3%)s, and bacterial pneumonia
and pneumopathy of unclear etiology in 77 patients
(42%). The leading symptoms of involvement of the skin
and the mucous membranes was candidiasis of the oral
cavity and nasopharynx (10.3%), straightening of the
hair (25%); herpes zoster in the acute stage or previously
experienced (13.6%); persistent skin itch (21%). An
increase in the size of lymph nodes, mainly of the
cervical and supraclavicular nodes, was identified by us
in 26 patients (14.1%), and generalized lymphadenopa-
thy, in 3 patients. Kaposi’s sarcoma was noted in 5
patients (2.7%), the septic form of salmonellosis in 16,
the septic form of acute myocarditis with features of
pericarditis, in 5.

The frequency of the neurological manifestations of
AIDS is 30-40%; we found these in 62 patients (33.7%).
Involvement of the nervous system was caused by a
pronounced activation of opportunistic infections (tox-
oplasma, the mycobacteria of tuberculosis, cryptococcus,
cytomegalovirus, etc.), and is the direct consequence of

SUB-SAHARAN AFRICA 3

these diseases. The neurotropism which is characteristic
of the immunodeficiency virus promotes the occurrence
of peripheral neuropathies, acute and chronic menin-
goencephalitis, and acute and chronic encephalopathy.

Toxoplasmosis, which had previously been viewed as a
relatively benign disease, is capable of inducing embry-
opathy, and is characterized by the most frequent
involvement of the central nervous system in HIV infec-
tion. Of 23 patients suffering from toxoplasmosis, the
clinical picture of neurotoxoplasmosis was expressed in
various degrees in 14 (60.9%). Neurotoxoplasmosis
evolved in 5 patients as the “pseudotumorous form”,
with an acute onset and high temperature in combina-
tion with various “loss-of-function symptoms”,
depending upon the localization of the process (hemi-
paresis or hemiplegia, hemianopsia, aphasia). General-
ized convulsive attacks were observed in two patients.
The “encephalitic form of neurotoxoplasmosis” was
observed in 9 patients, characterized by gradual onset,
moderate hyperthermia, mild disturbances of conscious-
ness, in combination with “loss-of-function symptoms”,
When the cerebrospinal fluid was examined, an insignif-
icant increase in protein (0.5-0.7 g/l) and a moderate
lymphocytic pleocytosis were observed.

Infection with the tuberculosis mycobacteria is observed
frequently in the presence of AIDS and reaches 50-70%,
The involvement of the nervous system is the result of
hematogenous dissemination of the causative agent. Of
34 pulmonary tuberculosis patients, neurological mani-
festations were observed in 11 (32%); of these, tubercu-
lous meningitis was diagnosed in 7, manifested by
marked general cerebral and meningeal syndromes,
involvement of the cranial nerves, lymphocytosis, and
decrease in the sugar content of the cerebral spinal fluid.
The clinical picture of tuberculous angiitis with a pro-
nounces general cerebral syndrome, loss of conscious-
ness, and “loss-of-function symptoms” was observed in
4 patients.

Cryptococcosis is most frequently observed in AIDS.
When the cerebrospinal fluid was examined cyto- and
bacteriologically in 7 patients with the clinical picture of
meningoencephalitis and a progressive course in combi-
nation with moderate hyperthermia and a mild
meningeal syndrome, the presence of cryptococci (Cryp-
tococcus neoformans) was noted. Neurological manifes-
tations were caused in other patients by the direct
neurotropism of the virus; peripheral neuropathies of the
mono- or polyneuritic type, accompanied by pareses of
the extremities or certain muscle groups, and distur-
bances in sensitivity in the zone of innervation of the
involved nerves, were diagnosed in 17 patients; the
clinical picture of chronic meningoencephalitis with a
progressive decrease in intellect, disturbance in
behavior, the presence of focal insufficiency (8) and
epileptic attacks (2) was observed in 13 patients.



SJPRS-TEP-92-003
12 February 1992

through many steps, which will take a long time. The
institute wants to test the vaccine in several countries
throughout the world.

Dr. Prawet said that the reason for testing the vaccine in
Thailand is that the AIDS virus differs from country to
country. A vaccine that is effective in one country may
not be effective in another country. The same is true for
Thailand. A vaccine that can be used in another country
may not be effective here. Thus, tests must be conducted
in Thailand. Moreover, Thailand does not have the
capability to produce a vaccine of its own. We must rely
on other countries to help us produce a vaccine. We can
then test it here to see how effective it is in Thailand.

The chairman of the National Epidemiology Committee
said that in any event, there are many things that must be
done before this vaccine can be tested in Thailand. The
Military Medical Research Institute must present con-
crete data on the AIDS problem to committees in
Thailand and the United States and to the World Health
Organization so that the ethics of conducting tests on
humans and the safety and efficiency of the vaccine can
be considered before any tests are conducted.

“Thus, in considering whether to test this drug in Thai-
land, Thais won’t be guinea pigs. Such talk is an insult to
the Thai people,” said Dr. Prawet. He added that before
any tests are conducted, we must study things to deter-
mine which group of people to test the vaccine on. In any
event, the subjects must be well-educated people who
understand the problem and who have volunteered to do
this. No compensation will be paid. This will be done in
an ethical manner. Studies done in Thailand have shown
that this can be done, because medically, we are ready,
and we have sufficient data.

Dr. Prawet also talked about how this will benefit
Thailand after the tests have been conducted. He said
that this will lead to the development of a vaccine to
prevent or treat AIDS. Those with AIDS will be the first
to receive this vaccine. Concerning this matter, the
National Epidemiology Committee will appoint experts
to study the data in detail once more and have them
present their findings to the Ministry of Public Health,
which is handling this matter.

A reporter asked if it is true that the Thai soldiers who
are cooperating with the U.S. Military Medical Research
Institute and the Thai military are using draftees as
guinea pigs. Dr. Prawet said that we can’t do this on our
own. This must first be approved by the World Health
Organization. Also, there is a committee that is respon-
sible for monitoring the production of vaccines, and
production must be approved by the government. How-
ever, those who volunteer to take this vaccine must be in
one of the groups that are at risk of contracting AIDS at
a hospital. That is, the volunteers must be doctors,
because doctors know themselves very well. The volun-
teers will be divided into two groups, those who have the

EAST ASIA 19

AIDS virus and those who do not, said the chairman of
the National Epidemiology Committee. [passage
omitted]

Trend Rise in AIDS in Military Noted

92WE0120B Bangkok THE NATION in English
2 Nov 91 p a2

[Article by Sirod Sukpinyo and Dom Suwawan: “US
Military AIDS Plan Should Be On Government Level”]

[Excerpts] The United States armed forces proposed
yesterday that its project to test potential AIDS vaccines
on Thai military personnel should be implemented on a
government level instead of between the armed forces as
earlier planned. [Passages omitted]

Deputy Public Health Minister Dr. Athasit Vejj
said no matter on what level the project was conducted,
it still had to win approval from the ministry’s sub-
committee on technics and then from the National
Committee on AIDS Control, chaired by Prime Minister
Anand Panyarachun.

Meanwhile, a senior military officer said yesterday that
the number of conscripted young men nationwide who
have been infected with AIDS has been rising and will
increase about ten times more in the next decade.

The third Army Commander Lt. Gen. Pairote Chan-
urai, after chairing a meeting on AIDS control in Phit-
sanulok province, said that the more soldiers became
infected with AIDS, the weaker the army would be.

The army had found that the conscripted soldiers whose
blood tested positive for the HIV virus came mostly
from the northern region.

And the blood tests showed that 2.1 percent of the
soldiers from the northern region have been infected
with the fatal disease. However, he did not disclose the
total number of soldiers who had had the test.

The army’s medical department had found out that
about 0.5 percent of the conscripted men recruited into
the army in 1989 were AIDS carriers. This increased to
2.5 percent and 3.2 percent in 1990 and 1991 respec-
tively, Pairote said, without detailing the entire number
of conscripted men each year.

He predicted that if no effective preventive measures
were launched immediately, by the next decade the
number of AIDS-infected conscripted soldiers would
reach 30 percent.

Northern Province AIDS Profile
92WEOI50A Bangkok NAEO NA in Thai 7 Nov 91 p 10

[Text] Dr. Phuchong Wiraphlin, the public health officer
in Phrae Province, discussed the AIDS situation in the
province. He said that blood tests conducted in the
province and tests of donated blood showed that as of 15
October 1991, 1,029 people in the province had the



JPRS-TEP-92-003
12 FEBRUARY 1992

Fonreien
Broapcast
INFORMATION
Senvice

PRS Report—

Epidemiology

AIDS

Approved for public release;

“DPIBTHIBUTION STATEMENT AZ
| Distribution Uniimited i

an

REPRODUCED BY

U.S. DEPARTMENT OF COMMERCE DTIC QUALTTY INSPECTED @
NATIONAL TECHNICAL H
INFORMATION SERVICE

_SPRINGFIELD, VA 22161



JPRS-TEP-92-003
42 NEAR EAST & SOUTH ASIA 12 February 1992
EGYPT Therefore there must be an alternate way to protect

Officials Support Law Against AIDS Carriers
91WE0433A Cairo AL-WAFD in Arabic 3 Jul 91 p 3

[Article by Sabir Shawkat]
[Excerpts] [Passages omitted]

Crime ... and Punishment

Khalid al-Musalmi, first deputy prosecutor of al-’Ajuzah
said: “The threat to us now from AIDS patients, espe-
cially in the case of the official who deliberately spread
the disease among kidney failure patients, comes from
the fact that there is no law in Egypt that makes what he
did a crime, and we cannot prosecute any patient who
repeatedly commits such a crime. Even the African
student with AIDS who has now fled into the streets of
Egypt—if we caught him spreading his disease among
innocents we could not prosecute him because there will
be no crime and no punishment unless clearly stipulated
by law. Therefore we demand that the Egyptian legisla-
ture speedily enact a law criminalizing the spreading of
AIDS among law-abiding citizens, and criminilizing as
well causing death or threatening death by transmitting
deadly diseases in general.” [Passage omitted]

“With all the more reason we in Egypt must hasten, now
that the danger has begun to threaten us on a large scale,
to enact such a law for every Egyptian, because a carrier
of this disease threatens any person whether he be at
fault or an ordinary citizen. Legislation must also be
enacted to quarantine AIDS patients until a medicine
becomes available for them in order to protect society
from the spread of the disease, since our capabilities do
not allow the protection needed.

“The law would come as an expression of prevailing
public opinion, which throughout the world, as well as in
Egypt, fears the spread of AIDS. Therefore the legislature
must respond and enact a suitable law that would protect
our people from this deadly disease.”

Alternate Law of the Ministry of Health

In the Doctors’ Union, Secretary General Dr. ’Abd-
al-Mun’im Abu-al-Fattuh said that even though the
World Health Organization refuses to list AIDS among
the diseases whose victims must be quarantined, because
it is transmitted through blood and sexual activity, not
through daily contact, it has left it to each society to
decide how it would protect itself from the spread of this
deadly disease.

“In spite of that, our circumstances in Egypt have caused
the spread of this disease among us because of the weak
capabilities of the Ministry of Health, and because of the
mistakes which occurred in the incident of the senior
official who spread AIDS among kidney patients, as well
as in the incident in which contaminated blood spread
from the prisons because of imprecise testing. [passage
omitted]

Egyptians from the spread of AIDS, and because the
international health system requires that any patient
who presents a threat to society must be quarantined, we
must turn to the legislature to enact a law on quaran-
tining AIDS patients within special communities, That
would be the humane thing to do until the state can
provide effective means of protecting society from the
spread of AIDS.“

Results of AIDS Tests ... in Error

Dr. Usamah Raslan, professor of immunology at the
*Ayn Shams [College of] Medicine and secretary of the
Cairo Doctors’ Union, brought up a serious issue. He
said that the process of kidney dialysis is considered to
be one involving blood transfusion. This means that if an
AIDS patient is hooked up to the dialysis machine, any
healthy person who comes after him must also become
infected with AIDS. Even if the Ministry of Health has
tested the kidney failure patients to find the victims of
the official who spread AIDS among them, this testing
must be done again despite its cost, because the body
incubates the AIDS virus after it has entered for a period
of up to six months, during which it does not appear
upon testing. Therefore they must be retested by the
antigen method, which detects the virus itself, and which
is what is used by the American “Namru” laboratories,
and not by the “liza” method performed by the equip-
ment which the Ministry of Health provides to hospitals
and blood banks.

In fact, the “aliza” equipment used here in Egypt for
AIDS testing, or what is called the serology test, is not
adequate for detecting the disease, because it can give a
[false] positive, meaning that the case is infected with
AIDS, whereas the antigen test would confirm that the
person is healthy and not infected with AIDS. This
means that this equipment would create a disaster for
some victims, for if we took the results of the AIDS test
to the Ministry of Health, and it said that the person was
positive or infected with AIDS, when he was healthy,
and we took this person to be treated with AIDS patients
just like the kidney patients, then this erroneous test
would be the primary cause of AIDS being transmitted to
this person. Therefore effective systems for testing blood
transfusion operations in Egypt must be provided. [pas-
sage omitted]

A responsible doctor at the Himyat al-’Abbasiyah Hos-
pital stated that unfortunately the AIDS patient is not at
fault, and often does not mean to spread the disease;
rather our health policy is at fault. For example, the
kidney patients infected with AIDS are victims of a
mistake by the state which allowed an infected person to
transmit the disease to them, so it must treat them at its
expense; but it allowed him to have dialysis once a week
at its expense, and if he comes complaining that he wants
it done again because he is tired, they should refuse.



6 SUB-SAHARAN AFRICA

MAURITIUS

Cost of AIDS Action Plan Estimated

92WE0198B Port Louis LE MAURICIEN in French
14 Nov 91 p 12

(Unattributed article: “AIDS Action Plan: 17 Million
Rupees”)

[Text] “The sum of 17 million rupees will be necessary to
implement the anti-AIDS action plan.”

This is what a highly placed official of the Ministry of
Health told LE MAURICIEN yesterday.

Furthermore he indicated that, to date, 19 HIV-positive
cases had been reported to the ministry. The number of
cases, he went on to say, has doubled this year in
comparison with 1990, when 10 cases were reported.

The population most affected by this disease is between
the ages of 20 and 39. Hence the need to maintain the
AIDS prevention program.

The action plan will be implemented in 10 ways: epide-
miological oversight, administration, counselling, pre-
vention and control of sexually transmitted diseases,
laboratory work, and the information program.

Nineteen HIV Positive Cases

92WEO0198A Port Louis WEEK-END in French
1 Dec 91 p7

[Unattributed article: “AIDS on Mauritius: 19 Identified
Cases To Date; 6 Deaths Thus Far”)

[Text] Nineteen cases of HIV infection have been iden-
tified on Mauritius to date. Of these infected persons, ten
have developed the disease. Six out of these ten AIDS
patients have already died.

The first case of HIV infection was detected in Sep-
tember 1987. Whereas last year only four cases were
reported, to date nine infected individuals have been
reported in 1991.

According to the official projections, if the present trend
continues, the island could have between 60 and 100
infected individuals in 1993. This fact suggests that the
spread of the disease—though initially slow—has now
taken an upward turn.

MOZAMBIQUE

Official Reports 63 AIDS Cases in Manica
Province

MBO0412185891 Maputo Radio Mozambique Network
in Portuguese 1730 GMT 4 Dec 91

[Text] Armando Djedje, executive coordinator of the
AIDS prevention and combat program in Manica Prov-
ince, has reported that 63 AIDS cases had been recorded
in Manica Province up to September.

IJPRS-TEP-92-003
12 February 1992

In a speech to mark AIDS Day on ! December, Djedje
said that the number of AIDS-related deaths is unknown
because of control difficulties. He noted that most AIDS
sufferers are in the 20-30 age group.

NAMIBIA

President Nujoma Underlines AIDS Danger

92WE0204A Windhoek THE NAMIBIAN in English
27 Nov 91 pp 1, 3

[Text] Fifty-eight people had died from AIDS, and the
number of cases in Namibia had increased sharply.
Opening a Safe Motherhood Conference, Namibian
President Sam Nujoma yesterday said that AIDS was a
scourge threatening the country.

“The number of AIDS cases and HIV infections stands
at 1,575 with 58 deaths. This figure may look small but
the implications are serious,” he said.

The President urged participants to learn from other
countries where AIDS had reached endemic proportions.

“The disease is killing the economically active young
men and women. In addition countries face a serious
problem of orphans due to deaths of parents.” In Zim-
babwe the Minister of Health, Dr. Timothy Stamps, had
estimated that by the year 2000, the Zimbabwe labour
force would have been wiped out because of AIDS. It is
estimated that more than half a million Zimbabweans
are AIDS carriers. .

Nujoma urged the conference to find ways of protecting
mothers and children from AIDS.

SIERRA LEONE

AIDS Situation Said Not Alarming

AB2312093091 Freetown SLBS Radio in English
2000 GMT 21 Dec 91

[Excerpts] Out of 10,000 Sierra Leoneans who were
screened to test for HIV virus AIDS 127 were proved
positive and 29 have already died of the disease. This
was disclosed by the head of Laboratory Services at the
National AIDS Secretariat, Mr. Edmund Matthew, at the
two-day workshop, organized by the National AIDS
Control Program, held at the Institute of Education, Tah
Hill in Freetown. [passage omitted]

The chairman of the workshop, Mr. David Williams,
who is program assistant at World Health Organization
in Sierra Leone, said the AIDS situation in Sierra Leone
has not reached an alarming rate but warned the young
population to be cautious as they run the risk of con-
tracting and spreading the virus to other people.

He said that AIDS is causing considerable havoc in the
world and Sierra Leone is no exception and commended



JPRS-TEP-92-003
12 February 1992

The report says out of a population of about 1 million
Ghanaian residents in Cote d’Ivoire, 90 percent is made
up of women and about 70 percent of them are prosti-
tutes. The SPECTATOR is said to learn that Ghanaian
women are dying in Cote d'Ivoire out of immoral
practices which have been tarnishing the image of Ghana
in the eyes of foreigners.

Investigations conducted by the paper show that those to
blame most for this misbehavior by Ghanaian women
are agents who come to Ghana to recruit, train, and force
teenage girls into the immoral profession. How these
agents can be tracked down and made to stop this illegal
traffic of Ghanaian women is the problem at hand, says
the SPECTATOR. There is also the problem of stopping
those women who. go on their own to earn money the
immoral way.

While urging Ghanaians at home to find a way of
arresting this anomaly, the SPECTATOR makes it clear
that even if these women do not lose their lives in Cote
d'Ivoire, they return home to infect their fellow citizens
with the AIDS disease.

GUIN

Official Gives AIDS Figures

AB0701124192 Conakry Radiodiffusion Nationale de la
Republique de Guinee in French 1945 GMT 4 Jan 92

[Excerpts] The health topic today is AIDS. The subject is
a tragic issue in Guinea. The threat is growing and the
perspective at.the end of 1991 is bleak. Let us listen to
Dr. Tiecoura Kourouma, national coordinator of the
Sexually Transmitted Diseases- AIDS program who was
the guest of our radio Saturday Club program, taking
stock of the situation in our country: [Begin recording]

Kourouma: From 1987 to December 1991, we had about
386 AIDS cases and we told you at that time that most of
the patients were men.

Unidentified reporter: [passage indistinct]

Kourouma: Yes. There are infected women but their
number is far behind that of men. There are children as
well, We have clearly noted that every semester, we have
doubled the number of AIDS cases and we also have
similar figures from 17 prefectures. This means that
there is no longer a region in Guinea which is not
affected by the disease. The figures we just gave you just
concern those who report to hospitals. We also know that
married men who carry the virus, have also contami-
nated their wives. As of 1987, we know that one out of
200 blood donors is contaminated. [passage omitted]

Up to now, we can say that 80 percent of AIDS patients
were Guineans living outside the country where they
contracted the disease. The current problem, however, is
that we have AIDS cases among people who have never
left our country. [passage omitted] [end recording]

SUB-SAHARAN AFRICA 5

MADAGASCAR

Only 25 HIV Positive Cases; Threat Remains

92WE0194A Antananarivo MADAGASCAR TRIBUNE
in French 18 Nov 91 p 5

[Article by Jaobarison R.: “Seminar on AIDS; 25 Serop-
ositive Cases in Madagascar”]

[Text] In the year 2000, 40 million human beings will
probably be victims of AIDS (Acquired Immune Defi-
ciency Syndrome). This colossal figure has been pub-
lished officially by the WHO (World Health Organiza-
tion). In the United States, the director of the overall
AIDS program of that international organization, Mr.
Mearson, declares that with each passing day 5,000 more
human beings become seropositive: in other words,
5,000 more people are carrying the virus. In Madagascar
the figures still appear to be small, because of the 60,000
individuals examined only 25 seropositive cases were
detected, of which two have come down with AIDS, And
of these two AIDS patients, one died in 1990 and the
other has already returned to France.

This does not mean, however, that Madagascar is shel-
tered from this worldwide scourge. Far from it. The
serious problem now is the fact that these 25 persons
infected by the HIV (human immunodeficiency virus)
will continue for five to 10 years in a satisfactory state
and can still carry on a normal life like everyone. That is
to say, to the extent that during this long period there has
been no manifestation or sign to reveal the presence of
the virus that has become established and encrusted
throughout their entire system. They will not contract
AIDS for five, six, or seven years after infection. Then,
only one or two years after the onset of the initial AIDS
symptoms, the death of these 25 seropositive individuals
will be inevitable. The terrible thing about all this,
however, is the fact that also according to the studies that
have been made, a single AIDS patient has probably
contaminated 123 other persons before dying—not to
mention the other new seropositive individuals.

How then is it possible to combat the propagation of this
mortal disease that no one knows how to cure? The
WHO has found no better solution than prevention.
Nothing other than prevention, because so far no vaccine
against the disease, nor any truly effective medication,
has been discovered. In order to arrest the propagation
of AIDS, it is therefore a question of informing the
population that AIDS can be avoided and is not inevi-
table, and of urging people to reduce the number of their
sexual partners, to use condoms, and to have sexually
transmissible diseases treated. For their part, the Chris-
tian churches recommend sexual abstinence outside
marriage—in other words, conjugal fidelity. The seminar
that will be held beginning today at the Solimotel will
enable us to learn more about this disease that day by
day is continuing its advance throughout the world (and
perhaps in Madagascar as well).



JPRS-TEP-92-003
12 February 1992

The epidemiological situation in regard to HIV infection
in the world is presently complex. In cities of Africa with
the highest level of infection, up to 5 percent of women
of childbearing age have AIDS, and 5 percent of the
children manifest clinical signs of disease during the 2
years after birth. The total fraction of children among
AIDS patients in Africa is 10 percent and more. In the
USA, the risk of infection is carried predominantly by
children of the male sex. In Africa and Latin America,
the number of boys and girls among infected individuals
is approximately the same [4,15]. Anthony Fosi [trans-
literation], director of the American National Institute of
Allergic and Infectious Diseases, believes that there are
1.2 million AIDS patients and 10 million virus carriers
in the world, of whom a third are children who were
infected by their mothers [7].

In our country, cases of HIV infection have been regis-
tered in 12 out of 15 union republics. By the end of 1990
almost 600 Soviet citizens were infected with the virus.
The number of infected individuals predicted in 1991
will be 6,200, and by 2006 around 50 million persons
may be infected in the USSR, according to a scientific
prediction. Immune- deficiency virus strikes children
and young persons predominantly. More than 270 chil-
dren have already been infected in hospitals in large
cities (Volgograd, Rostov-on-Don, Stavropol, Elista,
Shakhty), of whom 18 have died. After the year 2010 the
threat that up to 40 percent of the country’s young
generation will die becomes real [1].

Three basic pathways of infection of children with HIV
have been revealed: transplacental, during blood trans-
fusions and other parenteral manipulations, and from
mother to child during breast-feeding. Intrauterine
transmission of infection can be detected beginning with
the 15th week of pregnancy. Infection of the infant may
also occur during its passage through the birth canal. The
possibility of infection of children at an unusually high
frequency during nursing, with the infection being trans-
mitted from mother to child and from child to mother,
was demonstrated for the first time [9]. Fifty to 70
percent of all children born to infected mothers are
infected by HIV. After intrauterine infection, children
are often born prematurely, and with various neurolog-
ical disorders. They develop poorly, they are prone to
repeat infections, and their lymph nodes, liver and
spleen are perpetually enlarged. The first signs of disease
often include candidosis of the skin and mucous mem-
branes, pneumocystic pneumonia, persistent enteritis
and weight loss. Psychomotor development falls behind,
and so-called AIDS-embryopathy arises in certain cases
een is disrupted, and microcephaly develops)
15,18].

The latent period of the disease is shorter in children
than in adults. More often than in adults, AIDS-related
illness begins with elevated temperature and with
enlargement of lymph nodes, liver and spleen. Children
quickly grow thinner and weaker. Dermal pruritis,
patchy papular rash and hemorrhagic eruptions caused

CENTRAL EURASIA 55

by thrombocytopenia develop very often. More fre-
quently than in adults, lungs and the intestine are
afflicted, neurological symptoms taking the form of
encephalopathy, seizures and convulsions develop,
parotitis and anemia arise, opportunistic infections pro-
ceed more malignantly, and they yield to treatment with
greater difficulty. Children infected by the intrauterine
pathway or as a result of transfusion of infected blood
die within 8 months after the beginning of illness [20].

The clinical course of AIDS in children is conditionally
divided into five types: pulmonary, gastrointestinal,
cerebral, disseminated and undifferentiated [5,11,15]. In
pulmonary forms, pneumocystic and cytomegaloviral
pneumonia or pneumonia elicited by avian tuberculosis
bacillus, coupled with development of the clinical pat-
tern of atypical tuberculosis, often develops. The disease
may manifest itself as mediastinal or apical adenopathy,
on its own or in combination with lobar infiltrates; a
disseminated process is possible as well. Lymphocytic
interstitial nonspecific pneumonia that is not associated
with any disease agent but manifests itself clinically only
as hypoxemia is commonly taken to be a unique afflic-
tion of the lungs in children with AIDS. The process in
the lungs intensifies or abates periodically, and it may
not manifest itself for many months and years. Oppor-
tunistic infections do not usually occur in such patients
(11,18).

The gastrointestinal form manifests itself as enteritis or
enterocolitis, usually elicited by fungi and protozoans.
Especially typical of this form is invasion of oral and
esophageal membranes by Candida fungi. Long-lasting
salmonellosis, staphylococcal enterocolitis and other dis-
eases are also encountered. Weight loss coupled with
progressing dystrophy is the most typical. Mesenteric
lymph nodes, the liver and the spleen are often enlarged.
Mesenteric lymphadenopathy is often elicited by avian
tuberculosis bacilli, and liver and spleen afflictions arise
secondarily as a rule due to complication by viral hepa-
titis B, Epstein-Barr infection, atypical tuberculosis etc.
[15].

In the cerebral form we observe development of toxo-
plasmic cerebral abscesses, herpetic or cytomegaloviral
encephalitis, primary or secondary B-cell lymphoma,
hemorrhaging into the substance of the brain, unique
neuropathy and chronic meningitis, and in some cases
seizures and encephalopathy; brain weight gain is
arrested [15,18].

Kaposi’s sarcoma is encountered significantly more
rarely in children suffering AIDS than in adults; how-
ever, it proceeds in a more malignant form. The centers
of affliction appear on the head, torso and mucous
membranes of the oral cavity and the digestive channel.
These places of affliction are completely uncharacteristic
of typical Kaposi’s sarcoma, the signs of which are noted



38 LATIN AMERICA

“AIDS is already a part of the daily life of the people in
Rio Preto,” said Tania Andrade Baron, coordinator of
the AIDS Control Program in this city. According to the
coordinator, such health units as the Base Hospital and
the Santa Casa de Sao Jose do Rio Preto are now
admitting AIDS carriers from several other cities, where
things are not very different. “Drugs are always the
principal means of infection,” she said.

HIV Carriers Seek Help

Located in the midwestern part of the state, Marilia
attracts patients who seek out the Clinical Hospital
maintained by the Faculty of Medicine in that city.
According to Aurea Tavares Villagra, coordinator of
treatment for HIV carriers in the Clinical Hospital, the
problem of intravenous drug use is nothing new here.

Among the countless cases she sees, quite a few are under
16 years of age. “My newest patient is a lad of 13 who
began using drugs when he was nine years old,” Aurea
said. “AIDS has become a big problem in the region.”

In Aracatuba, which is near the Marechal Rondon
Highway (SP-300) and is also served by the rail line that
links Bauru to Corumba (Mato Grosso do Sul), 47.5
percent of the cases of HIV infection resulted from drug
use.

The situation is the same in Bauru, where 50 of the 215
reported cases are linked to cocaine consumption, even
if some other high-risk behavior is involved, such as
homosexual and bisexual relations. At the far west of the
state, near the Raposo Tavares Highway (another major
link with Mato Grosso), is Presidente Prudente; 64.4
percent of the cases of infection here are the result of
sharing contaminated needles. Neighboring Presidente
Venceslau has 42 cases, 71.42 percent of which were laid
to the same cause.

Profile

The physicians themselves recognize that the profile of
the evolution of the disease to date in the interior does
not represent the whole picture. ““There are many cases
that are not reported,” said the Marilia physician, “‘espe-
cially those cases involving middle- and upper- class
patients.”

According to Irineu Maia, of Sao Jose do Rio Preto, this
type of patient conceals his disease as much as possible
and seeks treatment in the capital, far from his native
city. “Even though it has almost 500,000 inhabitants,
Rio Preto is still a city in the interior,” he said.

Statistics in Santos

92WE0179B Sao Paulo O ESTADO DE SAO PAULO
in Portuguese 16 Dec 91 p 10

[Article by Welfer Freitas: “Santos Said To Have More
Reliable Data’”’]

[Text] During the last three years, the medical authori-
ties in Santos have attempted to explain why the city,

JPRS-TEP-92-003
12 February 1992

called the “world capital of AIDS,” has a larger propor-
tion of carriers of the AIDS virus than any other muni-
cipio in the country. According to the specialists, it is
because Santos has an efficient notification system.

Epidemiologist Andrew Moss, of the University of Cal-
ifornia, one of the most respected AIDS researchers in
the United States, was in Santos recently and confirmed
this explanation, declaring that few cities in the world
are working so seriously to monitor the disease. David
Capistrano Filho, secretary of health and hygiene, told
the Agencia Estado: “We know how many cases there are
in Santos because the health service is organized.
Knowing the health situation in other large Brazilian
cities, we know that they are concealing the truth about
the disease.”

Physician Fabio Caldas Mesquita, of the AIDS Referral
Center, cited a significant example. The notifications of
AIDS cases in the first half of the year in Rio de Janeiro
City, with 8 million inhabitants, were exactly equal to
those of Santos, which has a little over 500,000 inhabit-
ants.

He said this happened because in Santos, unlike other
cities, people infected with the AIDS virus have recourse
toa specialized polyclinic, a referral center with a staff of
21, a support house, a telephone information service,
and the possibility of obtaining a diagnosis anony-
mously.

Deaths

Mesquita also noted the work of the epidemiological
vigilance department in Santos, which is responsible for
searching out cases, calling in patients who interrupt
their treatment, paying investigatory visits to hospitals
and households, and studying the death notices in the
registry offices. The AIDS death rate in Santos (68.9
percent) is higher than the average rate in Brazil because
of the identification of death certificates that do not
mention AIDS as the cause of death but in which the
consequences of the AIDS syndrome are reported to
justify the death. In these cases, a retrospective study of
the cases confirms the presence of the disease.

With 1,866 notifications since 1985, Santos has the
largest proportion of cases in the country, in relation to
population. The AIDS syndrome has been confirmed in
781 of the notifications; 749 of these cases (95.9 percent)
are adults over 15 years of age. The ratio of males to
females is 3.27 percent, whereas the national average is
8.35 percent. In 1991, the incidence was 49.78 per
100,000 inhabitants.

In 35 percent of the cases, transmission was sexual, with
heterosexual relations (14.6 percent) predominating over
homosexual or bisexual relations (13.8 percent and 6.4
percent, respectively). In Brazil as a whole, sexual trans-
mission accounts for 58 percent of the cases, with 31



26 EAST ASIA

singers—“because people look up to them.” Soon it will
extend to other people in the industry as well.

“We'll also train live movie-dubbers so they can insert
AIDS messages into the movie at appropriate places.
They'll know how to do it without messing up the
script,” Mechai said, becoming more excited as he
talked.

“Producers of movie videos have agreed to insert mes-
sages in their copies. Movie theatres will show spots
without charge. And music cassettes will soon have
AIDS messages.

“We may subsidise movies which contain AIDS mes-
sages because these are forms of entertainment which
draw a large number of people.”

Even Buddhist monks will be recruited to lend a hand.
Monks will be invited to learn about AIDS so that they
may include it in their sermons, Mechai said. In the
future, when the number of orphans and abandoned
children begins to rise as a result of the disease, temples
will be asked to serve as orphanages, since government
facilities will be inadequate to handle them, he added.

The education campaign will carry two major themes,
Minister Mechai explained. “One is on prevention—
what is AIDS, how you get it, how you don’t get it, and
what to do if you get it. The second one, which is the
most important, will focus on understanding, discrimi-
nation, human rights, and compassion.

“The campaign will have a very strong human face,” he
continued. “It. will appeal to people to have compassion
and understanding for those who are unfortunate enough
to be infected.”

He said that the programme aims to accomplish three
things within the next two years: reduce sexual contacts
with different partners by half, double condom use from
the current 30 percent to 60 percent, and treat sexually
transmitted diseases quickly and effectively. “If we can’t
do this, we'll have a big problem.”

Mechai estimated that it will cost over $100 million a
year to run the programme. But he claimed that if the
programme is sustained for the next decade and
assuming that extensive behavioural change occurs in
the near future, the number of infected people can be
reduced by 3.5 million, and $5.1 billion can be saved.

He said that as of September, an estimated 200,000 to
400,000 people have been infected. “Already, more
Thais have been condemned to die today than the
number of Japanese killed by the two atomic bombs
dropped on them during the Second World War.

“If nothing is done, we'll have two to four million
infected people by the year 2000. In that year alone,
180,000 people will become sick, and 160,000 will die
from the disease,” he said. “That means one out of every
three funerals you go to will be funerals of people who
die because of AIDS.”

JPRS-TEP-92-003
12 February 1992

The projected levels of illness and death will create a
significant financial burden on families and the govern-
ment, he said. Health care costs for people with AIDS in
Thailand are estimated to be $1,000 per person per year.
He said this conservative estimate assumes that care is
received in the lower-cost state hospitals, rather than
private facilities, without the benefit of expensive drug
therapies such as the anti-viral drug AZT.

As it is, the treatment cost represents half of the annual
household income for an average Thai family, he said.

Because most of the people infected with HIV are in
their most productive years of life, the minister said, a
far greater cost to the economy will result from their
death.

“We assume that each infected person will lose 25 years
of his working life and that he earns an average of $1,500
per year,” he explained. “Taking into calculation a social
discount rate of five percent, we'll lose about $22,000 per
person.

“We have roughly calculated that the total annual health
care costs plus the value of lost income is to grow from
$100 million in 1991 to $2.2 billion by the year 2000.
Over the ten-year period, we'll lose about $8.7 billion
due to AIDS illness and death.”

There is yet another cost to the economy, which he terms
the “macroeconomic cost.” This is incurred from such
factors as the shortage of labour, both in quantity and
quality, high absenteeism brought on by illness, and
declines in tourism, in export of labour, in land prices,
and in foreign investment.

“It'll take time to calculate the total cost. But you can see
from this rough estimate how scary it is,” said Minister
Mechai.

It was this gloomy scenario which prompted him to
publicly predict a short time ago that Thailand was
facing a catastrophe brought about by the uncontrollable
spread of AIDS. Now that he is leading the charge on the
lethal virus, he is seeing a different picture.

“We still have a problem, but it is no longer a catastro-
phe,” he said. “AIDS has done its damage here as it has
in every country it is visited upon. Whether the damage
can be contained depends very much on the leadership.
We now have a very good leadership. Our prime minister
understands the problem and has decided to take com-
mand to minimise the damage.

“T’m confident that we will see positive results in Thai-
land because we are very serious about our prevention
efforts. We’ve got our budget, and our prime minister is
seriously involved. Our dream is becoming a reality.”

His confidence and buoyancy notwithstanding, he still
has a few hurdles to get across.

Whether his optimism is warranted depends very much
on what the prevention programme can do. to change a



IJPRS-TEP-92-003
12 February 1992

Protection Bill in the Consultative Council

Dr. Mukarram Hilali, director of the Umm al-Misriyin
Hospital and member of the Consultative Council,
believes that the AIDS disease, as well as infectious liver
[diseases], have become a sure threat to Egypt now, and
because the threat is hidden, any protective measure
taken, however violent, would ultimately be for the good
of society. Therefore as he says, he is now preparing a bill
to be put before the Consultative Council on taking
effective protective measures against these diseases.
Until that is done we must be aware of the seriousness of
the AIDS disease, and perform AIDS tests on all
patients, doctors, and those working in places most
exposed to AIDS. This week all workers in the hospital
are being tested free of charge. He said, “The AIDS
testing equipment that we have, the doctors, and the
needed supplies will expand the field of testing for a
token fee of 20 pounds, the actual cost to any person
requesting a test.”

Dr, Ra’uf Salam, medical [deputy] of al-Azhar Univer-
sity, believes that the disaster of the spread of AIDS
among dialysis patients was due to the fact that no
decisive decree was issued by those in the Ministry of
Health responsible for preventive medicine on the need
for obligatory AIDS testing before using the dialysis
machine. He believes that those patients who were
infected because of this mistake in prevention have a
right to be compensated for the harm that has afflicted
them, a tremendous harm that threatens them with
certain death, and they have the moral right to receive
any treatment and complete care at state expense. As for
quarantining AIDS patients, he believes that no one can
object to the need to enact such legislation to protect
society. [Passage omitted]

At the Ministry of Health, I contacted Dr. Raghib
Duwaydar by telephone, and his response was that he
did not know anything about the truth of what we had
published in AL-WAFD on the spread of AIDS, and that
he could not discuss issues such as these; rather the one
who could discuss them and had the reports and facts
was Dr. Fathi Shaybah, deputy minister of health for
preventive medicine. He concluded his response by
talking with Dr. Fathi Shaybah, for whom I have been
looking for a week and who refuses to meet with me or to
discuss this matter. But at the Interior Ministry, a senior
responsible source, who refused to reveal his name, said
that the Interior Ministry does not have the budget to
treat prisoners in the first place. The budget does not
exceed 70,000 pounds a year, with 15 piasters a day per
prisoner for treatment, which is not enough for an
aspirin tablet. So where would the ministry get the
money for treating addicts and AIDS patients in the
prisons? He called on the AL-WAFD newspaper to help
in opening the door to donations to the prisons for
treating prisoners with diseases that have spread among
them and that threaten society outside.

NEAR EAST & SOUTH ASIA ck}

INDIA

AIDS Reported Spreading Rapidly in Goa

92WE0132 Madras INDIAN EXPRESS in English
10 Oct 91 p 6

[Text] EXPRESS NEWS SERVICE, Panaji, Oct. 9—The
dreaded Acquired Immuno-Deficiency Syndrome seems
to be rapidly spreading in Goa.

From just one AIDS case reported in 1987, the number
of detected AIDS cases in the state in the last five years
has shot up to 74, according to official figures.

A more disturbing aspect is that while some of the early
detected AIDS cases involved mostly foreigners, the ones
detected more recently are mainly locals,

Of the 74 cases—31 AIDS carriers are found among
migrant population mainly hailing from Karnataka,
Kerala and Maharashtra. The remaining cases include
24 locals and 19 foreigners.

Papers Report Continuing Spread of AIDS

Cases in Bombay, Madras, Manipur

92WE0165A Bombay THE TIMES OF INDIA
in English 11 Nov 91 p7

[Text] New Delhi, 10 November: About 5,700 people in
the country are carriers of the AIDS virus. Most are
concentrated in the three epicentres—Bombay, Madras
and Manipur, according to Mr. Shiv Lal, deputy direc-
tor-general in the director-general of health services.

Mr. Lal was speaking on Friday at a two-day national
symposium on AIDS. Since detection of the first AIDS
case in the country six years ago, he noted, India now
had 85 people infected by the virus. Almost all states in
the country had reported cases of infection, he added.

The Human Immuno Deficiency Virus (HIV) which
causes the Acquired Immuno Deficiency Syndrome
(AIDS) is currently thought to infect six million people
in the world. A person can be infected in two senses: He
can become a carrier and finally get the disease, or he can
become infected with the disease straight away. The
AIDS virus completely destroys the immunology system,
making the person susceptible to all diseases.

Mr. Lal said Delhi alone has about 464 cases, 14 of these
full-blown. Transmission mainly by infected needles
(drug users), blood transfusion and sexual intercourse
with infected persons. There is no evidence of AIDS
being passed on through any other means. He said
studies show a majority of those infected are in the
young and economically productive group.

Prof. Kusum Sehgal, from Maulana Azad Medical col-
lege, said the scenario was alarming. Statistics show for
every case of full-blown AIDS, there are another 50 to
100 infected persons, with no symptoms.



IJPRS-TEP-92-003
12 February 1992

One expert predicted, however, that since Thailand was
a lot more advanced in medical science and technology,
it would probably not experience a jump in infection
rates like those of lesser developed African countries.
Still, indications are that health officers’ lives are going
to become a lot harder trying to fight the disease’s
spread,

“They will need to put a lot more effort into controlling
it, and it won’t be easy,” he said. [Passage omitted]

MINISTER Discusses AIDS Strategy, Impact

92WE0182A Bangkok BANGKOK POST in English
29 Nov 91 pp 29, 31

[Article by Wasan Dechawongtham who talked to
Mechai Wirawaitiya: “A Plan for All-Out War Against
AIDS”]

[Excerpts] There is an air of excitement these days in the
office of Mechai Wirawaitiya, minister attached to the
prime minister’s office overseeing the country’s fight
against AIDS. [passage omitted]

We are off and running,“ declared the flamboyant min-
ister. "We now have the prime minister as chairman of
the national AIDS Committee which has been drafting
the National AIDS Programme... I can say that Thai-
land has one of the best AIDS prevention programmes in
the world.“

His enthusiasm is understandable. The latest develop-
ment is little short of revolutionary, if he can see it
through. Probably for the first time, all sectors of soci-
ety—government, private sector, non-government
organisations, educational and religious institutions—
will join forces in an effort to tackle a menace which
experts predict could bring about a national calamity if
left unchecked.

Mechai himself issued a similarly dire warning as a
private citizen heading an NGO at a time when the
prevailing attitude in the government was to deny the
seriousness of the AIDS situation.

The time between September 1984 when the first AIDS
cases exploded in Thailand and 1990 was a period of
denial, Mechai said.

“While the NGO’s had been pushing for action, figures
of infected persons were kept low so that people wouldn’t
think there was a problem,” he recalled. [passage
omitted]

This group was preparing a national AIDS prevention
plan when the February coup took place. Ironically, the
person who was pushing for the plan happened to be
included in the next government, which accounted for
the plan being revived and strengthened.

“I received very strong support from Dr. Athasith,”
Mechai said referring to Deputy Minister of Public

EAST ASIA 25

Health Dr. Athasith Vejjajiva. “Together, we set up a
new AIDS committee and convinced the prime minister
to be chairman.”

Gaining Prime Minister Anand Panyarachun’s confi-
dence was perhaps the most significant move, for it
enabled the committee to obtain cooperation from all
ministries and to acquire additional budget for the first
phase of the plan. Within a month, a supplementary
budget of 248 million baht had been allocated to be
distributed among all ministries for expenses in their
individual education campaigns.

Education, Mechai says, is at the heart of the pro-
gramme. The most important part is the massive public
education employing the government media. All 485
government radio stations and five television networks
will provide free air time to broadcast 30-second spots of
AIDS education messages every hour, he said.

Starting next year, students in all educational institu-
tions from primary schools on up will learn about AIDS
as part of their course work and school activities.

“The Ministry of Education has finished laying down the
curriculum. We are ready to go,” Mechai said, adding
that all teachers will be educated on the issue and trained
to teach their students on the subject.

Meanwhile, he said officials at all levels in every ministry
will also be educated about the disease. Explaining the
training process, Mechai and that teams of experts will
provide training for key staff in every department.

“Three persons from each department will participate in
the training. They in turn will form a cell to train all
other staff members in their departments,” he said.

For those departments having contact with the public, he
said, officials will help disseminate AIDS information to
people doing business with them. The Ministry of Inte-
rior, being an agency with the most extensive network of
offices dealing with the public, will play a major role in
this effort.

“The ministry will be developing AIDS education pro-
grammes for 65,000 village women’s committees, village
headmen, and the police force,” Mechai said. This will
ensure that AIDS education will reach even those people
in the remotest parts of the country.

The private sector will be asked to cooperate in making
the programme a success, he said. “The private sector
can help by providing AIDS education training for their
employees. Companies which deal extensively with the
public may insert AIDS information material inside the
packages in their products. Bank tellers can distribute
brochures to bank customers. ATMs can be programmed
to display AIDS messages.

Entertainment companies and people in the arts also will
have a significant role to play, he added. The Thai
motion picture federation has agreed to cooperate fully,
he said. Training has already started for actors and



62 WEST EUROPE

do with the good way Denmark has handled this com-
pared with other countries.”

The national association has born the brunt of the fight
against AIDS ever since the first Dane died of the illness
10 years ago. Health officials asked the association
directly to manage the HIV/AIDS campaign for men
who had sex with men. In this way, an outstanding
cooperation between an official agency and the gay
milieu came into being. It is a cooperation that did not
exist in the Anglo-Saxon countries, where officials
latched onto the well-known campaign trick: A blend of
scaring and threatening. The Danish advantage is that
the milieu can use words and expressions an official
body either does not know or can simply not use without
receiving a shower of complaints. Economically the
advantage is that every paid campaign worker brings
with him a great number of volunteers. Effective and
cheap.

Something for the Money

In 1992, the joint endeavor will be included into the
budget. The sum of 6.4 million kroner is earmarked for
the national association. For the first time, it will not be
obliged to solicit funds from the so-called AIDS pool two
times a year. In other years, the uncertainty surrounding
finances has meant long pauses in the campaign and the
interruption of planning. With the exception of the
Progress Party, everyone voted to put the association’s
work directly into the budget. The amount, 6.4 million,
is the same as this year.

The total amount of money for AIDS prevention next
year will be nearly 28 million kroner, a rise of seven
percent, and consequently one of the better years. But
more money could and should be used. “It concerns me
that more is not done for such a big and expensive illness
like AIDS,” said Prof. Peter Skinhoj of the Rigshospital’s
epidemic division.

“An AIDS patient costs about a million kroner in direct
hospital expenditures. We estimate that there are at least
5,000 infected in Denmark, that is, a cost of five billion.
If a large, well mounted campaign can prevent even 10
cases, it might cost 1 or 2 million. It would still be a
tremendously good deal.

“Everybody wants to invest in the lottery. The problem
is that some political groups have difficulty defending
the use of so much money for a single disease when there
are so many others. But this is an area in which they
really would get something for their money.”

Why should AIDS have priority over other illnesses?
“Because AIDS has a very simple set of problems: A little
dumb mistake signifies certain death and suffering.
Other major causes of death are more difficult to do
anything about, as in the case of two of the biggest, auto
accidents and suicide. Since apparently we must have the
speeds we have, and we do not have a tradition of
spending much money for psychiatry, it is correspond-
ingly difficult to make inroads here. With AIDS it is

JPRS-TEP-92-003
12 February 1992

pathetically easy. AIDS is on the verge of becoming the
leading cause of death in the United States between the
ages of 15 and 50. It will not be that bad here at home,
but it is nevertheless wise to put more money into
this—also from an economic point of view.”

Sources in the Health Board have said that they have cut
many excellent and sensible programs this year because
there are not enough funds in the so-called AIDS pool
that is distributed to fund preventive work. It will be 3
million kroner next year, and anyone may apply for it.
Among the steady applicants are Denmark’s Hemophilia
Association and the Positive Group, but more and more,
guidance counselors and associations are coming and the
pool is getting smaller and smaller.

Dr. Else Smith of the Serum Institute: “It is not enough
to launch a campaign just one time. A campaign’s
message lasts an incredibly short while. It draws atten-
tion for a certain time, but it must be maintained at the
same level and followed up. Later, it is necessary to go
into more detail. There are many more nuances than:
You must protect yourself with a condom. How much
may one kiss and deep kiss and where. When should one
put the condom on, etc. People are very confused about
AIDS when it comes to the more complicated matters.
There is no way around it. There are still various risk
groups who must have their own specialized informa-
tion, and there are constantly new people going in and
out of these risk groups. In the last two-three years, one
HIV positive has registered each day, but we do not
know which "pool we are drawing from. Is it soon
empty? How much of it will women ultimately fill? As
long as we do not know this, the AIDS priority must not
be lowered.”

Of those now showing up infected with HIV, half are
men infected by men, 20 percent are drug addicts, 30
percent are heterosexuals. Denmark, as of today, has had
900 AIDS cases, 350 of whom still live, but about 5,000
HIV infected, who sooner or later will develop AIDS.

FINLAND

Fewer Helsinki HIV Cases in 1991

92WE0158A Helsinki HELSINGIN SANOMAT
in Finnish 2 Dec 91 p BI

[Unattributed article: “Fewer Carriers of HIV Than Last
Year”)

[Text] In the capital region this year fewer carriers of
HIV have been found than last year. The year 1990 was
the darkest virus year in history; there were 42 con-
firmed infections in the capital region; in the entire
country there were 91. This year 70 HIV carriers have
been found in the entire country, of which about half are
in the capital area.

There are about 290 who have gotten infected by HIV in
the capital region, 35 of whom are females. At the end of



2 SUB-SAHARAN AFRICA

sterilizing them—of needles, syringes, and other instru-
ments used to pierce the skin or to practice similar
techniques.

In any event, the leaders of political opinion; the media;
those who exercise authority in the mystical, magical,
and religious sects; public health personnel; and even
those individuals who are infected with the HIV,
together with their families—in short, the entire
Beninese community—are in the front line of the fight
against AIDS and are therefore confronted by a challenge
that demands great creativity, unflagging energy, and
immeasurable resources.

The degree of commitment on the part of everyone, the
collective will, and the individual capacity to meet this
challenge will undoubtedly have a profound impact on
the evolution of the AIDS epidemic in Benin.

BURKINA

Committee To Fight AIDS Formed

AB1912122491 Ouagadougou Radiodiffusion Nationale
du Burkina Radio in French 0700 GMT 14 Dec 91

[Message to the nation from the Minister of Health,
Amado Ouiminga; read by Joseph Ouedraogo, secretary
of state for social welfare on 14 December—live or
recorded]

[Excerpts] For the past four years on the first of
December the international. community has celebrated
the international day for fighting AIDS. The celebrations
remind each and everyone of us of the reality of this
sickness to which individual and collective attention
must be paid. [passage omitted]

The number of AIDS’ cases in our country is increasing.
Therefore, it must become everyone’s daily concern. Ten
cases were discovered in 1987; we now have 1,300
confirmed cases in the second quarter of 1991. This
alarming rate should inspire cause for concern. In fact,
out of every 100 AIDS’ cases, 75 percent are young
people between the ages of 20 and 39. Tests conducted in
1989 among the Awori group in Ouagadougou reveal
that 61 out of every 100 people carry the virus. In the
face of this evil, whose negative effects on the family,
society, and economy need no longer be demonstrated,
the Burkinabe Government has done everything to
establish a National AIDS Control Committee. This
multisectoral committee has been tasked with coordi-
nating, evaluating, and promoting all the strategies
aimed at limiting the spread of AIDS in our country.
[passage omitted]

JPRS-TEP-92-003
12 February 1992

BURUNDI

Neurological Disturbances in AIDS (Based on
Data from the Republic of Burundi)

92WE0113A Kiev VRACHEBNOYE DELO, in Russian
No 6, Jun 91 pp 82-84

{Article by V. V. Andreyeva and A. E. Andreyev; Prince
Regent Charles Hospital; under the rubric “Assisting the
Practicing Physician”]

UDC 616.8:616-097

[Text] Neurological Disturbances in AIDS (Based on
Data from the Republic of Burundi)

The acquired immune deficiency syndrome (AIDS) was
first described in 1981 in the USA in representatives of
high risk groups (homosexuals, drug addicts). In 1982,
when the number of patients with various clinical man-
ifestations, mainly those of T-cell immunological insuf-
ficiency, exceeded 1,000, the principal signs of the dis-
ease were established. A virus, the causative agent of the
disease, was isolated in 1983 in France and the USA; this
agent belongs to the group of retroviruses. The causative
agent of AIDS was designated HIV in 1987 by the World
Health Organization (WHO). AIDS was discovered over
the course of five years in more than 100 countries on all
continents; the total number of cases was about 100,000.

The republic of Burundi is one of the countries of central
Africa in which an increase in the number of cases of
AIDS has been observed in recent years. The spread of
AIDS in the developed countries and the countries of the
African continent has several characteristic features.

1. Intense development of the epidemic process. The
number of cases identified in the USA and Europe in
1981-1985 increased on the average by 160% per year,
and reached a maximum in 1985 in the principal foci
(New York, San Francisco).

2. Unevenness of geographic distribution. Thus, 60% of
all cases in the country are concentrated in five large
American cities.

3. The majority of newly reported cases are homosex-
uals, drug addicts, recipients of blood and its compo-
nents, sexual partners of infected individuals, and chil-
dren of infected mothers.

In 1988-1990, 184 patients, age 15-70-years, with a
serologically confirmed diagnosis of AIDS were found in
the women’s internal medicine division of the Prince
Regent Charles Hospital. The ELISA test and the control
WESTERN BLOT test were used for serological diag-
nosis. All age groups are subject to infection with AIDS;
however, according to published data and our observa-
tions, its frequency is higher in individuals aged 26-30
years, which corresponds to the period of greatest sexual



16 : EAST ASIA

time was Lieutenant General Phinyo Siriyaphan. He was
in favor of this and made an effort to have this project
implemented as soon as possible. But this project came
to a halt when he left earlier than normal as a result of a
conflict over a transfer. The United States will have to be
given an answer by next January. The project will get
underway in March if the Army agrees.

Dr. Redfield conducted a test in June 1991 in the United
States. But it will be another 18 months, or around
December 1993, before the results of that test are known.
But he has asked to test this drug on Thai soldiers. He
has supposedly asked to test this vaccine on 100 soldiers
who do not have the AIDS virus and 30 soldiers who
have the virus. The test will take only one year. Those
who agree to participate as guinea pigs will be given a life
insurance policy. The question that arises is, Why does it
have to be Thai soldiers?

What facilitates the tests, which requires evaluating the
results and monitoring the people injected with the
vaccine, is that these are soldiers. These people are well
disciplined, which is a “spec” that has been mentioned
by the researchers. And if tests are done, it’s certain that
lower ranking soldiers, who are called “novices,” will be
chosen to serve as guinea pigs. And it won’t be difficult
to get them to sign the consent forms. If they are ordered
to do so by their superiors, they will obey immediately.

A person who is well informed about this said that the
main reason why Dr. Redfield wants to conduct tests in
Thailand is that if the tests achieve results, it will be
possible to produce the vaccine and use it worldwide.
But if the tests are done elsewhere, such as in African
countries, which are third-world countries, too, it won’t
be possible to use the vaccine worldwide. This is because
Thais are not a, “pure” race. There has been much
crossbreeding and so it would be easy to sell this vaccine,
which would earn the producers a fortune.

Dr. Redfield, who traveled here and met with officials
from the Army Medical Department, had great hopes of
being able to use the Army as a testing ground. More-
over, people with the power to make a decision on this
traveled abroad using funds provided by him. This
increased his confidence. But that was the situation prior
to 1 October 1991.

A news source close to the deliberations on this project
told KHAO PHISET that the longer that this drags on,
the less likely it is that we will cooperate in testing this
vaccine. This matter has been discussed, but no progress
has been made in getting the Medical Department to
issue a proposal on this project. If the committee of the
Medical Department agrees with this, it will have to
submit the matter, in order, to the RTA CINC [Royal
Thai Army Commander in Chief], the Medical School,
and the Ministry of Public Health, which is directly
responsible. Each step will take much time. It will
probably be January 1992 before a decision is reached.
The batch of this drug that was produced is about to
expire.

JPRS-TEP-92-003
12 February 1992

The reason why those considering this matter have not
yet reached an “agreement” with the United States is
that in the future, the healthy people who are given this
vaccine will test positive for the AIDS virus if they have
to take a blood test for a job or for some other reason. It
will be difficult for them to tell if they have tested
positive because of having received the vaccine or
because they actually do have the AIDS virus. Moreover,
the drug has been tested on Americans for only a very
short period. There may not have been time for any
complications to appear. No one knows what the results
will be in 10 years. Normally, in conducting such tests,
the subjects must be monitored until they die. Those
conducting the experiment then draw conclusions.
Another point is that those infected by the AIDS virus
may live another six years. But if they are given this
vaccine, they may die even sooner. These are the things
that are being considered by those who must make the
decision on this.

If those who are considering this matter decide not to go
ahead with this, that will be the end of the matter. People
close to senior people feel that there is little chance that
this project will be approved. At a time when the image
of the military in general is bad, this project, which
directly concerns the military, will be viewed with sus-
picion by outsiders. And those with the power to make
the decision are probably still asking, Why Thailand?
The answer to that probably has to do with the huge
profits to be made from selling this drug worldwide once
the drug is tested on people here.

Doctor Views AIDS Ramifications, Trends,
Reactions

92WE0121B Bangkok SIAM RAT in Thai 27 Oct 91
p4

[Article by Dr. Chumsak Phruksaphong]

[Excerpts] In the end, the attempt to use resolute mea-
sures to solve the AIDS problem in Thailand by imple-
menting a compulsory law met with failure. The subcom-
mittee considering the AIDS control draft act, which was
chaired by Saisuri Chutikun, decided that there was no
need at this time to implement a law to control the
spread of AIDS in Thailand. [passage omitted]

I am referring to those Thai men who like to “fool
around” and who have turned Thailand into the sex
capital of the world. [passage omitted]

There is clear evidence indicating that men are 17.5
times “better” at spreading AIDS than women. This is
another reason for seeking ways to control the sexual
activities of Thai men.

Let’s look at the AIDS situation as of 30 September
1991. Thailand had a total of 172 people with full-blown
cases of AIDS, and there were 436 people with AIDS
related symptoms. There were 33,832 people with the
AIDS virus. This last figure is just the number who have
tested positive and who have been reported to the



JPRS-TEP-92-003
12 February 1992

Reading Hospital auditorium, Peshawar, on Tuesday.
Dr Naveed Shaukat said, “We do not want to create
panic but the disease is spreading at an alarming rate and
all forces capable of restricting its spread, must fight
unitedly before the damage is declared beyond repair”.

Others who offered their findings about the spread of
AIDS precautions particularly in NWFP [North-West
Frontier Province], included Dr. Abdur Raziq Khan of
the Peshawar AIDS Centre and Dr, Liaqat Ali from
National Institute of Health, Rawalpindi. They stressed
immediate measures like increasing the number of
screening centres with more equipment and latest
methods to check the disease from touching un-
manageable proportions since the “AIDS carriers are on
the loose and nobody in the country is on guard against
them”.

They called for restricting contacts between those
detected (HIV) positive and the rest of the population.
They lamented that the existing apparatus for detection
of AIDS carriers and patients did not allow an optimistic
result of the efforts undertaken so far. “Transmission of
the disease from numerous sources, from within the
country and abroad, were the most horrible threat to the
AIDS-free people living here or visiting countries, from
where they brought it without being detected”, they
pointed out.

Quoting the recent tests carried out on those returning
from Gulf states, Dr. Abdul Raziq Khan said, “18 out of
30 were found positive”, which shows the magnitude of
the threat. “The menace becomes even more horrifying
in view of the anti-hygienic habits of common man
prone to come in contact with the un-detected carriers
and patients of AIDS”, they emphasised. “Follow up on
those found positive carriers of the disease has not been
effective, particularly in the NWFP, and there were no
reports on the activities of such patients on the loose”,
they noted.

It was considered to be the main cause for concern that
while the entire population of the country was unpro-
tected, the concerned high ups in the government were
found reluctant in allowing the electronic media to
launch a mass education campaign against AIDS. “The
PTV [Pakistan Television] and radio could be the most

NEAR EAST & SOUTH ASIA 53

effective channels for this purpose but the government
does not seem convinced to use them for creating aware-
ness among the people about the causes, dangers and
preventive measures against AIDS”, remarked one
expert, who also complained that the print media too
was not playing its duo role in this respect. [Passages
omitted]

Over 100 Said Infected With AIDS

92WE0159A Lahore NAQWA-I-WAQT in Urdu
27 Nov 91 pp 7, 8

[News Report: “104 Individuals in Pakistan Are Infected
With the AIDS Virus; Doctors Should Use Blood
(Transfusions) Sparingly and After Proper
Investigation’)

[Text] Lahore:(news reporter): Dr. Navid Shaukat, man-
ager of the national AIDS program in Islamabad said
that at present 104 individuals in Pakistan were infected
with the AIDS virus; 18 had contracted AIDS and of
these, 16 died. He made the statement recently in a
seminar on the role of high officials in AIDS prevention
held in the blood transfusion department here. The
seminar was arranged with the help of the World Health
Organization. Dr. Sakhia Sakha Ullah, director of the
blood transfusion service in Punjab, also addressed the
seminar. Dr. Navid Shaukat said that AIDS had been
brought under control to a great extent in Europe and the
United States but that it was spreading in Asia. Report-
edly, at present 1 million individuals worldwide were
suffering from AIDS and the number of AIDS patients in
Asia was now comparable to that of Europe. Dr. Navid
Shaukat said that AIDS was spread through the HIV
virus transmitted from one person to another through
blood transfusions, at the time of birth, and by the use of
contaminated syringes, and that the incubation period
could be from six months to 10 years. He said that
Punjab had the largest number of blood donors but that
AIDS screening tests were not available in some areas. It
was thus necessary for doctors to use blood [transfu-
sions] as little as possible and to do so only after proper
investigation. Dr. Sakhia Sakha Ullah said that the
World Health Organization had designated the blood
transfusion department in Lahore as the province’s local
point where the latest AIDS diagnostic tools and per-
sonnel were available.



60 WEST EUROPE

AIDS Deaths Traced to Contaminated Blood
Supply

92WE0111D Copenhagen BERLINGSKE TIDENDE
in Danish 28 Oct 91 p 1

[Article by Louise Fleischer: “Every Fourth AIDS-
Infected Hemophiliac Is Dead”—first paragraph is BER-
LINGSKE TIDENDE introduction]

[Text] The scandal concerning the unscreened donor
blood from the mid-1980’s has had tragic consequences.

One out of every four of the 89 Danish hemophiliacs
infected with AIDS in the early and mid-1980’s by means
of unscreened donor blood is dead today. And half of the
survivors have had difficult and serious HIV-related
illnesses.

According to one prediction, 50 percent of hemophiliacs
will have full-blown AIDS in four years.

This is the conclusion of a new and still unpublished
report from Denmark’s Hemophiliac Association. The
report is the result of a three-and-a-half year long project,
“Hemophiliacs and AIDS,” and it reveals great social
and human costs for HIV-infected hemophiliacs.

They have more colds, more frequent headaches, and
more eczema than other hemophiliacs. Many of them
have experienced feelings of isolation and being without
close friends, the survey shows.

But many hemophiliacs do not say they are infected. One
survey shows that HIV-infected hemophiliacs are afraid
they will be stamped as homosexuals or drug addicts.
They harbor feelings of being “infested or defiled.”
Consequently, they are guarded about their illness and
rarely tell their fellow workers that they have the HIV
infection. Even so, 40 percent of them have experienced
being “looked down upon, avoided, or put down”
because of the HIV infection.

The 89 hemophiliacs were infected through infected
blood used in the vital medicine, blood preparation
“Factor VIII.” The medicine was manufactured from
unscreened donor blood. The matter developed into a
scandal which ended in a judicial investigation, an
adminstrative court case, and a criminal case. Even so,
the blame was never fixed.

Agency Studying Employer Policy on HIV
92WE0111C Copenhagen BERLINGSKE TIDENDE
in Danish 4 Nov 91 p 2

[Article by Bodil Jessen: “The Medical and Health Board
Investigates AIDS Policy Among Business Firms”—first
paragraph is BERLINGSKE TIDENDE introduction]

[Text] AIDS: Of 2,000 businesses, very few have formu-
lated a definite AIDS policy, according to the results of a
current survey undertaken by the Medical and Health
Board.

JPRS-TEP-92-003
12 February 1992

Hardly any Danish businesses have established what
they will do if one of their employees is infected with the
HIV virus, which causes AIDS.

The Medical and Health Board is currently engaged for
the first time in a survey of how many Danish businesses
have introduced an AIDS policy into the workplace. The
current results of a survey taken of 2,000 Danish busi-
nesses shows that only about one percent have set down
a definite AIDS policy.

There are HIV infected individuals at two to 3,000
Danish businesses, the Medical and Health Board
reported.

“Businesses should take a stance on the AIDS problem
before it affects one of their employees. That way we can
avoid it becoming a personal problem for the HIV-
infected individual. It should be discussed thoroughly in
the workplace so that colleagues do not become nervous
because of ignorance of the HIV infection,” said Hen-
ning Jorgensen, a spokesman for the Medical and Health
Board.

Personal problems in the workplace can be major, as a
report published last Monday by the Hemophiliac Asso-
ciation concerning the HIV-infected shows. Thoroughly
67 percent of the HIV-infected felt that they were looked
down upon by their colleagues because of their disease.

“The problem is not management in the workplace.
They have the economic responsibility and merely treat
the HIV-infected as they treat their other employees,
allowing, for example, the same amount of sick leave.
Nevertheless, it is important that a business have a clear
policy that fellow workers of HIV’s can be guided by. In
this way, transfers and threatened work stoppages by
colleagues can be avoided,” said Ronny Soderstjerne,
chairman for the HIV positive group in Copenhagen,
which counts 300 HIV-infected.

Not Fired

The Danish Employers Association (DA) also strongly
encourages businesses to introduce an AIDS policy
before they encounter the problem. Attorney Dorthe la
Cour from DA says that it is typically the biggest
businesses who decide to put in place a general AIDS
policy in order to derail future problems. Grundfos, FDB
[Federation of Danish Farm Organizations], P&T [Post
and Telegraph Office], and DSB [Danish Railways] are
among the businesses which today have introduced an
AIDS policy.

FDB’s head of personnel, Palle Juul Jensen, writes
among other things that FDB has introduced an AIDS
policy because there is a statistical probability that the
disease sooner or later will hit one of its 14,000
employees.



SJPRS-TEP-92-003

12 February 1992 LATIN AMERICA 33
Intravenous Drugs Chief Means of Transmission Among Men*
(means of infection, in percentages)
Year Homosexual Bisexual Heterosexual Drugs Hemophiliacs | Transfusion | Under investi-
gation
1985 61.5 26.2 27 23 15 12 46
1986 58,2 24.1 46 5.6 17 12 4.6
1987 $0.5 17.4 5.4 14.5 17 37 67
1988 43.3 15.9 6.2 22.1 13 2.6 8.6
1989 39.3 14.8 8.0 26.1 0.9 22 87
1990 33.4 12.8 75 33.8 0.8 13 10.3
19919" 30.4 13.2 9.6 35.2 0.7 12 9.8
* Data for Sao Paulo State.
** To July.
Sexual Relations Second-Largest Cause of AIDS Among Women*
(means of infection, in percentages)
Year Sexual relations Drugs ‘Transfusion Under investigation
1985 66.7 16.7 16.7 0.0
1986 31.3 25.0 43.8 0.0
1987 325 46.5 14.9 6.1
1988 21.6 54,7 10.3 13
1989 32 514 8.0 9.5
1990 414 46.7 55 6.4
19918* 36.6 42.2 43 16.8
* Data for Sao Paulo State.
“* To September.

Infection Increasing Faster Among Women

Every man and woman who engages in casual sex,
regardless of his or her sexual preference, faces the risk of
infection with the AIDS virus. According to Michael
Merson, director of the WHO's World Program To
Combat AIDS, running the risk of engaging in unpro-
tected sexual relations with a casual partner may be a
fatal mistake. “Anyone who still thinks the disease is
restricted to homosexuals and drug addicts should
remember that the number of infected women exceeds
the number of infected men in Africa,” he says.

The level of infection through heterosexual relations has
been rising sharply all over the world. In France it rose
from 6 percent of all cases in 1986 to 9.3 percent last
year. That is similar to the situation in Brazil. In Sao
Paulo, which is the state most affected by the disease and
the one with the most accurate data on the subject, the
number of infections through heterosexual relations
accounted for 2.6 percent of the total in 1985, but is now
up to 9.6 percent.

According to data from the AIDS Training and Refer-
ence Center (CTRA), which is run by the state Secre-
tariat of Health, the progress of the disease among
women is striking. In 1985 there was one infected

woman for every 40 men. In six years, that ratio has
become one woman for every six men. This means that
women now account for 14.2 percent of all those
infected—whereas in 1985 they accounted for only 2.4
percent.

According to Merson of the WHO, the rise in the number
of infected women is explained by the fact that they are
more susceptible to infection by a man who has the virus
than the reverse. According to his explanation, the
concentration of the virus in the vaginal mucous mem-
brane is more dangerous than its fleeting presence on the
male organ. In Africa, which is the continent hardest hit
by the disease, the number of women carrying the virus
is already 5 percent higher than the number of infected
men.

Preventive measures: Health specialist Elizabeth
Arevolo of the CTRA points out that homosexuals are
now being more careful than heterosexuals when it
comes to preventive measures. That would help to
explain the drop in the percentage of infections due to
homesexual relations.

In 1985, the chief means of infection among male
carriers of the virus was homosexual relations (61.5
percent of the total). Today the number of infections



JPRS-TEP-92-003
12 February 1992

give the order to use the available HIV test on blood at
French blood donor centers.

The ultimate cause of the catastrophy is said to be the
demand from higher officials to economize. The three
bureaucrats, one who has resigned his position as head of
a blood tranfusion center, blame the health care minister
and the minister of finance during that period. The three
bureaucrats claim to have received the order to save
millions on blood transfusion routines. As a result, the
American test, which was available by March of 1985,
was ignored.

Nor did anyone bother to use the method of heating
blood which was common in the rest of Europe by 1985.
The method was claimed to be too expensive. The stock
of untested blood was used to the last drop, in expecta-
tion that a cheaper French test would be brought out.

HIV Incidence Among Pregnant Women Increases

92WE0143C Stockholm DAGENS NYHETER
in Swedish 14 Nov 91 p 5

[Text] The number of women infected with HIV has
doubled compared to last year. Numbers from the State
Bacteriological Laboratory (SBL) indicate that this year
19 women did not discover that they were infected until
they became pregnant.

So far most of the infected pregnant women have been
immigrants, according to the SBL. Pregnant women who
have received blood transfusions or who have been on
drugs have also shown to be infected.

Of the 19 women who turned out to be infected with HIV
this year, five who are Swedish and not of foreign
extraction were infected heterosexually. In 1989 eight
pregnant women were infected with HIV, last year the
number was ten.

Paper Views Quarantine Law, AIDS Danger

92WE0143A Stockholm DAGENS NYHETER
in Swedish I Dec 91 p 2

(Editorial: “AIDS Cannot Be Legislated Away; Including
HIV in Communicable Disease Statute Undermines
Confidence in Care”’]

[Text] The picture of Sweden’s treatment of the AIDS
problem is full of contradictions. The Swedish Govern-
ment acted forcefully and invested a lot of money not
only in research but also in preventive work, No one can
doubt the good will behind the efforts to counter the
spread of the infection.

At the same time, there is a clause in Swedish legislation
that is surprising, especially to other countries. Since
1986, AIDS is included in the communicable disease
protection statute. This means that Sweden is one of the
few countries in the world, where HIV infected persons

WEST EUROPE 3

are subject to involuntary isolation. It means further-
more that the anonymity of a person infected with HIV
is not guaranteed.

The fact that Sweden has such good AIDS statistics is not
due to legislative or control policies. It is the individual
doctors, nurses and all the volunteer workers who
deserve the honor for the excellent AIDS care that exists
in Sweden. Volunteer organizations have also shoul-
dered a large part of the responsibility for conveying
information.

Ove Berglund, assistant chief physician at Roslagstull
Hospital, says in an article in the LAKARTIDNINGEN
that he has been forced to break the law on numerous
occasions. It has happened that someone suspected of
being infected has refused to be tested while reporting
that he lives in such a way that he cannot spread the
infection. Subsequently, the doctor did not obey the law,
and did not report him and his full identity to the
communicable disease protection physician.

The law prescribes that you can be tested anonymously,
but if the test is positive, you must be identified. Fur-
thermore, it is still not clear whether a physician can
offer treatment if the patient refuses to reveal his iden-
tity.

Experience is lacking within the infectious disease care
on long-term involuntary care. As it is now, the infec-
tious and the communicable disease protection physi-
cians are forced to accept the roles of informer, prose-
cutor, police and jailer.

Since the infectious disease physicians have refused to
handle the involuntary care, special clinics have had to
be established. A number of women in an annex to the
Danderyd Hospital have been guarded for several years
by commercial guards at enormous costs.

On paper the treating physician is responsible for the
reporting. This was also stressed by Brith Christensen,
the communicable disease protection physician in Stock-
holm, in a contribution to the debate about changes in
the law: “It goes without saying that the communicable
disease protection physician only acts on the basis of a
report from the treating physician.” Despite this, the
communicable disease protection authorities visited the
special office for homosexual men last fall and asked to
see the patient journals. The reason was that the author-
ities had received a report from an outsider, maintaining
that a large number of people active within the volunteer
organizations are spreading the infection.

When those responsible were questioned last Thursday
at a Medical Association meeting, the reply was that it
was a routine mission.

In connection with the visit a spokesman for the AIDS
delegation went to the media and explained that if the
allegations were true, subsidies for the organizations
would be withdrawn.


34 LATIN AMERICA

occurring in relations of that kind has dropped to 30.4
percent of the total. During the same period, on the other
hand, infections among individuals using intravenous
drugs has risen from 2.3 percent to 35.7 percent of the
total.

The Brazilian situation is one of the most disturbing in
the world. “The WHO’s attention is currently centered
on a few countries such as India, Thailand, and Brazil,”
says health specialist Maria Eugenia Fernandes of the
CTRA. According to Maria Eugenia, what those coun-
tries have is a dangerous combination of large popula-
tion groups and a low level of information, a situation
that favors the rapid advance of the epidemic.

Statistics from the Ministry of Health reveal that
advance. In 1980, when the disease arrived in this
country, only one case was recorded. Five years later, in
1985, the number of patients was already up to 478. Last
year the ministry received notification of 5,665 cases in
an escalation that gives no signs of stopping. In just the
first eight months of this year, 3,233 new cases of AIDS
were reported.

Collor Urges Nation To Combat AIDS

92WE0160C Rio de Janeiro O GLOBO in Portuguese
28 Nov 91 p8&

[Text] Brasilia—Following the recommendation of the
World Health Organization [WHO] and impressed by
the projections of the Ministry of Health, which points
out that Brazil is in danger of reaching the year 2000—
only eight years away—with 1 million AIDS patients,
President Fernando Collor decided to take personal
command of the work of AIDS prevention.

Yesterday he taped a statement to the nation, which will
be aired Saturday night on radio and television.
Sounding the alert, Collor will say that the only way to
prevent this catastrophic picture—by reducing the
number of cases from the projected 1 million to about
100,000—is to initiate serious prevention measures and
engage the entire society in this effort.

The statement was suggested by the WHO, through
Michael Merson, director of the WHO’s World Program
for AIDS, in an interview with O GLOBO on 18
November, in which he pointed to Brazil as one of the
problem countries with regard to AIDS. Collor will
invite the public to watch a video tape produced by the
Health Ministry, which will be aired on Sunday morning
over network television, presenting the standards for
individual prevention and urging the municipal govern-
ments to form municipal AIDS commissions. The pres-
ident will also announce the creation of a National
Council on AIDS prevention, which will be chaired by
Pele.

In one of the most recent dispatches to the president,
Health Minister Alceni Guerra presented the AIDS pro-
jections for the end of the century in Brazil. Shocked,

IJPRS-TEP-92-003
12 February 1992

Collor decided to follow the WHO's suggestion and
ordered Alceni to give first priority to AIDS combat and
prevention.

“With the creation of the municipal AIDS commissions,
our intent is to decentralize prevention and combat,
delivering the educational and consumer materials to the
municipal governments for distribution. The Health
Ministry campaigns will simply support the work of the
health officers,” Alceni Guerra explained.

By the end of this year he hopes to have 3,000 municipal
commissions, in addition to the already existing state
commissions, and including the 700 municipios where
verified AIDS cases have been reported. In 1992 the goal
is to cover all the Brazilian municipios.

With the data supplied by the Health Ministry and the
WHO, Collor will demonstrate the nation’s AIDS situa-
tion. There are about 500,000 carriers of the AIDS virus
and 10,000 patients in treatment. About 10,000 people
have died of the disease in this country.

Existing Data on AIDS May Be Invalid

92WE0160A Sao Paulo O ESTADO DE SAO PAULO
in Portuguese 1 Dec 91 p 20

[Article by Daniel Hessel Teich]

{Excerpt] On the World Day of Struggle against AIDS,
those responsible for the AIDS figures in Sao Paulo
report a new problem. The statistics on the progression
of the disease in the state may be worthless. Underre-
porting and the consequent increase in cases in which the
means of transmission is unknown or still under inves-
tigation could jeopardize the way in which the data are
currently tabulated.

The revelation comes at a time when the Brazilian
authorities agree that there is a crisis. Last evening,
President Fernando Collor made a 14-minute statement
on radio and television, warning that the situation is
extremely serious and that the entire population should
mobilize. Today Health Minister Alceni Guerra will
appear on the networks to answer questions from the
public about AIDS. All over the world, events will be
held to call attention to the epidemic.

As the WHO (World Health Organization) has done in
various African countries where there are no standards
for collecting accurate data, the Secretariat of Health
may be obliged to adopt new methods for calculating the
development of the epidemic in Sao Paulo State.
According to Debora Barbieri, a public health physician
with the Division of Epidemiological Vigilance of the
CRTA (AIDS Referral and Training Center), the figures
indicate that in 9.2 percent of the cases the means of
transmission is unknown. “If this figure reaches 10
percent, the statistics will cease to be valid,” the sani-
tarian said.



SJPRS-TEP-92-003
12 February 1992

Yusuf Merchant, the doctor in charge of the Drug Abuse
Information and Rehabilitation Research center in Bom-
bay, argued that drug traffickers were becoming smarter
and drug types more sophisticated by the day, and it was
impossible to wipe them out.

He pointed out that small quantities of the new
“designer heroin”—1,000 times more powerful than
normal heroin—could satisfy huge numbers of addicts.

TRAN

AIDS Patients Identified by 10 Nov Total 182

LD1I511125891 Tehran IRNA in English 1054 GMT
15 Nov 91

[Text] Tehran, Nov 14, IRNA—A total of 182 patients
infected by the acquired immune deficiency syndrome
(AIDS) have been identified throughout Iran until 10
November, according to the latest figures released by the
AIDS campaign committee here.

Dr. Ms. Shirvani, a member of the committee told IRNA.
here today that of these patients 37 are male between
eight to 14 years of age, and 11 are between 15 to 30
years of age. “There are only two women among the
infected people,” she added, noting that the rate of the
AIDS patients in Iran is almost nothing compared with
the 60 million population. Dr. Shirvani said AIDS is not
a serious syndrome in Iran.

She said the AIDS campaign committee has established
provincial departments in order to identify, control, and
educate patients and prevent the disease.

A report on the situation of the AIDS patients in Iran is
delivered to the World Health Organization (WHO)
every three months, she added.

Quoting WHO figures she said each day 5,000 patients
are added to the number of the infected people in the
world and that it is mostly observed in the developing
countries among the youth and particularly men.
According to WHO predictions, Dr. Shirvani said, a
total of 30 million people including 10 million infants
would be infected by AIDS until the year 2000.

On the situation of the hemophilic patients, she said the
number of such patients is estimated at some 6,000 in
Tran, of whom 2,538 have so far been identified.

Official Details AIDS Cases
92WE0152W Tehran ABRAR in Persian 18 Nov 91 p 3

[Excerpts] Dr. Cheraghchi, general manager of the Min-
istry of Health Care, Treatment, and Medical Educa-
tion’s Anticontagious Disease Office, said: There has
been a striking decrease in the spread of contagious
diseases in the country compared to the years before the
triumph of the Islamic revolution. [Passage omitted]

NEAR EAST & SOUTH ASIA 49

Dr. Cheraghchi discussed AIDS in the country. He said:
This disease is found mostly in patients afflicted with
blood disease who have used imported blood products,
and this problem exists everywhere in the world, because
until 1974 experts did not know that blood products
could also carry AIDS.

Speaking at a national anticontagious disease seminar at
the Dizin Hotel, he said: Since 1365 [21 March 1986-20
March 1987] only 39 cases of AIDS have been found in
Iran, and there are 170 people infected with the AIDS
virus, which is 6.2 percent of those patients who have
received blood transfusions. In other countries this
figure is 15 percent. [Passage omitted]

JORDAN

Article Reports Total of 66 AIDS Cases

92WE02054 Amman JORDAN TIMES in English
28 Nov 91 p 3

[Article: “Total Cases of AIDS in Kingdom Since 1986
Rises to 66, Ministry Reports”]

[Text] Amman (J.T.}—The Health Ministry Wednesday
revealed that the total number of AIDS cases in the
Kingdom since 1986 has now reached 66, 59 of whom
are Jordanians.

Of the Jordanians infected with the disease, 14 have
already died, one of whom passed away last week, said
the ministry in a statement prior to the World AIDS
Day, 1991, which is to be observed Sunday.

Only one AIDS patient out of the seven foreign nationals
died in the Kingdom, the statement said. The rest have
been repatriated, said the ministry’s statement, carried
by the Jordan News Agency, Petra.

The Ministry of Health has been able to control the
spread of the AIDS disease through strict monitoring of
the blood transfusion processes and through stringent
precautionary measures, including laboratory tests, the
statement said.

All blood banks in Jordan conduct tests on the blood of
donors to ensure that they are safe, especially if the
donors had undergone surgical operations abroad. At the
same time, Jordan restricts the importation of any
amount of blood from other countries, the statement
added.

Jordan is considered among the first few countries of the
region to take precautionary measures against the spread
of the AIDS disease. According to World Health Organ-
isation (WHO) estimates, there are between eight and 10
million men, women and children around the world who
are infected by this disease and that more than 5,000 are
infected by AIDS daily.

The ministry statement noted that Jordan, through the
continued efforts of a National Committee to Combat



2 EAST ASIA

government wants to hit the government's targets in
fighting and controlling AIDS in Malaysia. AIDS will
have a direct effect on the economy and security of the
country.” Mrs. Liang Choeng Lan also mentioned a
statement by Dato Lee Kim Sai, the Malaysian minister
of public health. Besides politicians and civil servants,
Malaysians in general have been asked not to travel to
Thailand unless absolutely necessary. This does not
include businessmen, who must travel there on business.
Nevertheless, they should definitely stay away from the
entertainment spots in Thailand, because the AIDS
situation in Thailand is now very serious.

Besides this, the report also mentioned another state-
ment made by the Malaysian minister of public health.
This statement said that another problem is that Thai
prostitutes are bringing the AIDS virus into Malaysia.
International gangs try to bring Thai prostitutes into
Malaysia. Concerning this matter, the Malaysian min-
ister of home affairs is trying to formulate a plan to
suppress this. The laws will be revised to increase the
penalties for this in order to curtail the trafficking in
prostitutes. He has called on all Malaysians to cooperate.
If they see prostitutes entering the country, they should
immediately inform officials, said the report.

Concerning this situation, Ist Lieutenant Pokkhrong
Chindaphon, the governor of Songkhla Province, said
that it isn’t known whether that story was accurate or
not. The article has not yet been evaluated. He said that
he regularly meets with officials from the Malaysian
consulate in Songkhla Province. He will meet with them
in order to discuss the truth of this article. Such stories
will harm Songkhla Province and Thailand. He said that
he plans to send a note to the Malaysian consulate in
order to have them inform the Malaysian Government
of the facts. Unclear reports about the AIDS situation
have confused people. Whenever someone tests positive
for AIDS, people automatically assume that the person
has AIDS. But a positive blood test could indicate that
they have some other disease.

“In this situation, we will have to meet with Malaysian
doctors in order to foster understanding. We will also
meet with various organizations such as the Tourist
Association, the Hotel Association, the Chamber of
Commerce, and the Makkhutesk Association in order to
look for a way to solve this problem. From what I have
observed, tourism in Songkhla Province has not
declined. Tourists are still coming here,” said the gov-
ernor of Songkhla Province.

Mr. Songchai Chirachotikamchon, the president of the
Songkhla Provincial Tourist Association, said that the
association is making an effort to get businessmen to
cooperate with each other. Because today, people are
acting on their own. Business is stagnating. That is,
business has dropped by about 50 percent. Several other
types of businesses lack capital. “The reason why I have
taken the lead in meeting with various units is to show
that we are taking action and want cooperation. The
Songkhla provincial Chamber of Commerce doesn’t

SJPRS-TEP-92-003
12 February 1992

know what to do. It should look at what is happening
close at hand, that is, in Songkhla Province. Or don’t
these business activities concern the Chamber of Com-
merce here? I am a member of the Songkhla Chamber of
Commerce. At the meeting in March, I will have to speak
out on the various problems,” said Mr. Songchai.

AIDS Vaccine Testing Discussion, HIV-Positives

92WEOI51A Bangkok THE NATION in English
24 Nov 91 p b4

[Article by Yongyuth Pahirah, Mukdawan Sakboon: “A.
Shot in the Arm, or in the Back?”]

[Excerpt] No matter what official statistics say, the AIDS
situation in Thailand is worse than most people
expected. The epidemic, which two years ago seemed to
be confined to only a small group of drug addicts and
prostitutes, is now breaking into Thailand’s general
population.

Health officials are reluctant to reveal anything but a
muddy picture. The official number of HIV positive
cases runs no more than 50,000, while non-government
organizations put it at around 300,000. But reliable
medical sources said 500,000 would give a more realistic
picture.

So it should come as no surprise (especially for Thai
health officers) that Thailand was selected by the World
Health Organization (WHO) as one of four countries,
including Brazil, Rwanda and Uganda, fit for an AIDS
vaccine test, a project that WHO officials say could begin
by June next year if things go according to plan.

“If possible, we hope to conduct the vaccine test simul-
taneously in all four countries WHO has selected,” said
Dr. George Loth, a WHO official in Thailand. “But, of
course, that would mean that the project must receive
approval by the host countries’ health authorities first,”
he said.

He added, however, that definite details had yet to be
outlined for Thailand.

“We must wait for the WHO team to visit Thailand in
January to coordinate with the Thai government and
draw up the test protocol. The protocol would then work
its way up the channels until approval from the National
AIDS Committee and the government. And if things go
well, June would be the earliest that the test could begin.
So you can see, it’s still quite a long way to go before the
test would actually be carried out,” he said.

About 15-20 people would be involved in the first trial
tests conducted jointly with Thailand’s Health Ministry.
These people, which Loth said will all be volunteers, are
expected to be picked mainly from Health Ministry
medical personnel.

“This is normal practice for WHO, when conducting a
test in a developing nation. Medical personnel, because



52 NEAR EAST & SOUTH ASIA

If a person is tested positive, then his name and identity
is kept confidential and he is provided free counselling
and taught the care he needs, and the preventions to not
infect others.

The family members are also educated to supportively
interact with the patient, said Dr. Shaukat.

“When there is neither a cure nor a vaccine available
prevention and health education are the only ways out,”
Dr. Shaukat believes.

Government Said ‘Doing Nothing’ To Prevent
AIDS
92WE0159b Karachi AMN in Urdu 17 Nov 91 p 3

[New report: “No Steps Have Been Taken in Pakistan
for the Prevention of AIDS; Pakistan AIDS Society Will
Present Its Report to the Convention on AIDS of Nonof-
ficial Organizations To Be held in Geneva”]

[Text] Lasbela, 16 November (P R). Shaukat Ali, secre-
tary general of the Pakistan AIDS prevention society
said that no effective measures had been taken at the
government level in Pakistan to combat the dread dis-
ease AIDS, in spite of the fact that AIDS had reached
Pakistan and the government acknowledged that this
was true. Before leaving for Geneva to participate in the
convention of nonofficial organizations being held under
the UNESCO auspices, Shaukat Ali said that he would
present a detailed report at the convention on the efforts
of the nonofficial Pakistan AIDS prevention society in
connection with AIDS prevention and the creation of
public awareness of the disease. But that he was sorry
that in his report to the international conference there
would be no mention of any offical efforts and that this
could be interpreted as lack of concern on the part of the
government and high officials, but there was nothing he
could do except to express regret. He added that the
Pakistan AIDS prevention society was actively engaged
in persuading the people to abstain from sexual promis-
cuity and the use of drugs especially by means of
syringes; these were the two most important factors in
the spread of the disease,

Ten Million AIDS Victims Forecast by 2000
92WE0I59C Karachi AMN in Urdu 18 Nov 91 p 3

[News report: “The Lack of Any AIDS Prevention Pro-
grams in Pakistan; the Single AIDS Research Laboratory
in Jinnah Hospital Cannot Combat the Ravages of This
Pernicious Disease”’]

[Text] The AIDS prevention society of Pakistan is trying
to spread awareness among the people regarding protec-
tive measures against the lethal disease AIDS. The
society arranged several discussion meetings in which
many citizens benefited from the talks given by experts
on the disease. Groups were formed to discuss and
exchange ideas on the subject of AIDS and publicity
material in the form of pamphlets and folders was

JPRS-TEP-92-003
12 February 1992

distributed in large numbers in offices, colleges, schools,
business centers, in short, everywhere. The pamphlets
are in Urdu and English and will also be printed in
regional languages. All these things are being done by a
nonofficial service organization and the government has
paid no attention to this serious health issue. All that has
been learned is that a laboratory in Jinnah Hospital is
doing AIDS research, diagnosing the disease, and
offering advice to patients who need it. In a country that
is developing, is beset by ignorance and poverty, which
has a population of more than 100 million, of which it is
believed that by the year 2000, 10 million will be
suffering from AIDS, in such a country can one labora-
tory alone combat the disease? It is necessary for the
government to grasp the implication of the situation and
to place preventive measures against the disease on an
emergency basis.

The World Health Organization, UNESCO, and other
organizations are putting forth great efforts to combat
the disease and they give generous financial aid to
countries, which try to stop the spread of the disease.
They also provide expert advice and scientific informa-
tion; nevertheless, no preventive steps against the dis-
ease are being taken in our country. How can a nongov-
ernment society alone, which is tackling the problem out
of a sense of human sympathy and duty, successfully
shoulder such a major responsibility?

The most important cause of this disease is wrong
behavior and individuals of weak character get involved
in sexual promiscuity and drugs. These are the two
curses of promiscuous individuals. It is society’s respon-
sibility to see to it that drug prevention programs are
followed and promiscuous individuals are made aware
of the terrible consequences of their actions. These are
heavy responsibilities that cannot be carried out without
the imposition of laws and regulations and the coopera-
tion of those executing the laws. It is the duty of the
government to take the responsibility of this important
task in its own hands and protect its countrymen from
this pernicious disease. Reflection shows that AIDS
prevention may be as important as the defense of the
country.

Government Accused of Criminal Neglect
Regarding AIDS

92WE0166B Peshawar THE FRONTIER POST
in English 20 Nov 91 p 1

[Article by Ikram Hoti: “Government Accused of Crim-
inal Neglect in Preventing AIDS”]

[Excerpt] The criminal neglect on the part of the govern-
ment to assist the anti-AIDS preventive measures on
social scale, has exposed the entire population of the
country to the incurable killer disease. Anybody, any-
where can pick up the disease and spread it further.

The warning was issued by the director of the National
AIDS Centre, Islamabad, while delivering a lecture to
the high officials of the Frontier government at the Lady



JPRS-TEP-92-003
12 February 1992

FDB’s AIDS policy establishes that HIV-infected indi-
viduals should be treated like other employees and that
they may not be fired merely on the grounds of HIV
infection.

The Medical and Health Board last month distributed
informational materials to all businesses with over 30
employees.

The objective was partly to urge businesses to put an
AIDS policy in place and partly to eradicate prejudice
among employees by means of the informative material.

Next spring the Medical and Health Board will deter-
mine whether the campaign succeeded in inducing more
businesses to formulate an AIDS policy.

‘Safe-Sex’ Habits of Homosexuals, Bisexuals
Studied

92WE0173B Copenhagen BERLINGSKE TIDENDE
in Danish 28 Nov 91 p 9

[Unattributed article: “Unsafe Sex Among Young Gay
Men”)

[Text] The younger they are, the more unsafe sex is
practiced, is one of the conclusions in a just completed
study of the sexual behavior of homosexual and bisexual
men in 1988. Poor information is adduced as the reason.
This was the most extensive European study of its kind.
The study also showed that on the average gay men had
3.5 sexual partners per year, and that a large number of
gay men had changed their sexual habits owing to the
risk of AIDS. Among other facts, the practice of anal sex
has dropped dramatically.

Figures for HIV Infections in Early 1980’s
Revised

92WE0207A Copenhagen BERLINGSKE SONDAG
in Danish 8 Dec 91 p 9

[Article by Soren Kassebeer: “Fifty Infected With HIV
via Blood Transfusions”—first paragraph is BER-
LINGSKE SONDAG introduction]

[Text] In the early 1980’s 40-50 Danes were infected
with the HIV virus as a result of blood transfusions. This
figure does not include hemophiliacs infected with HIV.

“Between 40 and 50 Danes—not counting hemophili-
acs—became HIV positive following blood transfusions
in the black period between 1980 and 1985 when the
Danish health authorities had not yet begun to test donor
blood.”

So said Dr. Henning Sorensen, chief physician at the
National Hospital’s blood bank.

“This is a rough estimate. We cannot know for sure how
many patients acquired the disease, as some died from
other causes before the HIV diagnosis was made,”
Sorensen added.

WEST EUROPE 61

Although all donor blood is tested for the HIV virus
today there is still a risk of being infected via a blood
transfusion, according to the chief physician.

“If the donor becomes HIV positive shortly before giving
blood, doctors have no chance of detecting the virus.
This means that one out of half a million to a million
patients will still be infected with the HIV virus,” he
said.

Dr. Sorensen said that the need for blood transfusions in
operations has declined due to improved operating
methods.

“In addition doctors have become more cautious about
giving blood because there is a risk of transmitting other
infectious diseases, for example hepatitis. All in all this
means that the need for blood donations will decline in
the future.”

All the patients who are alive and were definitely
infected with the HIV virus following a transfusion have
received compensation. The money comes from the
same fund that pays hemophiliacs 250,000 kroner apiece
in compensation.

AIDS Infection Threat Seen Adding to Jail
Sentence

92WE0173D Copenhagen BERLINGSKE TIDENDE
in Danish 18 Dec 91 p 3

[Unattributed article: “AIDS Sentence”’}

[Text] “I’ve got AIDS and I’ll bite you if you come any
closer.” Using this threat, on 6 May 1991 a 23-year-old
drug addict and thief from Haderslev attempted to keep
two police officers at bay when they attempted to arrest
him and his girlfriend. At Vestre District Court yes-
terday this threat, together with a string of store rob-
beries and the purchase of hashish, earned him a prison
sentence of one year and three months.

Government’s AIDS Funding Discussed

92WE0186A Copenhagen BERLINGSKE AFTEN
in Danish 24 Dec 91 - 2 Jan 92 p 6

[Article by Pernille Stensgaard: “Ten Years of AIDS”]

[Text] “While other countries, especially England, Aus-
tralia, the United States, and Canada, have run pure
scare campaigns around AIDS, here at home we have
used humor and popular wisdom. And in the middle of
it all, Denmark introduced registered partnership—
recognition of a lifestyle that in other places is subject to
hatred. We have come through the first 10 years of AIDS
with dignity and good sense. We can be very proud of
that,” said Bent Hansen of the National Association of
Gays and Lesbians. “The Danish policy on AIDS was
established already in 1987 and the fine words about
anonymity and being voluntary have, in fact, had great
practical value, because one may refer to them as official
guidelines. I think this early initiative has had much to



IJPRS-TEP-92-003
12 February 1992 3 AIDS

THAILAND
Use of Troops as AIDS ‘Guinea Pigs’ Discussed

[Uaiphon Taechutrakun; Bangkok KHAO PHISET, 7-13 Oct 91] 15
Doctor Views AIDS Ramifications, Trends, Reactions
[Chumsak Phruksaphong; Bangkok SIAM RAT, 27 Oct 91] ..... 16

Army Officer on Northern Conscripts’ AIDS Incidence [Bangkok BANGKOK POST, 31 Oct 91] . 17

Songkhla Officials View AIDS Economic Impact /Bangkok SIAM RAT, I Nov 91] 17
Health Official Discusses AIDS Vaccine Tests /Bangkok DAO SIAM, | Nov 91] 18
Epidemiologist on AIDS Vaccine Experiment /Bangkok SIAM RAT, 3 Nov 91] 18
Trend Rise in AIDS in Military Noted

[Sirod Sukpinyo and Dom Suwawan; Bangkok THE NATION, 2 Nov 91] 19
Northern Province AIDS Profile {Bangkok NAEO NA, 7 Nov 91] ...... 19
Doctor Backs AIDS Vaccine Trial, Mayor Opposes /Bangkok DAILY NEWS, 8 Nov 91] . 20
Interior Ministry AIDS Effort, Budget /Bangkok BAN MUANG, 8 Nov 91] .... 20
Chiang Mai AIDS, Condom Use, VD Rates [Bangkok THAI RAT, 11 Nov 91] .. 21
Officials React to Malaysian AIDS Fear [Bangkok SIAM RAT, 16 Nov 91] ... 21
AIDS Vaccine Testing Discussion, HIV-Positives

[Yongyuth Pahirah, Mukdawan Sakboon; Bangkok THE NATION, 24 Nov 91] .... 22
MINISTER Discusses AIDS Strategy, Impact

[Wasan Dechawongtham; Bangkok BANGKOK POST, 29 Nov 91] _....... . 25
Drug Addiction on Increase in North /Bangkok THE NATION, 7 Dec 91] . . 27
Nineteen AIDS-infected Babies Die; Hospital Gives Abortions

[Bangkok THE NATION, 16 Dec 91] . 27
New Office Established To Oversee Anti-AIDS Policy {Bangkok BANGKOK POST, 28 Dec 91] 28
Total of 180 People With AIDS Admitted to Northern Hospital

[Bangkok BANGKOK POST, 4 Jan 92] ..... 28

VIETNAM

Blood Tests Show | Vietnamese, 49 Thai HIV Carriers
[Tieu Lien; Hanoi Voice of Vietnam Network, 1 Dec 91] .....
French Medical Equipment for Institute in HCM City /Hanoi VNA, 4 Dec 91] ..

EAST EUROPE
CZECHOSLOVAKIA

‘Several Hundred Thousand’ HIV Cases Expected by 2000 (Bratislava PRAVDA, 19 Dec 91] ....... 30
ROMANIA

First Congress on AIDS Ends /Bucharest ROMPRES, 7 Dec 91]

LATIN AMERICA
BRAZIL

Free AZT Projected To Reveal Unreported Cases
[Aureliano Biancarelli; FOLHA DE SAO PAULO, 13 Nov 91] ...
AIDS Incidence Through August
[Roldao Arruda, Neldson Marcolin; Sao Paulo O ESTADO DE SAO PAULO, 18 Nov 91] . 31
Collor Urges Nation To Combat AIDS [Rio de Janeiro O GLOBO, 28 Nov 91]
Existing Data on AIDS May Be Invalid
[Daniel Hessel Teich; Sao Paulo O ESTADO DE SAO PAULO, 1 Dec 91] ..... a
Government’s AIDS Prevention Campaign Criticized /Sao Paulo ISTOE SENHOR, 11 Dec 91]
Drug Use Spreads AIDS in Sao Paulo Interior ...... .
More Use Than Imagined
[Daniel Hessel Teich; Sao Paulo O ESTADO DE SAO PAULO, 16 Dec 91] ....
Statistics in Santos /Welfer Freitas; Sao Paulo O ESTADO DE SAO PAULO, 16 Dec 91]
Poor Areas Affected (Sao Paulo O ESTADO DE SAO PAULO, 16 Dec 91) .....

DOMINICAN REPUBLIC

Hato Mayor Official on AIDS Epidemic, Control Efforts
[Santo Domingo Cadena de Noticias, 20 Dec 91]

. 39



IJPRS-TEP-92-003
12 February 1992

in the area will meet in Nicaragua from 11 to 15
November to draft strategies for controlling the disease.

Epidemiological inspectors are once again reminding
Honduran citizens that condoms or prophylactics are the
way to prevent becoming infected with AIDS, for which
reason they should be used in all sexual relations.

Thirty-three Additional AIDS Cases

92WE0184B Tegucigalpa EL HERALDO in Spanish
17 Dec 91 p 18

{Text] Yesterday the Epidemiology Division reported 33
new cases of acquired immune deficiency syndrome
(AIDS). These patients include 23 men and 10 women,
and this report raises the number of Honduran victims
of this deadly disease to 1,535.

The new group of patients includes two infants under
two years of age who got the disease from infected
mothers. On the national level, there have been 54
children reported as AIDS patients.

The epidemiological reports indicate that some 500
AIDS patients have died, while some 50,000 individuals
who have the human immunodeficiency virus (HIV) are
living in our national territory.

Twelve of the new cases were reported in La Ceiba, along
with six in Choluteca, five in Copan, four in Comayagua,
three in Tegucigalpa, two in El Paraiso, and one in San
Pedro Sula.

More than 50 percent of the AIDS cases in Central
America have been reported in Honduras. The first four
cases were reported in 1985, while 13 were added in
1986, 103 the following year, 189 in 1988, 251 in 1989,
and 575 in 1990,

The epidemiological authorities believe that the increase
in AIDS patients in Honduras is occurring at a rate of
more than 100 percent every year. Four hundred cases
have been confirmed in 1991 to date, but the definitive
total will only be available at the beginning of 1992.

LATIN AMERICA 41

Epidemiological assistant technician Cesar Antonio
Nunez stated that the work done since the first cases
surfaced has been intensive. However, the population
has still not become aware of the need to use condoms or
prophylactics, a practice which reduces the potential for
infection by 95 percent.

He noted that campaigns concerning AIDS have been
organized, and seminars and workshops have been held
to train the health personnel responsible for caring for
the patients.

And in conclusion, he urged the people of Honduras to
avoid sexual relations with multiple partners, and to use
condoms during intercourse.

ST. LUCIA

Majority of AIDS Cases Contracted
Heterosexually

FL2001220892 Bridgetown CANA in English
1945 GMT 20 Jan 92

[Text] Castries, St. Lucia, Jan 20, CANA—St. Lucia
health authorities reported on Monday that 72 persons
on the island had so far tested positive for the HIV virus,
which causes the deadly Acquired Immune Deficiency
Syndrome (AIDS).

Dr. Michele Ooms, director of the national AIDS pre-
vention and control programme, said the figures, com-
piled from 1985, included 34 deaths from the disease,
which kills by destroying the body’s immune system.

Males accounted for a higher percentage of both deaths
and persons carrying the HIV virus. Twenty-two males
had died from the disease, compared with 12 females.
Dr. Ooms said 74 percent of the confirmed HIV cases
had contracted the virus through heterosexual activity,
with the highest number in the 30-34 age group. Last
year 16 persons contracted the HIV virus, and six have
so far died, the figures showed.

Dr. Ooms said the AIDS action committee had agreed to
publish quarterly bulletins on the AIDS situation here.



JPRS-TEP-92-003
12 February 1992

percent laid to homosexual relations, 14 percent to
bisexual relations, and 13 percent to heterosexual rela-
tions.

According to Health Secretary David Capistrano, in
Santos AIDS is strongly associated with intravenous
drug use (responsible for 49 percent of the confirmed
cases). It is less predominant among males and is higher
among infants who contracted the virus from their
mothers.

A study financed by the University of California and
conducted by Fabio Caldas Mesquita among 100 drug
users in Santos shows that 57 percent of them were
infected through shared syringes. Currently, drug users
are primarily responsible for the spread of the disease.
The study shows that 54 percent of these individuals use
other people’s syringes and 65 percent of them habitually
offer their syringes to friends.

Poor Areas Affected

92WE0179C Sao Paulo O ESTADO DE SAO PAULO
in Portuguese 16 Dec 91 p 10

[Text] When night falls in Sao Jose do Rio Preto, groups
of young people on the fringes go out in search of a place
to take a “hit” [“baque”]. Armed with a needle, a
syringe, and cocaine, they look for a place where there is
enough light to discern a vein and water in which to
dissolve the drug. It could be in a shack illuminated by
candle light or underneath a lamp post. The water may
come from a spigot or even from a puddle.

Once the mixture is prepared, in a spoon or a bottle cap,
the drug is injected directly into the veins of the partic-
ipants of the “little get-together.” To dilute the solution,
they usually extract a little blood from their own veins.
The syringe, now called the “little bat” [““morceguinho”]
is then passed on to the next in line.

For four years, S.V.S., aged 26, a former domestic
worker, devoted her nights to the “hits” which she took
with friends, It was in one of these get-togethers that she
contracted the AIDS virus, which was detected eight
months ago. She has already spent three months interned
in the Santa Casa de Sao Jose do Rio Preto Hospital and
survives today with the support of volunteers from the
city’s welfare services.

Shared Syringes

“The drug consumption on the fringes of society is
preposterous,” said vendor Valdete da Silva Souza, a
resident of Vila Elmaz, known as one of the areas most
frequented by the drug traffickers in Sao Jose do Rio
Preto, After seeing his brother, who was addicted to
cocaine, die of AIDS, Valdete now devotes his leisure
time to helping AIDS patients. According to Valdete,
there are 12 people with AIDS in Vila Elmaz alone. “All
of them were infected by using shared syringes,” he said.

According to S.V.S., intravenous drug use and the shared
“little bat” are inseparable. “The drug is expensive and

LATIN AMERICA 39

in the group, one individual latches on to another's
‘scene’ when the depression comes,” she said. Under the
influence of the “hit,” the former domestic recounted, it
is impossible to think about the cleanliness of the needle
or the syringe. “You might think about it in the first
round, but after the drug takes effect no one cares any
more.”

In Marilia, cocaine trafficker J.B., aged 30, discovered
that he had AIDS at the beginning of the year. The
former soccer player says he does not believe he con-
tracted the disease in a “round of hits” [“roda de
baque”]. He prefers to say he was infected during inter-
course with a prostitute in the interior of Parana. He
does not, however, deny the risks of the “little bat.”
Today he is taking a mixture of herbs to attempt to cure
himself of tuberculosis and he only sniffs cocaine; he
does not inject it.

J.B.’s large clientele consists primarily of middle-class
youths in Marilia City. “I sell about 300 grams of cocaine
a week, at 8,000 cruzeiros a gram,” he said. With the
profits from his business, J.B. buys pieces of land in the
region.

DOMINICAN REPUBLIC

Hato Mayor Official on AIDS Epidemic, Control
Efforts

FL2012174291 Santo Domingo Cadena de Noticias
in Spanish 1600 GMT 20 Dec 91

[Text] Dr. Cesar Augusto del Pilar Mola Vasquez, dis-
trict attorney of Hato Mayor, has called the Public
Health secretariat to declare an emergency situation in
this town before a death holocaust results from the AIDS
virus, The district attorney of Hato Mayor reported that
more than 200 individuals are currently suffering from
the disease, while 10 others have died of AIDS over the
past two year, including two homosexuals. Dr. Cesar
Mola Vasquez said that the situation in Hato Mayor is
alarming due to the fact that in some homes, up to four
members of the same family are infected with AIDS.

The doctor added that he is willing to participate in a
medical campaign to identify and isolate all those
infected by the illness of the century, AIDS, in Hato
Mayor. He added that the situation becomes even more
alarming with the knowledge that most of the 200 young
men and women infected continue to have sexual rela-
tions despite their awareness that they are infected. The
doctor called upon the sincerity of the citizens of Hato
Mayor to disclose to the public any family member
infected with AIDS to avoid further spreading the dis-
ease. He also suggested that the local youth marry and
have pure relations as instructed by Christian laws. He
said that if the daily rate of infection continues, by the
year 2,000 there would be more than 10,000 people
infected with AIDS in Hato Mayor.



64 WEST EUROPE

apparent. He died in 1989, when he was just 18 years
old. For many years, his father, Juergen Gabbert, was the
president of the DHG, he is now an honorary member,
Gabbert is well informed: “Many doctors injected left-
over supplies to the very end.”

The AIDS virus was in these leftover supplies, and the
doctor’s injection brought death—even in 1986, five
years after alert scientists had pointed out the danger for
the first time. The chronology of the scandal can be
dated in each instance to the exact day—in Germany as
precisely as in France. But many of those involved act as
if everything were really a matter of opinion. But it can
be proved beyond any shadow of a doubt who made a
mistake when—or, more frequently, which doctors,
health authorities and drug producers negligently or even
knowingly accepted the death of the German hemophil-
iacs,

In 1982 the first reports of a new, life-threatening infec-
tious disease came from the United States. “Terror from
Across the Atlantic” was the title of the very first AIDS
report in German (DER SPIEGEL 22/1982). The “mys-
terious, not infrequently fatal disease” affected, it turned
out, primarily homosexuals, drug users, and hemophil-
iacs; the cause of the infection was in no doubt; the
illness was transmitted quite clearly by means of blood
or bodily fluids.

That made hemophiliac patients high-risk patients.
Because most of them were regularly injected with so-
called Factor VIII preparations, coagulant factors that
had been filtered out of the mixed (“pooled”) blood
protein of thousands of donors.

This treatment was extremely expensive (many hemo-
philiacs cost their AOK [General Health Insurance Plan]
1 million German marks [DM] a year), extremely prof-
itable for the Factor VIII manufacturers and very pop-
ular among hemophiliacs in spite of numerous side
effects: It removed the patients’ fear of fatal incidents of
hemorrhaging and gave them mobility, because their
joints were exempt from spontaneous hemorrhaging
during Factor therapy. A half dozen large “centers”
provided medical treatment to German hemophiliacs;
the largest one was in Bonn (800 patients).

The head doctor there, the hematologist Professor Hans
Egli, was regarded as the pope of hemophiliac therapists.
His practice was to give “high dosages” of coagulant
factors. Besides fame it also brought a great deal of
annoyance: Egli’s senior physician, Franz Etzel, accepted
almost DM2.5 million in bribes from the drug manufac-
turers; his punishment: 22 months in prison (on proba-
tion) and DM600,000 in fines.

No one among the experts was surprised that the very
first German AIDS death was a hemophiliac from Bonn,
a patient of Dr. Egli at the “Institute for Experimental
Hematology and Blood Transfusion.” The patient died
in the spring of 1982. He had been treated, like the other
patients, with high-dosage Factor VIII preparations,
made in the United States. There, often quite obscure

JPRS-TEP-92-003
12 February 1992

drug companies mixed the desired medications for the
German market. The blood often came from the poorest
of the poor in the south of the country, who were bled for
a few dollars.

The statement that “treating hemophiliacs with pooled
plasma concentrates” for these patients “represents a
particularly great risk of AIDS,” appeared at the begin-
ning of January 1983 in the respected U.S. medical
periodical NEW ENGLAND JOURNAL OF MEDI-
CINE. Anyone who wanted to hear, could hear: On 18
January 1983, Johanna L’age-Stehr, professor at the
Office of Health, gave her first warning lecture to the
Berlin Microbiological Society on the “new infectious
illness AIDS” and its risks, including those for hemo-
philiacs.

Two weeks after DER SPIEGEL had published its first
cover story on AIDS (23/1983) and an “Epidemic That
Is Just Beginning,” German hemophilia experts met with
virologists, drug manufacturers, and health bureaucrats
for a crisis conference, as befitted their position, in the
Airport Hotel at Frankfurt/Main.

Professor Luc Montagnier had come from Paris and
lectured on his discovery of the AIDS virus. On his
departure he gave the German professor of hygiene
Friedrich Deinhardt the AIDS virus culture in a refrig-
erated container as baggage to be carried to the United
States; there Deinhardt met Robert Gallo, who later also
sighted the virus, thanks to this assistance.

Why on this day at the latest, 18 June 1983, the alarm
bells did not go off among the assembled experts, why
the otherwise customary and proven legal epidemic and
drug measures were not set in motion, can only be
understood if the widely diverging interests of the par-
ticipants are considered.

The meeting was sponsored by the “Immuno” drug
company from Vienna, heavily involved in business with
the hemophiliacs. It was moderated by Professor Dein-
hardt from Munich, to whom any talk of infected blood
products was anathema, for he had after all just devel-
oped a new vaccine against the blood disease hepatitis.
Deinhardt claimed at the time through the authority of
his office (but without a shred of evidence), that at the
most 5 percent of those infected with AIDS would
become ill. The first Egli death, according to Deinhardt,
was “erroneously” described as an AIDS victim.

Among the participants were the heads of all the German
hemophiliac centers. In the best case, the imminent
catastrophe surpassed their powers of imagination; in
the worst case they were probably thinking more of their
business and not of their patients.

The Ministry of Health in Bonn remained idle. At the
time when a policy course should have been established,
it was being administered as a secondary office by the
secretary general of the CDU, Heiner Geissler. He was
interested in election strategy and the “New Poverty.”



SJPRS-TEP-92-003
12 February 1992

quarter of 1991. A statement from the ministry’s director
of health services, Dr. John Mbambo, says the five
already dead are amongst the 21 cases reported in the
country in the last quarter of 1991. The statement said:
As of 30 June 1991, there were 45 cases and 26 deaths;
and as of 30 September 1991, there were 71 cases and 21
deaths; and as of December 1991, there were 92 cases
and 34 deaths.

Dr. Mbambo said the main weapon of prevention and
controlling the HIV infection and AIDS is public health
education, and that will remain the strategy to combat
the transmission of this virus. He said the most effective
way to prevent transmission of the virus is to abstain
from sexual intercourse, or for the two unaffected part-
ners to remain faithful to one another, and the proper
use of condoms can also help reduce the risk of spreading
the virus.

UGANDA

Danish Agency Funding Health Projects in Rakai

92WE0112A Copenhagen BERLINGSKE TIDENDE
in Danish 22 Oct 91 p 6

[Article by Sten Jensen: “Christmas Calendar Helps in
AIDS-Devastated Area of Uganda”—first paragraph is
BERLINGSKE TIDENDE introduction]

[Text] The profit of the sale of the Children’s Developing
Nations Calendar will supply the province of Rakai in
Uganda with new schools. It is an area where adults die
of AIDS and their surviving children receive no formal
education.

Danish children will be getting their Christmas cheer
mixed with the tragic consequences of AIDS when DR
[Denmark’s Radio] TV in December launches this year’s
edition of the Children’s Developing Nations Calendar.
Profit from the sale of calendars will go to help children
in the province of Rakai in Uganda. The area is one of
the places in the world hardest hit by AIDS.

Rakai has 380,000 inhabitants and in certain areas over
50 percent of the adult population is HIV positive.
Illness and death, resulting from the population’s
destroyed immunity, are rising catastrophically.

Thousands of children have already lost their parents,
and even though the family, as is African custom, cares
for the orphans, it is an insurmountable burden. Because
the province of Rakai is among Africa’s poorest, very few
children go to school.

The intention is to use the Christmas calendar profit to
build 250 classrooms divided among 35 small schools at
the primary and secondary level and a couple of elemen-
tary technical schools where students can learn the basic
skills of a trade and be able to support themselves in the
small towns. The hope for the new schools is that all
children, not merely the orphaned, can receive instruc-
tion there.

SUB-SAHARAN AFRICA 9

In earlier years, the sale of Developing Nations Calen-
dars yielded a profit of five million kroner. A similar
profit this year could finance the projected schools.
“There are almost no schools in the area anymore, and it
is almost unimaginable what will happen there in the
years to come,” said Danida [Danish International
Development Authority] representative, Wagn Winkel,
who has visited Rakai.

Plans for 15-20 Years

A local committee, together with Ugandan Danida
employees, will decide where the schools will be built,
but it will be the Danish Church Relief organization
which will administer the funds from the Developing
Nations Calendar.

Danida plans to go into the area with projects worth up
to 50 million kroner over the next three years, and the
Danish Church Relief organization intends to go in with
20 million kroner. This includes support for road-
building and AIDS counseling, for which local pastors
will be trained.

Danida’s plans in the area extend over 15 to 20 years.
The goal is to stimulate increased production and
income in the hardest hit areas by means of aid for
development of local administration and support to the
area’s industry, health sector, and other infrastructures,
together with various kinds of AIDS education.

Wagn Winkel explained that as a result of the high death
rate in Rakai Danida must educate two workers for each
job.

Museveni Appeals for Acceptance of AIDS
Victims

EA0412075291 Kampala Radio Uganda Network
in English 0400 GMT 1 Dec 91

[Text] President Yoweri Museveni has appealed to all
the people of Uganda to learn to accept people with
AIDS in the same way as they accept people who are
suffering other ailments. In an address to the nation on
the eve of world AIDS day, which is being marked today,
Mr. Museveni told the people of Uganda that the way we
behave towards AIDS victims would determine those
victims’ response to society. He, therefore, cautioned
that ostracization of AIDS victims can only breed a
negative spirit among them and desire on their part for
revenge on society. He added that the humane treatment
of AIDS victims was of mutual benefit to everybody. To
this end, the president advised the people of Uganda to
care for people with AIDS as a community and as
individuals.

At this juncture, the president commended the efforts of
the people of (Kamucha) in Kampala for organizing
themselves in cells to support the sick materially and
spiritually, adding that this form of organization and
community service should be emulated in the country.



SJPRS-TEP-92-003
12 February 1992

AIDS, 32.2 percent of the AIDS victims are hetero-
sexual, and close to 25 percent have been involved in
intravenous drug abuse. We must pause to consider this
point.

One out of every four Moroccan AIDS cases involves
addicts who indulge in the so-called “hard” drugs. What
this shows is that the scourge of drug addiction is also
beginning to reach alarming proportions in our country.
Hence the need to act quickly and effectively to:stem it
while it is still (let us hope) embryonic, We could thus kill
two birds with one stone: by curbing an evil that
threatens to undermine every society, we also help
protect our own society against the spread of AIDS.

That being the case, the theory that AIDS was brought
here from abroad is no longer relevant.

AIDS has now become indigenous. That means the
danger is greater, and we must combat it from inside the
country.

The fact that nearly 60 percent of Morocco’s AIDS
victims (the figure last year was only 44 percent) con-
tracted the disease through sexual contact shows what
direction must be followed in waging an effective, well-
targeted prevention campaign.

Hence the need to break taboos and call things by their
real names. There is only one way to prevent HIV
contamination via sexual contact: the condom or pro-
phylactic, known pejoratively as the “English hood.”
Except for abstinence, there is no other way.

From another point of view, it is imperative that any
prevention campaign begin by attacking the disease at its
sources, Because we can no longer afford to ignore the
fact that AIDS is a scourge that unmasks others—such as
prostitution, homosexuality, and drug addiction.

And that is where any prevention campaign must begin.
NEPAL

AIDS Cases Increase as Prostitutes Return

92WE0174A Kathmandu THE MOTHERLAND
in English 2 Dec 91 pp 1, 4

[Article: “Three AIDS Victims Die, Four Facing Death”]

[Excerpt] AIDS viruses were found in 35 of the 40
thousand people whose blood sample was tested in
Nepal.

Of these ten men and fourteen women are Nepalis while
three women and eight men are foreigners.

Positive AIDS virus was also found in two other persons
whose identity could not be established.

Three out of seven persons who suffered from advanced
stage of AIDS have already died.

NEAR EAST & SOUTH ASIA 51

The remaining four others are facing impending death.
All four are Nepalis of whom two are at Teku Hospital
and two others are staying at their homes.

Information to this effect was given by chief of the AIDS
Prevention and Control Programme Dr. Bijaya Lal
Gurubacharya at the one day National Seminar On the
Role of Media on Prevention of AIDS and Its Control
held here yesterday under the joint auspices of the World
Health Organisation and the Ministry of Health, HMG
to mark the World AIDS Day.

At the seminar, National Planning Commission Member
Dr. Balgopal Vaidya disclosed that 30 percent of Nepali
women who returned from Bombay in India, 65 to 85
percent of those who returned from Bangkok and 50 to
60 percent of those women who returned from Singapore
have AIDS. They all indulged in prostitution.

Secretary in the Ministry of Health Mukunda Shamsher
Rana informed that ten different centres had been
opened for blood testing under management of hospitals
and eight others are run by Nepal Red Cross to detect
AIDS victims in the country. [Passages omitted]

PAKISTAN

Number of Individuals With AIDS Increasing
Steadily

92WE0166A Peshawar THE FRONTIER POST
in English 12 Nov 91 p 4

[Article: “AIDS Creeping Into Pakistan”]

[Excerpts] Islamabad (APP)—Since 1986, the cumula-
tive numbers of persons infected with HIV (the virus
causing AIDS) has risen from four to 102 now.

The National Institution of Health (NIH), which coor-
dinates the activities of the 19 AIDS centres in the
country has documented reports on more than 150,000
persons so far, and has found 102 persons as positive to
HIV (human immuno-deficiency virus).

A positive test means the person has been exposed to
HIV and will develop the full blown disease known as
AIDS (acquired immune deficiency syndrome).

In Pakistan 18 out of the total of 102 have progressed to
AIDS till now.

The affected persons comprise 72 percent Pakistanis and
28 percent foreigners, whereas the ratio of male and
female infection is 2.6 male to one female. [Passages
omitted]

The government is trying its level best to control HIV
infection in Pakistan, through the 20 AIDS centres
established under the National AIDS Programme.

All the centres, including the one at the NIH provide
voluntarily diagnosis of AIDS.



SJPRS-TEP-92-003
12 February 1992

accumulate must be “decelerated,” for example by
cyclosporin. Next, antiviral immunity should be stimu-
lated, after which the entire immune system may be
activated. Serotherapy by specific monoclonal anti-
bodies and immunoregulatory, immunosubstitutional
and symptomatic (against secondary infections) treat-
ment should be carried out at all clinical stages of
development of HIV infection, as a preventative means
and in response to medical indications [11,21,23,28].

Azidothymidine, suramin, ribavirin (virazole), cyclos-
porin A, interferon etc. are used in children for antiviral
treatment. Good results have been obtained with pre-
scription of azidothymidine at a dose of 20-30 mg per
kilogram body weight, daily four times a day by mouth
over a period of 4-6 weeks. Complications are possible:
headaches, arousal, nausea, vomiting, leukopenia and
anemia. Foskarnet [transliteration] (a reverse tran-
scriptase inhibitor), the antiviral drug ribavirin, the
immunodepressant cyclosporin A and others are less
effective [15].

Immunity is restored with timalin, T-aktivin, inter-
leykin-2 [transliterations], levamisole (dekaris [translit-
eration]), sodium nucleinate, indomethacin etc. [4].
Their therapeutic effect is higher when combined with
antiviral drugs. Leukocytic and recombinant interferon
possesses antiviral activity, and evokes regression of
Kaposi’s sarcoma associated with HIV infection, but it
does not improve the indicators of immune status in
children stricken with AIDS [11,15].

Various antibiotics and sulfanylamides are used to sup-
press the activity of conditionally pathogenic bacterial
flora complicating the course of HIV infection. When
protozoic flora are present, trimethoprim- sulfamethox-
azole, pyrimethamine-sulfamethoxazole, pentamidine
etc. are prescribed. Fungal complications are treated by
amphotericin B, nystatin and levorin. Asymptomatic
virus carriers suffering “HIV- associated” and AIDS-
indicating diseases must be subjected to clinical exami-
nation and treatment, infectious disease offices must be
organized in pediatric polyclinics, and legal protection
must be afforded to children infected with HIV and
stricken with AIDS, which in a number of countries is
still absent or violated [15].

It is very difficult to prevent HIV infection in children,
inasmuch as women in high risk groups must be tested
prior to the onset of pregnancy, which is practically
impossible to do, though extremely necessary. In Bul-
garia for example, all pregnant and newlywed women are
subjected to mandatory immunological testing [6]. All
HIV carriers are potential patients. Mortality associated
with AIDS is 40-60 percent, and as the time of observa-
tion of patients increases, it may exceed 90 percent.

The epidemic control measures associated with HIV
infection in pediatric medicine are the same as with viral
hepatitis B. They must be organized with regard for the
fact that children are usually infected in high risk fami-
lies (HIV carriers, drug addicts, homo- and bisexuals,

CENTRAL EURASIA 57

prostitutes etc.). Therefore an all-out struggle for a
healthy way of life must be the principal focus. Control
over dependable disinfection, presterilization and steril-
ization of needles and syringes, intravenous probes and
surgical instruments, together with use of the azopyram
test, has extremely important significance. The latter is
10 times superior in sensitivity to the amidopyrine and
benzidine tests in revealing trace quantities of blood on
medical instruments. The components of azopyram are:
amidopyrine—10 percent; hydrochloric aniline—
0.10-0.15 percent; 95 percent ethyl alcohol—up to 100
percent. Control over the use of disposable syringes is
necessary, because cases of their reuse are known. Hemo-
dialysis systems must be safe, and intravenous (catheter-
ization) and other invasive methods of treating children
must be maximally limited. To prevent transmission of
infection during breast feeding from the mother to the
child and for the first time from the child to the mother,
cessation of breast feeding should be recommended in
the event of HIV infection in the mother and the child as
an epidemic control measure.

Service personnel that come in contact with persons
undergoing testing, with virus carriers and with AIDS
patients, as well as with laboratory workers testing bio-
logical materials of such patients must be examined for
the presence of HIV antibodies once a year. Blood serum
from seropositive children should be subjected to special
laboratory testing not less than twice a year, while the
children themselves should be examined periodically
and kept under observation by infection specialists [15].

1. Girin, V. N. and Porokhnitskiy, V. G., “Chto my
znayem 0 SPIDe?” [What Do We Know About AIDS?],
Kiev, Zdorovya, 1988, 89 pp.

2. Ivanov, N. R. and Drankin, D. I, “SPID (izdaniye
vtoroye)” [AIDS (Second Edition)], Saratov, Izd-vo
Sarat. un-ta, 1989, 160 pp.

3. Kovalchuk, L. V. and Martirosova, N. 1, “The
Acquired Immune- Deficiency Syndrome in Children,”
VOPR. OKHRANY MATERINSTVA I DETSTVA, No
2, 1988, pp 55-88.

4. Kozhemyakin, L. A., Bondarenko, I. G. and Tyaptin,
A.A., “SPID: Posobiye dlya vrachey” [AIDS: Handbook
for Physicians], Leningrad, Znaniye RSFSR, 1990, 112
Pp.

5. Lalayants, I. E. and Milovanova, L. S., “Modern
Aspects of AIDS,” PEDIATRIYA, No 96, 1989, pp
96-101,

6. Pokrovskiy, V. I. and Pokrovskiy, V. V., “Sindromy
priobretennogo immunodefitsita” [Acquired Immune-
Deficiency Syndromes], Moscow, Meditsina, 1988, 43
Pp.

7, Rytik, P. G., Kolomiyets, A. G. and Kolomiyets, N.
D., “SPID” [AIDS], Minsk, Belarus, 1988, 126 pp.

8. Rakhmanova, A. G. and Chayka, N. A., “Sindrom
priobretennogo immunodefitsita (SPID) (rekomendatsii



IJPRS-TEP-92-003
12 February 1992

He challenged nurse educators to join in national efforts
aimed at making people more aware of dangers of AIDS
and preventive measures which should be taken.

It was important to do so because the HIV pandemic and
AIDS would continue to present a global challenge to
health workers in the next decade and beyond.

“T hope that by the close of this workshop you should be
able to participate in counselling of individuals with HIV
and AIDS including family members,

“You should participate actively in teaching of HIV/
AIDS related issues in the care of individuals with the
disease in conjunction with home-based care teams and.
other agencies,” Dr. Nyaywa said.

The opening ceremony was attended by World Health
Organisation (WHO) regional representative Dr. Wilfred
Boayue.

ZIMBABWE

AIDS, Other Disease Figures for Bulawayo

92WE0133A Harare THE HERALD in English
15 Oct 91 p1

[Text] Bulawayo—At least 125 people died of AIDS in
Bulawayo between April and June this year, according to
City Health authorities.

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

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

Out of the 125, 71 were males while 54 were females.
The highest number of AIDS-related deaths occurred

SUB-SAHARAN AFRICA 11

among children under the age of four, followed by the 20
to 29 age group. Ten of the dead were over 50 years old.

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

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

Masvingo Province Records 2,800 New Cases of
HIV

MB0612051691 Johannesburg SAPA in English
2107 GMT 5 Dec 91

[Text] Masvingo Dec 5 SAPA—Zimbabwe’s Masvingo
Province has this year recorded 2,800 new cases of HIV
virus infections, and by September 500 patients had
developed AIDS, the ZIANA News Agency reported on
Thursday.

Masvingo Provincial Medical Officer of Health Robert
Moy said 75 percent of those tested for HIV proved
Positive.

“This year 3,700 pople were tested and 75 percent were
positive. This is about 2,800 new cases this year. By the
end of the year we could have 700 new AIDS patients.”

Mr. Moy said 15 percent of the 500 AIDS victims were
children under the age of five, and the adults mainly in
the 20-40 age groups.

He said AIDS was the third major killer of children in
Masvingo province after pneumonia and malnutrition.

Last year the province recorded 650 cases of AIDS, and
in 1989, 500.

“These figures are not very accurate. The actual numbers
could be four times as high.”



SJPRS-TEP-92-003
12 February 1992 2 AIDS

SIERRA LEONE

AIDS Situation Said Not Alarming Freetown SLBS Radio, 21 Dec 91] ....
SOUTH AFRICA
AZT Reportedly Being Smuggled Into Country
[Dawn Barkhuizen; Johannesburg SUNDAY TIMES, 24 Nov 91] .....
Health Department Notes Increase in Pediatric AIDS Cases
[Johannesburg THE STAR, 9 Dec 91] .
New Process Found To Identify HIV-2 AI ‘irus

[Johannesburg South African Broadcasting Corporation Network, 17 Dec 91]
Health Department Releases AIDS Data for 1991 /Johannesburg SAPA, 14 Jan 92]

SWAZILAND

Health Ministry Official Gives AIDS Statistics /Mbabane Radio Swaziland Network, 22 Jan 92] .
UGANDA
Danish Agency Funding Health Projects in Rakai
[Sten Jensen; Copenhagen BERLINGSKE TIDENDE, 22 Oct 91] ..

Museveni Appeals for Acceptance of AIDS Victims
[Kampala Radio Uganda Network, 1 Dec 91]

ZAMBIA

AIDS Statistics Show Increase Trend (Lusaka TIMES OF ZAMBIA, 5 Oct 91]
AIDS Beginning To Have Economic Impact /Lusaka TIMES OF ZAMBIA, 15

ZIMBABWE

AIDS, Other Disease Figures for Bulawayo /THE HERALD, 15 Oct 91] il
Masvingo Province Records 2,800 New Cases of HIV (Johannesburg SA. i

CHINA

Forum Discusses AIDS Situation /Fan You; Beijing GUANGMING RIBAO, I Dec 91] ...
China Seen Alert and Active on World AIDS Day [Beijing CHINA DAILY, (National) 2 Dec 91]
AIDS Victims’ Health Conditions Improve [Beijing XINHUA, 3 Jan 92] ....

EAST ASIA
CAMBODIA
Health Official Calls for Anti-AIDS Campaign /Phnom Penh SPK, 8 Dec 91]
HONG KONG

Positive HIV Tests Reach ‘Record High’ in Nov
[Helen Signy; Hong Kong SOUTH CHINA MORNING POST, 28 Dec 91] ..

INDONESIA

Health Minister—2,500 Possibly Infected With AIDS
[Jakarta THE JAKARTA POST, 12 Dec 91]
SOUTH KOREA
Ministry Seeks To Deport Nigerian Testing AIDS Positive /Seoul YONHAP, 21 Dec 91]
Number of AIDS Cases Reaches 169 /Seoul THE KOREA HERALD, 1 Jan 92] .....

LAOS

0 00

Cy

AIDS-infected People, Anti-AIDS Activities Reported Vientiane KPL, 7 Dec 91] ..... 14
TAIWAN
Health Department Requires AIDS Tests for Engaged Couples /Taipei CNA, 6 Dec 91] ... 15



JPRS-TEP-92-003

32 LATIN AMERICA 12 February 1992
3.237
Increasing number of
women with AIDS
2.034 ;
261 | 339
1985 86 1°
Data for Sao Paulo State RTO SepteMber
5.665
The disease in Brazil
. 4.684,
3.233
1
1980 81 62 63 64 85 66 87 88 89 90 91°
Source: Epidemiological Vigi- : *k To ‘Au ust
lance ‘Center. Sao Paulo SUDS; Ministry of Heal
More Children Being Born With Virus
(Patients under 15 Years old, in percentages)*
Year Transmitted by mother Hemophiliacs Blood transfusion Other
1985 0.0 60.0 40.0 0.0
1986 0.0 30.0 60.0 10.0
1987 42.6 31.5 24.1 1.9
1988 63.9 4.1 22.7 9.3
1989 68.5 12.0 13.9 6.5
1990 15.6 98 98 8.7
1991"* 85.5 0.0 8.6 8.7

* Data for Sao Paulo State.

“* To September.



74 WEST EUROPE

That is the most effective way to undermine the confi-
dence in authorities among those infected.

When HIV was beginning to spread in Sweden, the
government wanted to act forcefully. A parliamentary
agency was appointed—the AIDS delegation—which is
now part of the government offices.

Such an agency can be appointed in times of crisis, but
for the sake of public debate, it should not become a
permanent one. The AIDS delegation is now effectively
preventing a parliamentary debate about personal integ-
rity in the AIDS care.

To include AIDS in the communicable disease statute
goes against medical ethics, prevents Sweden from
signing the European Council’s declaration about treat-
ment of HIV positive persons and counteracts the most
important thing in this connection: the motivation of
those infected to refrain from unsafe sex for the rest of
their lives.

In September, there were 1,438 HIV positive persons in
Stockholm. According to the communicable disease pro-
tection authorities’ report at the Medical Association
meeting, 102 persons are subject to prosecution for
breaking the rules. Nine persons have been subject to
involuntary isolation, five women and four men. One of
those men is the so-called HIV man, another one was
included because of rape, and the rest were included
because of sharing needles. The women were taken into
custody because of prostitution.

Among those now being scrutinized by the communi-
cable disease protection physician, are persons who are
not drug users but “have insufficient understanding of
the meaning of HIV infection. It is a question of persons
with intellectually limited capacities or with large cul-
tural differences.”

Irresponsibility is not due to HIV. Criminals should be
handled by the police, the mentally ill by psychiatrists,
and drug users by the agency specializing in treating drug
abusers. It should not be possible to isolate a person for
the rest of his life on the basis of rumors heard by a social
worker.

Thirty New HIV Cases Registered Each Month

92WE0143B Stockholm DAGENS NYHETER
in Swedish 1 Dec 91 p 6

[Article by Carin Stahlberg and Karen Soderberg: “‘Epi-
demic Has Only Just Begun”’]

[Excerpts] [passage omitted] On the last of September
this year, there were 2,890 persons registered as HIV
positive in Sweden and of those 617 had developed
AIDS. A number of activities are underway today on
AIDS Day International for those who want to show
their solidarity with those afflicted or who want to help
in the fight against AIDS. [passage omitted]

JPRS-TEP-92-003
12 February 1992

Volunteers Against AIDS

When economic problems shrink public and private
sectors, volunteerism, the idealistic sector, becomes
indispensable. Volunteers perform one-third of all the
work at the foundation Noah’s Ark-Red Cross.

During the week before AIDS Day International, on 1
December, volunteers are putting up posters. They are
on duty at the AIDS clinic and handle the reception.
They support those who are ill. They handle the night-
shift at the guest house. They inform and_ arrange
courses. They make coffee and serve it. Last year 330
volunteers were responsible for 24,000 work hours,
What would happen if the volunteers were not there?
The Ark would founder.

Consoles

For over thirty years, Anne-Marie De Geer has worked
as a hostess at the blood center, the emergency clinic, and
the central X-ray department at the Karolinska Hospital.

“As a Red Cross volunteer, I do everything the regular
personnel don’t have time for, I converse, console and
help to make things right,” says De Geer.

During an information session for Red Cross personnel
in the early 1980’s, she heard about a disease called
AIDS and its puzzling virus. A new institution was going
to be opened at the Maria policlinic and volunteers were
needed, [passage omitted]

Many Young People

Today about 500 of those who are HIV positive are
younger than 25 years of age. A 17-year-old girl, who just
received the news, is at the Ark. There is a young boy
who has only been together with two girls. One of them
gave him the virus. Every month about 30 new cases are
discovered in Sweden. In Africa south of the Sahara,
every fortieth person is HIV infected, men and women
alike.

Raymond Eriksson did volunteer work at the Danderyd
clinic, while he was studying to become a mental health
nurse.

“J met people who were HIV positive and especially one
patient whom I followed through his illness. When the
Danderyd hospital opened a department especially
focused on HIV, I applied there. The spirit of the Red
Cross is to. show humanity to others.” [passage omitted]

TURKEY
Army Takes Measures To Prevent Spread of
AIDS

92ES0284A Istanbul MILLIYET in Turkish 4 Dec 91.
pl4
{Text] It has been disclosed that the Turkish Armed

Forces has taken the most effective measure against
AIDS, which is described as the plague of our era.



20 EAST ASIA

AIDS virus. Of these, 22 have died, and 1,007 are still
alive. Of those with the disease, 483 are prostitutes, 17
are drug addicts, 400 are ordinary citizens, 19 are
students, 35 are prisoners, five are homosexuals, eight
are infants below the age of one, and 62 are housewives.

As for where these people are concentrated, during the
period 1988 to the present, 207 cases have been found in
Phrae District, 110 have been found in Sung Men
District, 59 have been found in Den Chai District, 76
have been found in Song District, 50 have been found in
Wang Chin District, 67 have been found in Long Dis-
trict, 86 have been found in Rong Kwang District, and
15 have been found in Nong Muang Chai District. That
makes a total of 670 AIDS victims who come from Phrae
Province.

“Preventing and controlling this serious disease is some-
thing new for the province. This is a major problem. We
must have the cooperation of both the public and private
sectors,” said Dr. Phuchong. He added that the Provin-
cial Public Health Office has ordered public health
officials to ensure that hair and nail clippers are clean
and to focus on providing information to the people
about the dangers of sexual promiscuity, the use of
condoms, and the dangers of using needles that have
been used by people with the virus.

Doctor Backs AIDS Vaccine Trial, Mayor
Opposes

92WE0149D Bangkok DAILY NEWS in Thai 8 Nov 91
p3

[Text] At the administrative office in Bangkok on 7
November Dr. Krasae Chanawong, the deputy public
health administrator for Bangkok said concerning the
proposal of the World Health Organization that an AIDS
vaccine be tested in Thailand that he felt that this would
help more than it hurt. Those who agreed and are ready
and are prepared to act are medical experts and scientists
who had to be very careful and make sure that no one
was compelled to take part. It had to be voluntary, and a
vaccine containing the AIDS virus would not be injected
a protein would be injected instead which would not be
dangerous. This vaccine had been used to a certain
extent already.

Dr. Krasae also said with regard to experiments with this
vaccine in Thailand that there would have to be an
agreement to allow experienced Thai scientists to partic-
ipate in the experimentation and that after the experi-
ment was completed we would have to be allowed to
produce and use the vaccine. There would probably not
be a problem with regard to the medical patents involved
or the purchasing of ideas.

The deputy administrator said with regard to the dis-
agreement of Major General Chamlong Simuang, the
mayor of Bangkok, with allowing Thailand to become a
guinea pig for this experiment that he was probably
speaking about basic principles while in actual practice

JPRS-TEP-92-003
12 February 1992

there were many details of various agreements to con-
sider which would be advantageous for Thailand. If there
were a discussion about this, Bangkok would be ready to
cooperate as much as it could.

Before this Major General Chamlong expressed the
opinion that he did not agree with conducting experi-
ments in Thailand because it would be like making Thai
people into guinea pigs for other countries which had
many people of their own with AIDS. He felt that it was
very risky to experiment with this vaccine on people.

Interior Ministry AIDS Effort, Budget

92WE0149E Bangkok BAN MUANG in Thai 8 Nov 91
pp 1, 20

{Excerpts] [passage omitted] At 1700 hours on 7
November 1991 at the Interior Ministry R.T. Benchakun
Makarathat, a deputy undersecretary of interior, spoke
with reporters after a meeting of the AIDS Control and
Prevention Committee. At the meeting Mr. Michai
Wirawaithaya, a minister in the Office of the Prime
Minister, gave a briefing about the AIDS situation.
R.T.Benchakun reported that in this meeting they were
intent on adopting an AIDS prevention and control plan
for all the officials affiliated with the Interior Ministry in
its 14 departments and seven government enterprises
both at the central administration and in the provinces.
[passage omitted]

R.T. Banchakun said that at present the AIDS situation
was very serious and the disease was spreading a great
deal. According to statistics there were about 200,000
people with the AIDS virus. If the situation were allowed
to proceed without any attempt at prevention or control,
the number of those with the virus would increase to 4
million in less than 10 years. [passage omitted]

He said that they would stress to the government offi-
cials and the people that they should stop their sexual
promiscuity and change their perception of the danger of
AIDS. There was laughter and smiles when he reported
that Thai men generally had more than one sex partner
and if those with two partners would drop to one and
those with three would drop to two, AIDS would be
reduced and finally ended. In addition to reducing the
number of their partners they should also increase
condom usage to 100 percent, which would take care of
the problem for sure. As for those with venereal disease
the state would have to give them special care.

He said that they would stress this program among those
of the people who were ignorant, poor and engaged in
heavy physical labor. Statistics indicated that many
children had the AIDS virus. If children were not pro-
tected, in 20 years Thailand would collapse because
everyone in the country would have AIDS. In addition
the struggle would include brothels. [passage omitted]
This AIDS prevention plan would include plans for the
ministry level, the departmental level, government enter-
prises and the provincial level. More than 400 radio
stations would be included as well as television stations,



Epidemiology
AIDS

JPRS-TEP-92-003 CONTENTS 12 February 1992

[This EPIDEMIOLOGY report contains only material on AIDS. Other epidemiology topics are covered in a later
issue.]

SUB-SAHARAN AFRICA
ANGOLA
Health Official Notes Steady Increase in AIDS Cases
[Luanda Radio Nacional Network, 2 Dec 91] ......
BENIN

HIV Positive Figures Call For Urgent Action
[Ferdinand Houehou; Cotonou LA NATION, 13 Nov 91] ...

BURKINA

Committee To Fight AIDS Formed
[Ouagadougou Radiodiffusion Nationale du Burkina Radio, 14 Dec 91] ....
BURUNDI
Neurological Disturbances in AIDS (Based on Data from the Republic of Burundi)
[V. V. Andreyeva and A. E. Andreyev; VRACHEBNOYE DELO, No 6, Jun 91] ....
DJIBOUTI
Increase in HIV Positive Cases ‘Disturbing’
[Aramis Houmed Soule; Djibouti LA NATION DE DJIBOUTI, 3 Oct 91]...
ETHIOPIA

Estimates of 4,000 AIDS Cases in Country [Addis Ababa Voice of Ethiopia, 2 Dec 91]
GHANA

Daily Examines Women Dying of AIDS in Ivory Coast
[Accra Ghana Broadcasting Corporation Radio Network, 15 Dec 91] ....

GUINEA
Official Gives AIDS Figures
[Conakry Radiodiffusion Nationale de la Republique de Guinee, 4 Jan 92]
MADAGASCAR
Only 25 HIV Positive Cases; Threat Remains
[Antananarivo MADAGASCAR TRIBUNE, 18 Nov 91]
MAURITIUS
Cost of AIDS Action Plan Estimated Port Louis LE MAURICIEN, 14 Nov 91]
Nineteen HIV Positive Cases {Port Louis WEEK-END, 1 Dec 91] ...
MOZAMBIQUE
Official Reports 63 AIDS Cases in Manica Province
[Maputo Radio Mozambique Network, 4 Dec 91] ...
NAMIBIA

President Nujoma Underlines AIDS Danger (Windhoek THE NAMIBIAN, 27 Nov 91) ...

aa



44 NEAR EAST & SOUTH ASIA

She says transfusion of infected blood will pass on HIV
in nine of 10 cases. If a pregnant woman is infected, it
will be passed on to the child in the womb in up to two
in five cases. Sexual intercourse has the lowest risk: the
transmission rate ranges from one in every 100 to one in
every 1,000. And yet, three in four of AIDS-infected
Indians have got it through sexual intercourse. One in 10
got it through the infected mother and only one in 20
through infected blood.

Interestingly, she added, receptive partners in sexual
intercourse are more likely to get infected than incertive
partners. A “heartening” factor: correct use of condoms
minimise the chances of getting AIDS, she said.

Prof. Sehgal said it was believed prostitutes are the
biggest spreaders of AIDS. However, studies now show
the promiscuous male, who visits a prostitute, gets
infected and then gives it to the wife, who in turn gives
it to the baby, is a greater hazard.

Earlier in the day, the city’s Lt-governor, Mr. Markandey
Singh, inaugurated the symposium. He said such confer-
ences provide excellent opportunities to discuss causes
and what to do.

Spread in Gujarat
92WE0165B Bombay THE TIMES OF INDIA
in English 20 Nov 91 p 11

[Text] Ahmedabad, 19 November: AIDS seems to be
spreading menacingly in the state, with the number of
persons carrying the human immuno-deficiency virus
(HIV) having gone up from 90 in July last year to 715,
including eight children, till this month, as per data
available at the surveillance centre in F.J. Medical Col-
lege here.

Of the 715 HIV carriers in the state, 455 belonging to
Surat (all professional blood donors who are a floating
population), three each from Bulsar, Baroda, Jamnagar
and Rajkot, two from Nadiad and one each from Meh-
sana, Godhra and Bhavnagar.

Ahmedabad has 233 carriers of the AIDS virus and of
these eight are children, aged between three and 11. All
of them are patients of thalassaemia, requiring repeated
blood transfusion. Most of the other HIV carriers in the
city are professional blood donors.

The cases of all the eight children were detected by the
Indian Red Cross Society, Paldi Branch, which was the
first among the voluntary organisations in the state to
screen blood samples for detecting HIV infection.

Each of the children had received at least 30 bottles of
blood from professional blood donors in private labora-
tories before their samples were screened by the society.

Undergoing treatment for thalassaemia they had
received 80 bottles of blood from professional donors

IJPRS-TEP-92-003
12 February 1992

and died last year. A private laboratory in Lal Darwaja
found at least 12 of its professional blood donors were
HIV-infected.

According to Dr. H.S. Shah, superintendent of the V.S.
Hospital, so far 2,000 blood samples have been screened
and 27 people were found to be carriers of HIV infection.

The state health department confirmed that 689 people,
whose blood samples were screened at the surveillance
centres in Ahmedabad, Surat and Baroda, were carriers
of HIV. More than 70,000 blood samples have been
screened in the state.

Among carriers of HIV infection, Gujarat and West
Bengal, rank fourth in the country, after Maharashtra,
Delhi and Tamil Nadu.

Records of the Indian Red Cross Society and other
voluntary blood banks in the state indicate that more
than 160,000 bottles of blood are collected every year by
these agencies.

Besides these voluntary agencies, there are as many as
255 private pathologists in various parts of the state who
also collect more than 75,000 bottles of blood from
professional blood donors.

The Indian Council of Medical Research (ICMR) has
issued a circular with the slogan, “One blood sample, one
screening test.”

In order to prevent the transmission of HIV infection,
the circular states samples of the blood donor should be
screened by Elisa Test. If tests prove positive, the bottle
should be immediately discarded.

The ICMR officials fear that what has been detected in
Gujarat might be just the tip of the ice berg and the
actual number might be much more. Though a present
Gujarat has no AIDS patient they fear that by 1997,
more than 60 percent of the persons found to be carrying
AIDS virus will become full-fledged patients of the
disease.

In a bid to break the virus between professional blood
donors and private laboratories and for detecting HIV
infected cases, the state government has worked out an
AIDS control programme following a directive from the
Centre.

According to Dr. M.H. Patel, deputy director (epi-
demic), of the health department, the government has
decided to make it mandatory for the blood banks to
obtain a licence, this will enable the government to
identify those blood banks which are not following the
guidelines for screening blood samples.

He said an AIDS cell was being set up besides opening
blood screening centres in Baroda and Surat. The gov-
ernment proposes to set up such centres at Rajkot,
Bhavnagar, Bhuj, Nadiad, Mehsana, Palanpur, Broach,
Bulsar, Godhra, Surendranagar and Himatnagar.



28 EAST ASIA

But the government-run Sirirat Hosptial admitted in
July that it had been performing abortions for infected
women.

The government is drafting legislation to allow legal
abortions for HIV-infected women, despite strong oppo-
sition from pro-life activists. The activists quoted inter-
national specialists as saying that 70 percent of children
born to an HIV-infected woman do not develop the fatal
disease.

Wirat said the provincial hospital also encouraged par-
ents to take care of their own infected children if the
babies had not developed AIDS.

“The families will be much more warm,” the doctor said.

The Bangkok-based Children’s Hosptial said on
Thursday that it had been taking care of more than 40
AIDS infected children left behind by their parents.

The hosptial director, Dr. Chumphol Wongprathip, said
the hospital was facing a serious problem finding enough
funds to provide adequate medical care for the infected
children who needed expensive drugs.

The Public Health Ministry announced last month that
about 33,800 people have tested HIV-positive but med-
ical experts believe the real number might be about
500,000.

Anti-AIDS activists ahve expressed concern that the
number of HIV carriers will swell to 2-4 million by the
year 2000 if the government does nothing to contain the
spread.

PM’s Office Minister Michai Wirawaithaya has called
for the closure of all sex businesses in the country, citing
them as the main cause of the spread of AIDS.

New Office Established To Oversee Anti-AIDS
Policy

BK2812023091 Bangkok BANGKOK POST in English
28 Dec 91 p2

[Text] The National AIDS Policy Committee yesterday
approved a proposal to establish a permanent body to
coordinate the implementation of the anti-AIDS policy
among different government agencies.

The Office for Coordinating the Plan and Policy on
AIDS will be placed under the Office of the Prime
Minister, according to the PM’s Office Minister, Michai
Wirawaithaya.

The permanent secretary and a deputy permanent secre-
tary for the Public Health Ministry and representatives
from other ministries concerned will serve on the admin-
istrative body of the office, he said.

Mr. Michai said the committee should also set up a
subcommittee on the protection of citizens’ rights from
unapproved AIDS tests. The subcommittee will draft
guidelines on blood tests.

IPRS-TEP-92-003
12 February 1992

Any blood tests on AIDS conducted as a condition for
employment or admission to education institutions or
hospitals violate citizen’s rights, Mr. Michai said.

Such blood tests could be conducted only in a special
case, he added.

Total of 180 People With AIDS Admitted to
Northern Hospital

BK0501012092 Bangkok BANGKOK POST in English
4Jan 92 p3

[Text] A total of 180 patients with full-blown AIDS have
already been admitted to the Maharat Hospital in
Chiang Mai for treatment and the number is increasing,
according to Dr. Wichan Witayasai.

The THAI NEWS AGENCY quoted Dr. Wichan, who
works at the hospital, as saying that he believes the
number of full-blown AIDS cases throughout the country
might be 500.

This figure, he noted, differs from that of the Ministry of
Public Health which gave a comparatively smaller figure
because new cases might not have been reported to the
ministry or some agencies might not know who is
responsible for filing reports.

He also pointed out that some private hospitals might be
reluctant to file reports to the ministry of their AIDS
cases for fear their business might be affected if such
news leaked out to the public through the press.

VIETNAM

Blood Tests Show 1 Vietnamese, 49 Thai HIV
Carriers

BKO0512100191 Hanoi Voice of Vietnam Network
in Vietnamese 0015 GMT 1 Dec 91

[Article by Tieu Lien in “International Topic” program,
reviewing AIDS in the world and international cooper-
ation in Vietnam in anti-AIDS work]

[Summary] “Today, the entire world is worrying about
AIDS because of its great danger and no cure for it. AIDS
is occurring in every continent and spreading quickly.

“According to WHO, as of October this year, 163
countries discovered AIDS carriers in their countries.
WHO also predicted that by the year 2000, there will be
40 million people affected by the HIV virus, including 10
million children, and there will be between five to 10
million AIDS deaths a year.

“In the 90s, AIDS may kill four percent of the popula-
tion of San Francisco, three percent of New York popu-
lation, and 15 percent of the population of East Africa
and Central Africa. AIDS is a terrible threat to mankind.
Many AIDS specialists even call it ’the challenge of the
century.“



JPRS-TEP-92-003
12 February 1992

LATIN AMERICA 37

(2)

‘Na Estrada de Ferro Noroeste do
Brasil passa o “Trem da Morte”,
que vai de Bauru a Corumba

Key:
1. The Path of the Epidemic

A Aids se espalha pelo Estado por rodovias e ferrovias

Santos é onde ha o maior
ndmero proporcional de
casos de Aids no Pais

(4)

2, AIDS Spreads Through State Via Highway and Railway
3. On Brazil’s Northwest Railway, the “Death Train” travels from Bauru to Corumba.
4, Santos has the largest proportion of AIDS cases to population in the country.

field for drugs because of the large supply and the ease
with which they may be obtained. What is also pushing
young people into drug consumption, according to
Corazza, is the boredom of the life in the interior, as well
as the fact that the larger cities are receiving a continuous
stream of students from various regions in the state.
“The young people have more opportunity to engage in
these transgressions,” the delegate believes.

With the road opened by the first drug traffickers, AIDS
followed when the conventional way of ingesting cocaine
was no longer producing enough of a “high” for the
users, who were always eager for new experiences. “The
problem is that the drug has already reached the poorest
Population, which is not only using cocaine but has
begun to traffic in it,” explained Dr. Maria.

According to the physician, who treats AIDS patients at
the Base Hospital of Sao Jose do Rio Preto, the basic
profile of the AIDS carrier treated in this region is that of
a male between 15 and 20 years of age. Such individuals,
he said, have not only been infected through intravenous
drug use but are also involved in drug distribution.

Ranked Third

The Epidemiological Vigilance Department of the
Regional Health Office (Ersa-57) of Sao Jose do Rio
preto (which has about 500,000 inhabitants and has the
third largest number of AIDS carriers in the state, with
1,770 reported cases as of October) estimates that 48
Percent of the cases were the result of infection through
shared syringes.



IJPRS-TEP-92-003
12 February 1992

of their medical background, tend to have a better
understanding of the significance of a medical experi-
ment,” he said.

The doctor added that WHO has been eyeing about ten
vaccines as possible candidates for the test. Only one,
however, will be chosen.

The list includes GP160, a US-manufactured AIDS
vaccine that has shown promising results in an earlier
trial experiment in the United States. The same vaccine
is expected to be used in another less publicized experi-
ment now being worked out between the Royal Thai
Army and the US Army.

With a relatively high rate of HIV infection in its rank
and file (especially in the Third Army in the North), the
Army gave an unofficial nod to the US Army earlier this
year when it was approached for the project. US officials
admitted that the idea was to get the Thai Army to okay
the project first before seeking civilian government
approval.

The idea worked. The Armed Forces Research Institute
of Medicine (AFRIM) office, a Thai-US Army joint
venture assigned by the Thai army to handle the project,
said it is polishing the protocol for the project. The
protocol, to be finished within a few weeks, will later be
submitted to the government for approval. An AFRIM
official said if things proceed well, the actual test could
begin as early as February next year.

The AFRIM plan calls for 30-50 volunteers to be
injected periodically with the GP160 vaccine. The vac-
cine, manufactured by the Microgene Sys. Co., of the
United States, has already been tested on US Army
members by the US Army’s Walter Reed Institute.

Test results, which indicated the vaccine to have both
the ability to halt and to prevent the spread of the virus,
have established the GP160 vaccine as one of the most
promising AIDS vaccines.

“The test aims to see whether the vaccine would have the
same effectiveness with Thai people as it had in the
United States. If results are satisfactory, it would con-
tribute greatly to the finding of a preventive vaccine for
the AIDS disease and maybe a cure for it as well,” said
one source close to the project.

Sources said the US Army is preparing a US$1 million
package, including sophisticated equipment needed for
this type of experiment. The package, they said, would be
for Thailand to keep for later use.

But, no matter what benefits may come as a result, both
WHO and AFRIM officials said they will proceed care-
fully, trying to avoid creating any public resistance to
their programme which could make it difficult to con-
duct the test.

“The test will be entirely on a voluntary basis,” said one
WHO official.‘ That is one of the main points the WHO
programme follows in all the countries we have selected.

EAST ASIA 23

There would be absolutely no force used or human
guinea pigs involved,” he said.

The same attitude applied to AFRIM, who immediately
sought project acknowledgement from senior govern-
ment officials after WHO broke the news about choosing
Thailand for the AIDS vaccine test.

“We first thought to present our project through Defence
Ministry channels. We thought that with senior govern-
ment officials in on this it would be better,” said one
Thai Army source who did not want to be named.

To lessen resistance even more, AFRIM, like WHO,
plans to select medical personnel (including AFRIM
staff and possibility staff of the King Mongkut Hospital)
as their first test recipients. Next in line would be
civilians and Army personnel who had tested HIV pos-
itive at King Mongkut Hospital, but only if they decide
to volunteer for the programme.

Sources added, however, that aside from full medical
attention before and after the test, no financial remuner-
ation would be given.

“It’s standard procedure. If we ever did such a thing, it
would immediately give rise to the ‘guinea pig’ contro-
versy,” one source said.

But despite their legitimate worries, both organizations
might be overreacting to the Thai public’s response,
which for the most part has been light and surprisingly
supportive.

Said Dr. Wirasit Sittitrai from the Thai Red Cross AIDS
Programme: “We know that the WHO is now working
on setting a standard for an anti-AIDS vaccine testing
programme that would be used for tests conducted in
other member countries. I think the Thai government
should take the standard of the WHO as a guideline
before making any decision. But it should also set up its
own standard vaccine testing in the country, especially
an anti-AIDS vaccine programme.”

To avoid the guinea pig issue, Dr. Wirasit added that the
people chosen for the programme must be told in
advance everything possible about the vaccine including
its potential side effects.

“The most important thing is that vaccinees be volun-
teers. No one should be forced to accept the test, either
by misinformation or coercion under the military
system. The vaccinees must be told all about the vaccine
being tested, and that to have been vaccinated does not
mean that they are now "safe and cannot be infected
with the HIV virus,” said Wirasit.

Wirasit emphasized that the government must disclose
all information about the deadly virus and the vaccine
trial programme to the general public.

NGO representatives express a similar view. Most have
called for the WHO and the Army to open up the
programme to public examination and to provide a clear

a



SJPRS-TEP-92-003
12 February 1992

government for its tremendous assistance and contribu-
tion towards the AIDS program in the country. [passage
omitted]

SOUTH AFRICA

AZT Reportedly Being Smuggled Into Country

92WE0175A Johannesburg SUNDAY TIMES
in English 24 Nov 91 p 15

[Article by Dawn Barkhuizen: “Mercy Smugglers Fly in
AIDS Drug”)

[Text] The life-prolonging AIDS drug, Azido Thymidine
(AZT), is being smuggled into South Africa and distrib-
uted to AIDS sufferers who cannot afford sky-high local
prices.

The cost of the Schedule 4 drug—between R440 and
R800 for 100 tablets—have put AZT out of the reach of
many HIV-infected South Africans.

One of the recipients of the black-market supply was a
Brakpan businessman, Mr. Barry McGeary, who died in
September.

A friend bought AZT for him in Germany and brought it
in on an overseas flight, Mr. McGeary’s former lover,
Mr. Johan van Vuuren said.

Network

“Had Barry not been able to get AZT this way, he would
never have been able to afford it. He had to take six
tablets a day. Some months this bill for AZT alone was
R1,000.”

The Sunday Times was told this week that a loose
underground network of AZT users had been operating
for at least three years.

During that period the death rate from AIDS dropped
from 95 in 1989 to 74 in 1990, and 51 to date this year.

Experts say the drug has proved effective in prolonging
the lives of people with full-blown AIDS and delaying
the onset of full-blown AIDS in HIV-positive patients.

The contraband drugs are supplied at a nominal cost or
free of charge to South Africans, on a strictly “need-
to-know” basis.

“There’s no syndicate involved. The system is based on
sympathy rather than financial gain,” a source said.

“People bring AZT in from Britain, where you get it free
through the National Health Service, or from Europe
and America where it is readily available and cheap.”

But he warned against unscrupulous operators.

“T believe fake AZT is finding its way into South Africa
and people could end up with capsules of talcum
powder.”

SUB-SAHARAN AFRICA 7

Powder

Doctors consulted by the Sunday Times said the number
of AIDS-related deaths reported in South Africa had
dropped since the advent of AZT in November 1987.

Dr. Stephen Miller, head of the HIV clinic at the
Johannesburg Hospital said no AZT was being adminis-
tered to patients.

“We have more than 1,000 people on our books and,
because the government refuses to subsidise AZT and
medical-aid societies limit payouts for medication, it is
beyond their reach.”

Dr. Ruben Sher, head of the AIDS Centre at the SA
Institute of Medical Research, said: “Ideally, AZT
should be given to all people infected with the virus.

Dr. Manda Homeshaw, head of the Department of
Health’s AIDS Unit, said the drop in the death rate had
“nothing to do with AZT”. It was a “normal blip typical
of any epidemic”.

Health Department Notes Increase in Pediatric
AIDS Cases
MBO0912170991 Johannesburg THE STAR in English
9 Dec 91 p7

(Unattributed report: “Number of AIDS cases in SA
[South Africa] triples in one year”]

[Text] The number of full-blown AIDS cases in South
Africa has tripled in the past year and the number of
children who are diagnosed with AIDS as a result of
mother-to-child transmission is increasing steadily,
according to the Department of National Health.

Statistics released by the department last week revealed
that the number of South Africans with AIDS had risen
to 969 by November 21. Heterosexual contact accounted
for most—65 percent—of the newly diagnosed cases.

The largest hospital on the Reef, Baragwanath Hospital,
says the number of children with AIDS contracted from
their mothers has increased.

According to an obstetrician at the hospital, Dr. James
McIntyre, the incidence of pregnant mothers with AIDS
has increased from 0.8 percent to about 2 percent in a
year, therefore the case of mother-to-child transmission
would have increased accordingly. However, it was dif-
ficult to monitor the phenomenon of mother-to-child
transmission of AIDS because the virus could only be
detected 15 months after birth and by that time the
hospital no longer had contact with the child, he said.

The Department of Health said that 20 percent of newly
diagnosed AIDS cases in 1991 were children. Barag-
wanath and the Johannesburg Hospital have launched
research projects to monitor cases of paediatric AIDS.

Hillbrow Hospital does not treat child AIDS victims, but
reported 44 new adult AIDS cases in November. Deputy



IJPRS-TEP-92-003
12 February 1992

AUSTRIA

Experts Criticize AIDS Policy; 696 AIDS Cases
To Date

AU2201153492 Vienna WIENER ZEITUNG

in German 22 Jan 92 p7

[Unattributed report: “‘AIDS Prevention Imperfect and
Unsystematic””]

[Text] Austria’s AIDS policy is not properly organized,
support for AIDS patients is deficient, and health
workers and trainees are not thoroughly informed. This
is the criticism of seven Austrian experts in a study on
Austria’s AIDS policy. The experts have come to the
conclusion that AIDS prevention and further training
must be comprehensively reorganized.

The project was financed by the medical-scientific fund
of the mayor of Vienna. It involved experts of the
Regional Scientific Documentation Center, the Vienna
University Institute for Social Medicine, the Ludwig-
Boltzman Research Institute for hospital organization,
Department 17 of Vienna’s municipal authorities, and
the Harvard School of Public Health.

By 16 January 1992, a total of 696 people had contracted
AIDS in Austria, 386 of whom have so far died.
According to calculations by the experts, the number of
AIDS cases (including those who contracted the disease
and those who died) will be above 1,000. As early as
1996, there will be more than 1,000 AIDS patients in
Austria. Said Dr. Gerald Haidinger of Vienna Univer-
sity’s Institute for Social Medicine: “When people now
speak of an ‘explosion’ of the number of HIV infections
among the heterosexual population I call that panic-
mongering. From the very beginning HIV infections
spread among other groups of society than the homo and
bisexuals.” Between 1982 and 1989, for example, 115 of
those who were HIV positive were hemophiliac patients.

The authors of the study particularly criticized the
practice of HIV tests in Vienna hospitals. Because of the
low percentage of infected people it is not necessary to
test all hospital patients. That practice means that the
patients lose their right to “‘be treated as if they were HIV
negative even though they are possibly HIV positive.”
The authors emphasize that nobody must be directly or
indirectly forced to undergo such a test.

Despite all worries, AIDS will not constitute an excessive
burden for Austria’s hospital system: in 1989 the average
1,3 million schillings spent on the treatment of each
patient only accounted for less than 0.1 percent of
overall hospital expenses. No significant changes are
expected, the authors noted.

According to the paper, hospital staff are not offered
sufficient opportunities for further training related to

WEST EUROPE 59

AIDS. Moreover, any such activities are “not system-
atic.” Out of 15 institutions that offer treatment, most of
which are hospitals, only four stated that their staff had
special training.

In most cases the patients have no access to additional
opportunities for advice.

A survey carried out by the authors in the various
Austrian provinces also highlighted deficiencies. The
authorities in Styria stated that AIDS policy was a
matter for the “federal level.” In Burgenland, for
example, HIV testing is not anonymous, nor has access
to narcotics substitutes been changed or made easier. In
Carinthia, Upper Austria, and Burgenland sterile
syringes are unavailable to intravenous drug addicts.

The authors criticize the fact that up to 1991 as far as
AIDS policy is concerned all responsible sides relied too
much on the Aidshilfe organization, which went bank-
tupt in 1991. This organization was not qualified to
carry out the general information campaigns.

Information activities were only carried out “half-
heartedly,” both in schools and in the federal army. Here
the authors found fault with the “restrictive policy”
pursued by the Education Ministry. Moreover, there was
no intensive accompanying evaluation of the informa-
tion campaign.

The experts give the following advice: “It appears to be
essential to carry out a comprehensive reorganization of
all measures related to health policy in the area of AIDS
prevention and further training. This applies to forming
political opinion and defining political objectives as well
as for the requirements related to organization, staffing,
and financing.”

DENMARK

Minister Approves AIDS Vaccine Funding

92WE0111B Copenhagen BERLINGSKE TIDENDE
in Danish 26 Oct 91 p 5

[Unattributed article: “New Hope for AIDS Vaccine]

[Text] A research team at Hvidovre Hospital is hoping a
year-and-a-half from now to be able to test an AIDS
vaccine on Danish HIV and AIDS-infected individuals,
writes DET FRI ACTUELT. Health Minister Ester
Larsen (Liberal) has guaranteed Hvivovre Hospital the
approximately five million kroner that is necessary to
insure continuation of the research and the startup of
testing in Denmark. If successful, the vaccine will be able
to prevent the AIDS virus from multiplying in the body.



IJPRS-TEP-92-003
12 February 1992

Professor Melahat Okuyan, a member of the Supreme
AIDS Council, said in a statement during a “panel
discussion on AIDS” that barbers are no longer allowed
to shave soldiers in barracks. She added: “I would like to
congratulate those who took that decision.” Professor
Okuyan continued: “The blood is the principal vehicle of
AIDS transmission. A facial shave performed with tools
that are not properly disinfected may result in the
disease being transmitted to someone else. In view of
that, the measure that has been taken in the Turkish
Armed Forces deserves every praise. That action should
serve as an example to society in general.”

Officials of the Office of the Chief of the General Staff
confirmed the reports on the ban on shaving and said:

“No memorandum has been issued on this matter. All
units and subunits have begun to implement this mea-
sure in their own organizations as a precautionary step.
The decision was made by local units and regimental
commanders. In other words, the administrations of the
barracks have banned barbers from offering shaves at
their own initiative. The same has happened in the
military units.”

Alert in Istanbul

In a panel discussion organized in Izmir, Professor
Okuyan said that Istanbul has become a “high-risk
province” on the issue of AIDS. She said:

“Istanbul is a city which attracts people from all corners
of the world and where foreign prostitutes are multi-
plying. Consequently, the status of Istanbul is not very
encouraging. If very fundamental and systematic educa-
tional work is not carried out and the public is not
warned, and if the activities of prostitutes formerly from
the Eastern Bloc are not reined in, an AIDS epidemic can
be expected in Istanbul at any time.”

WEST EUROPE 15

Also speaking at the meeting, Professor Gazanfer
Aksakaloglu noted that the condom is an important
precautionary measure against AIDS and claimed that

condoms issued by the Ministry of Health are
“unhealthy.” He said:

“The best means of preventing AIDS is fidelity among
couples. However, that is nothing more than wishful
thinking, and the disease continues to spread rapidly
around the world. That leaves no option other than
emphasizing medical and hygienic measures.”

Professor Necla Cevik, a member of the faculty of 9
September University, reiterated the view that a major
AIDS epidemic may erupt in Istanbul. Professor Cevik
said: “Disco kids run the highest risk of exposure to
AIDS.”

No Worries in East

Professor Sedat Ariturk, the president of Tigris Univer-
sity, spoke to Namik Durukan of MILLIYET’s
Diyarbakir bureau about the status of AIDS in eastern
and southeastern Anatolia. He said: “The region has
many economic problems but we are fortunate in terms
of AIDS.”

Pointing out that not a single case of AIDS has been
observed in eastern and southeastern Anatolia, Professor
Ariturk said:

“The people of the region are strongly bound to their
religious beliefs and traditions. As a result, AIDS, which
is known to be associated with certain immoral activi-
ties, has not come to this region; it cannot find any
sanctuary for itself here. Indeed many diseases of civili-
zation cannot enter these regions. AIDS has entered
Turkey through population movements from outside.
Large Turkish cities that are subject to big influxes of
foreigners run a high risk of exposure to AIDS.”


JPRS-TEP-92-003
12 February 1992

The Rajkot and Jamnagar medical colleges will also have
blood screening laboratories.

Dr. Patel said the government would also launch a
programme to educate the people about AIDS.

Better AIDS Treatment Urged, Bogus Treatment
Scored

92WE0211A Bombay THE TIMES OF INDIA
in English 1, 2 Dec 91

[Article by Bachi J. Karkaria: “Bogus Experts Prey on
Scourge”]

[1 Dec 91, pp 1, 26]

[Text] Bombay, Nov 30—When the human immunode-
ficiency virus (HIV) began wreaking havoc in Bombay’s
red light area three years ago, prostitutes feared it would
become yet another weapon of police and goonda harass-
ment. Now, as Indian AIDS gets increasingly on the
international agenda, it is doctors, social workers and
politicians who are being accused of exploitation, getting
“money, fame and foreign trips out of our misery.” The
sex workers now divide activists into mehanat karne
walle and malaai-khaane walle, those who care and those
who simply cream off.

The long line of “Skin and VD” clinics on Falkland
Road is interrupted only by dentists, desi daru speak-
easies and Delhi Durbar’s “Family Rooms with Ladies.”
But only one out of three is manned by a qualified
medical practitioner. The others have simply painted on
ared cross and degrees like “BSAM (Bom)” or “BUMS”;
some get by with “Professor” instead of “Dr.”. Yet it is
they who have the most crowded dispensaries, adminis-
tering heat-generating calcium I.V. injections, which the
women believe “burns away” their illness, and scribbling
out massive doses of antibiotics. Some employ touts to
get custom; many give a cut to the brothel-keeper. There
has been no official investigation to separate the fraud-
ulent from the genuine doctor.

These clinics are popular because there’s no mention
here of the dreaded word, “AIDS”. A bona fide doctor
complains that the pre and post HIV-test counselling is
sketchy. “In two nights I had to rush to save four girls
who had swallowed Tik-20. They had been merely
informed that they were HIV-positive.”

Bogus practitioners bolster the “‘logic” that government
treatment “being free, can’t be effective.” In any case,
having worked all night, the women have little energy for
the lengthy procedures at the Bombay Municipal Corpo-
ration’s clinic for Sexually Transmitted Diseases (STD)
on the periphery of the squalid maze of Kamathipura.

Even if they are quacks, these men have the confidence
of their beleaguered clients, and the BMC would have
done well to have included them in the workshops
planned for AIDS Week that will be flagged off by World
AIDS Day on December 1.

NEAR EAST & SOUTH ASIA 45

More harmful in the long term is the disenchantment
over activists who descent on sleaze street, often with
foreign visitors in tow so as to showcase their “commit-
ment” and thus access funds and junkets. Since such
cynical manoeuvres also drive a wedge between the
afflicted and bona fide help, pushing the problem dan-
gerously underground, genuine workers demand closer
monitoring of agencies operating in the red-light area.

Tarabai’s florally laminated wall proclaims, “May God
Give You What You Want.” What she doesn’t want is
any talk of this “Aidis-Paidis.” “We don’t have it, it may
be there among the bungla-wallis.” The reference is not
to call-girls, who at a guesstimate outnumber street
solicitors five to one, but to the women in the numbered
establishments. From the perspective of the chalu ghar-
wali, whose business address is the pavement, the warren
of mezzanines might indeed appear to be a bungalow.

Tarabai, who comes from Belgaum, passes the buck to
the Nepalis who are patronised by Arabs. “India ka log
don’t have this bimari. And why blame us? Can we look
inside a man’s body? Why doesn’t the government catch
them as they step off the planes?” Thirty percent of
Bombay’s 250,000 red-light women may be HIV-
positive, but female-to-male infection is, biologically, 10
to 20 times less efficient than vice versa. In either case,
the presence of other STDs multiplies the risk. But, the
women have no control over the use of condoms—the
only protection, the only preventive. Instead, with tak-
ings down by at least 50 percent as a result of the AIDS
scare, prostitutes have become even more vulnerable.

Radha might declare, as she stretches languorously
beneath garlanded oleographs of Mrs. Indira Gandhi and
Dr. B. R. Ambedkar, that “I'll be content with just
chutney-roti,” rather than expose herself to unsafe sex,
but Tarabai is closer to reality. Pointing to a pot of
lumpy rice under the bed, she says, “Sometimes there are
two nights without boni. Khaane ka vaandha hai, rubber
ka baat kaun karega (When we don’t have anything to
eat, who will dare bring up the subject of condoms)?”

The sex workers’ worsening misery has boosted the
business of the moneylenders of Kamathipura, the new
“Malbari” operator now outdoing the traditional ones
from Rajasthan. The girl gets bonded to both them and
the gharwali, unable even to calculate what is really
owed. Yet electronic shops have mushroomed in the area
dispensing cordless telephones. Tailors continue to whirr
up the tight tinsel dresses.

Even organising prostitutes into self-help cooperatives
has become a racket, their names barely pronounceable
by their illiterate members. The Sanyukta Nepali Sat-
yashodhak Pidit Mahila Sangh was operative long before
AIDS was known. The more recent Asahit Triskrut Nari
Sangh of the Kannadigas was cobbled together by Brij-
mohan Sharma, better known as “Bhaisaheb.” He owns
the doodh and bhajia Mathura Bhavan in Kamathipura



JPRS-TEP-92-003
12 February 1992

The prancing stallion of Masti, the Hindustan Latex
product, hangs in streamers along with the sachets of
shampoo, paan masala and chewing tobacco from every
wayside stall in Bombay’s red-light district. This is the
“record-dancewalla” product pushed, with the help of a
nightly tamasha. Since it is bought, it is more likely to be
used, than a freebie.

The need for safe sex has created the designer barrier and
revolutionised its advertising. The AIDS control pro-
gramme could make a quantum leap if these new liber-
alised messages translate into down the-line acceptance
of condom use.

Continuing Reportage on Fight Against AIDS

AIDS Prevention Bill Withdrawn

92WE0215A Bombay THE TIMES OF INDIA
in English 4 Dec 91 p7

[Article: “AIDS Prevention Bill Withdrawn”]

[Text] New Delhi, Dec 3 (PTI): The government has
withdrawn the two-year old AIDS prevention bill, that
had kicked up a controversy, with criticism, that it
violated human rights and the World Health Organisa-
tion guidelines.

However, existing guidelines to screen for AIDS all
foreign students and foreigners planning to stay in India
for more than a year, will continue, senior health min-
istry officials said.

If passed into an act, the Acquired Immuno-Deficiency
Syndrome (AIDS) bill of 1989, would have made man-
datory the forced disclosure of the identity of all persons
in India, found infected with the AIDS virus.

Citing reasons for the withdrawal, health ministry
sources said, there was a fear that people would not come
forward for testing and those found infected would be
ostracised by employers, families or the community.

Under the bill, the health authorities would have been
empowered to direct an infected person to “remove
himself forthwith” to a hospital or any other place for
special care and to prevent spread of AIDS infection.

Health ministry sources said at the time the bill was
introduced the number of AIDS infections were few and
it was felt worthwhile to identify infected people to
provide them with medical care, social support and
counseling.

More Cases in Calcutta
92WE0215B Calcutta THE TELEGRAPH in English
3 Dec 91p5
[Article by Amit Ukil: “AIDS Virus Inflicts 3 More in
City”
[Text] Calcutta, Dec 2—Three more persons in the city
have been infected by the AIDS virus and, for the first

NEAR EAST & SOUTH ASIA 47

time, they are pimps from red-light areas. This brings the
total number affected by the dreaded HIV virus to 24.

Disclosing this at a workshop on drug-related AIDS at
the on-going International Conference on Drug Abuse
here, Dr. Manish Chakraborty of the School of Tropical
Medicine, who is in charge of AIDS surveillance pro-
grammes in the state, said reports on the blood tests of
the latest cases had been received just this morning.

Of the 24 cases, he said only three were prostitutes. This
is probably because only 1,200 of the estimated 22,000
women in the city’s six red-light areas had been screened.
In Bombay, detailed screening had revealed that 30
percent of the prostitutes had contracted the AIDS virus.
The true picture in Calcutta is still not known. Of the 68
intravenous drug users examined, only one has tested
positive so far in the city.

The situation in Manipur in this context is very bad. As
many as 1,400 persons have tested HIV positive till July
this year, of whom as high as 45 percent are drug addicts.
Dr. S. C. Pal of the National Institute of Cholera and
enteric diseases, which has conducted detailed surveys in
the state, said even though most of the drug abusers
knew about the dangers of AIDS, many were still falling
prey to the virus, even using ink droppers to inject heroin
into their blood.

Dr. U. Ko Ko, WHO director for Southeast Asia,
stressed measures to curb ignorance of how AIDS
spreads, which had resulted in an apathy towards AIDS
patients. According to projections, the incidence of HIV
and AIDS in India, Thailand and Burma by the mid-90s
will be similar to that in Africa in the late 80s if the
situation as it is now goes unchecked. It is possible that
by that time, 70 to 80 percent of the hospital beds will be
occupied by AIDS and AIDS-related cases, the WHO
official said.

To check the spread of the HIV virus among drug
addicts, England had started a needle exchange plan,
whereby used needles were exchanged for new syringes,
Dr. Brian Wells, an expert from London, told the work-
shop. Sharing of used needles by intravenous drug users
is one of the most rapid methods by which AIDS
spreads. All participants agreed that education played
the most vital role in checking drug-related AIDS.

Tamil Nadu Statistics

92WE0215C Madras THE HINDU in English
29 Nov 91 p4

[Article: “Programmes to Create Awareness on AIDS”]

[Text] Madras, Nov 28—Fourteen persons have so far
died of AIDS in Tamil Nadu, since the first cases of HIV
infection were detected in Madras in 1986.

Giving this information, Dr. Sundararaman, Secretary,
AIDS Research Foundation of India (ARFI), Dr. Suniti



10 SUB-SAHARAN AFRICA

President Museveni also reported that some ministries
and institutions of higher learning are establishing an
AIDS control program in coordination with the Uganda
AIDS Commission. He called on those institutions
which have not yet done so to do it at the earliest
opportunity. He promised government assistance in this
particular exercise. He, at this juncture, commended the
Federation of Uganda Employees for working to increase
awareness of workers through information, education,
and communication programs.

Turning to the problem of orphans into AIDS, President
Museveni called for the involvement of communities
and individuals to provide for them. [sentence as heard]
He warned that if we neglect the orphans now, we will be
doing it at our own risk. He said that Uganda has
between 600,000 and 1.2 million children under the age
of 15, and every year between 15,000 and 20,000 AIDS
orphans are being added to the number on account of
AIDS and other causes.

Turning to the people who are already having the HIV
virus, the president strongly advised them not to spread
it. President Museveni also disclosed that a team from
the WHO is already in Uganda to consider an HIV
vaccine trial in the country. He said that the Uganda
Government has asked the team for a therapeutic vac-
cine to be tried on people who already have AIDS, and
that it is hoped that trials will commence in April next
year. Mr. Museveni said that the Uganda virus research
center has done a lot in analyzing herbs geared towards
the finding of the drug to tackle the HIV virus. He said
that there have been positive results, but at the same
time warned that people should not be complacent at all
since there is no cure yet.

President Museveni thanked government and NGO’s
{Nongovernmental Organizations) and individuals for
their efforts in the fight against AIDS. He again urged
those with AIDS to have courage and live out their lives
positively.

ZAMBIA

AIDS Statistics Show Increase Trend

92WE0137B Lusaka TIMES OF ZAMBIA in English
5 Oct 91p1

[Excerpt] AIDS cases are high within the age group of
20-39 years and by the end of September last year 2,261
cases were recorded,

Of these, 1,119 cases involved men and another 1,140
were those of women in the same age group.

This is contained in a paper by Dr. Benson Himonga,
national AIDS manager and epidemiologist in the Min-
istry of Health presented to the just ended workshop for
chief executives on “AIDS and the workplace” held at
Hotel Inter-Continental, Lusaka.

JPRS-TEP-92-003
12 February 1992

He said people in the age group of 40-49 years were
second highest where 337 men and only 128 women were
affected by the killer disease.

There were more AIDS related complexes in the 20-39
age group in which 4,822 men and 4,426 women were
involved while 23 cases were not specified making a total
of 9,271 cases in all.

Dr. Himonga said AIDS related cases among young girls
between the ages of 15-19 years at 684 was high enough
to worry about as compared to only 122 cases for men
within the same age group.

He said 3,494 AIDS cases were reported and recorded as
at September 30, 1990 involving 1,791 men and 1,692
women and another 11 unspecified cases.

For AIDS related cases a total of 13,510 were recorded
and of these, 7,020 were of men, 6,449 of women and 41
could not be specified.

In June 1990, a research capability team from the World
Health Organisation (WHO/GPA) visited Zambia to
help in the process of research to identify priority and
support schemes, Dr. Himonga said.

The AIDS cases reporting had been further strengthened
through provision of stronger motivational activities
through Government, mines and mission hospitals.

Dr. Himonga -noted that information, education and
communication activities were targeted at school youths,
hotel and bar attenders on the dangers of AIDS and how
to prevent it.

[Passage omitted]

AIDS Beginning To Have Economic Impact

92WE0203C Lusaka TIMES OF ZAMBIA in English
15 Nov 91 p2

[Text] AIDS is beginning to have a negative economic
impact on the community, deputy director of medical
services, primary health care Dr. Sam Nyaywa has said.

The disease was on the increase and the economic
impact of the illness and deaths was beginning to have a
strain on the community.

He said in Lusaka urban hospital records showed 21
percent of blood donors and 25 percent of mothers
attending ante-natal clinics were infected while 54 per-
cent of those attending Sexually Transmitted Diseases
(STD) clinics had the HIV virus.

Dr. Nyaywa was speaking at the opening of a three-day
AIDS workshop for nurse educators in Lusaka on
Wednesday in a speech read for him by University
Teaching Hospital (UTH) executive director Dr. Eddie
Limbambala.