JPRS-TEP-93-016
28 June 1993

their parents, and solidarity with those infected.
“Decreasing the AIDS epidemic is a long-term objec-
tive,” explains Dr. Child.

The primary objective of the second campaign is to link
the action networks all around Chile that are involved in
the issue, publicizing their achievements. It also seeks to
deepen the level of discussion on the issue, extending it
into family conversation. A relevant point is the effort to
educate the people “face to face,” so that they are aware
of and then adopt preventive sexual practices, Likewise,
it emphasizes solidarity with those suffering from the
disease, advocating for them not to be discriminated
against and relegated to social banishment.

As with every campaign, this one does not aim to preach
to the choir, but rather it has a target audience, com-
prised principally of youths from around the country,
between 14 and 35, of both sexes. Members of all
Chilean families, of all socio-economic strata, including
the leaders, those infected with, and those suffering from
AIDS.

The “Network of Life” campaign is based on television
“because that is the medium that has the best results.” In
order to have access to the time slots with the highest
demand on the air, which are the most expensive, the
Health Ministry pays only half the normal rate, since the
AIDS campaign is one of public interest. Nevertheless,
like last year, it has not had complete acceptance on the
part of the television stations. “Channel 13 and Megavi-
sion accepted half the mini-programs offered to them for
an initial period, while the other stations accepted all of
them,” commented Dr. Child.

Raquel Child explains that Conasida’s second strategy is
a directed, participatory plan, in which groups of people
discuss and interact on issues related to prevention and
solidarity. “Personalized education undoubtedly paves
the way toward safest sexual practices. The ‘face to face”
programs are what generate change in a participatory
mode,” she states.

But there are several problems that the campaign has had
to face. Ever since the beginning, the Catholic Church
has disagreed with the methods, since these emphasize
various means of prevention, including abstinence,
which is included as only one of several possibilities.

Fr Baldo Santi explains: “The focus that the Church believes
to be most appropriate in the face of the challenge of AIDS
is one that is not limited to thinking of the disease as
exclusively a hygienic and sanitary issue, thus requiring only
technical solutions, like the condom.”

In Fr Santi’s view, AIDS involves moral and ethical values
that cannot be ignored or minimized without contributing,
to its blameful spread. “When one downplays the value of
responsibility, obscuring it with the false illusion of safe sex,
whatever that is, one opens the door wide to AIDS,
extending the culture of death, which is the most powerful
symptom of this disease today,” he states.

Fr Baldo Santi argues about the Government's role: “It
should reemphasize the subordinate role of the State

LATIN AMERICA 15

with respect to the family and all of society, and have the
courage to support interdependence between ethics and
economics, as demonstrated in the reign of John Paul II.
It is necessary to have an open, generous, and humanistic
vision of the person and also a responsible attitude by
politicians, even though this could result in their losing
some of their popularity.”

In response to the Catholic Church’s criticisms, Dr. Raquel
Child explains, “We have the duty to concern ourselves with
the health of Chileans, that is something we have to accom-
plish. In doing so, we base ourselves on the essential ethical
principles of Man, such as the right to life and the right toa
totally informed personal decision. In order to be a person,
one needs to be able to make decisions, And to do so, one
must have adequate information.”

Other Initiatives

Whether or not coordinated by the National Committee
Against AIDS, there is a network of 12 nongovernmental
organizations that work to restrain, or at least control,
the devastating epidemic. Among them is REOSS (Social
Health Education and Counselling Network), headed by
sociologist Max Cifuentes. Financed by WHO funds last
year, it is not yet clear how it will subsist this year. This
organization essentially works on three fronts: street
children, young girls in the sex industry, and women with
partners at high risk of infection.

Located in Conchali, the community with the highest
number of AIDS cases in Chile, REOSS carries out “safe
sex” workshops, provides consultations on venereal dis-
eases, carries out AIDS testing, and provides counselling for
minors, all anonymously and at no cost. Max Cifuentes
explains: “Both the counselling and the recommendations
are completely different for each person. We take into
account their anxieties and plans for life, to propose to them
a realistic prevention program, taking into account their
resources for changing their way of life. One cannot just tell
a sexually active person to stop overnight.”

His primary target is youths from low socioeconomic
classes: “The future also implies a life plan, the assump-
tion of life as a consequence of our actions, which are
values of the upper middle class. However, the farther
one descends along the social scale, the more fatalistic is
the attitude, of living day to day.”

He is gradually making contact with street children and
youths. “One gets closer to them little by little, and
gradually gains their trust, until one establishes a link
with the minor. In their homes there is a lack of family
organization, violence, alcoholism. They run away to the
streets, and in most cases survive through the sex indus-
try,” Cifuentes says.

The sociologist comments that the greatest difficulty in
counselling the minors is that “they associate the risk of
contracting AIDS with homosexuality, social class, and
external symptoms of the disease, which is totally erro-
neous. The only way of knowing whether a person is
infected is with the Elisa Test.”



JPRS-TEP-93-016
28 June 1993

was an in vitro enzyme immunoassay for the detection of
HIV antibodies type 1 and type 2 in human serum or
plasma.

The “Aidsida I, II” kits will be on sale in clinics and
hospitals at prices between 1,000 won and 1,500 won.

Development of the kit, two years behind advanced
countries, improves on the first-generation kit sold by
Tong-a since 1988.

The test is highly accurate in detecting the presence of
the human immuno-deficiency virus that causes the
deadly Acquired Immune Deficiency Syndrome.

Tong-a says the use of gene récombinant technology
eliminates the possibility of infection of staff with the
AIDS virus in the manufacturing process.

This method reduces production costs 30 percent
because it doesn’t need separate safety facilities in
farming the virus.

The domestic AIDS test market is worth 4 billion won
(4.9 million U.S. dollars) a year, of which a half are
imports, a spokesman said, adding that the new product
‘was expected to contribute to checking HIV proliferation
with its high accuracy and low cost.

THAILAND

Government Adopts National Policy on AIDS

BK0406034193 Bangkok BANGKOK POST in English
4 Jun 93 p6

[Text] The Government yesterday adopted a national
policy on AIDS and authorised the National Economic
and Social Development Board (NESDB) to be the
responsible coordinator in the execution of the AIDS
preventive and control plan.

The NESDB will also be responsible for drawing up the
plan and incorporating it in the 8th national develop-
ment plan which is to commence in 1997.

The national policy on AIDS was yesterday approved by
the National AIDS Prevention and Control Commission
headed by Prime Minister Chuan Likphai.

The plan calls for, among others:

—all governmental agencies and non-governmental
organisations to take part in the prevention and con-
trol of AIDS on a continuous basis in relation to the
government policy which urges cooperation in the
publicity campaign to educate the people about the
deadly disease;

—-separate budgets for governmental units at central and
local levels for prevention and control of the fatal
disease;

—promotion and support of research.

The committee also approved the setting up of four
sub-committees on planning and policy coordination, on

EAST ASIA 9

technical affairs, on protection of rights of AIDS suf-
ferers or HIV carriers and on the prevention and control
of AIDS.

Public Health Permanent Secretary Dr. Phaichit Pha-
wabut, meanwhile, reported that until May 28, there
were 2,039 AIDS cases and 2,235 AIDS-related cases in
Thailand.

He said 25 percent of the 404 new AIDS cases detected
this year had already perished.

Drug Patent Protection, Effect on AIDS
Prevention Viewed

BK2006015293 Bangkok THE SUNDAY POST
in English 20 Jun 93 p 2

[Text] The Public Health Ministry and nongovernmental
organisations [NGOs] yesterday called on the Commerce
Ministry to consider long-term adverse effects of retro-
active patent protection of drugs as demanded by the
United States.

At a discussion on the effect of pipeline protection on
AIDS drugs, conducted by the Coordinating Committee
for Primary Health Care of Thai NGOs (CCPN), the
panelists expressed concern about increasing economic
problems that would arise from purchases of imported
drugs which would be much more expensive than esti-
mated by the Commerce Ministry.

CCPN adviser Dr. San Hathirat said the ministry should
not take sides with the United States by caring about a
little gain from exports, but should consider the long-
term effects on Thais.

“The Commerce Ministry should not speak as if it
represented the United States concerning patent rights
for drugs registered in our country.” Dr. San said.

He called on the Public Health Ministry to play a more
important role in demanding that the Commerce Min-
istry should not provide pipeline protection because it is
against the ministry’s policies.

Dr. Suwit Wiphunphonprasoet, director of the technical
division of the Food and Drug Administration, said the
Commerce Ministry had underestimated the loss at only
25 million baht through pipeline protection.

He said Thailand would lose about 3,000 million baht.

Dr. Suwit said that an increase in demand for a new drug
would last for at least three to four years after it went on
the market.

Rural Doctors’ Association representative Prawit
Lisathaphonwongsa said that if Thailand agreed to pipe-
line protection for new drugs, AIDS vaccines would be
too expensive for most carriers in Thailand.

Prof. Chiraphon Limphananon of Chulalongkon Uni-
versity’s drug study group said the United States wanted
pipeline protection for drugs registered in the country
after 30 September 1991, which included medicines that
have to be continuously used by patients.



JPRS-TEP-93-016
28 June 1993

JAMAICA

Health Minister Discusses Government AIDS
Programs

FL1106123693 Bonaire Trans World Radio in English
1100 GMT 11 Jun 93

[Text] AIDS continues to be a scourge worldwide,
affecting Caribbean islands as well. Jamaica’s Health
Minister Easton Douglas describes what steps are being
taken in the way of prevention in Jamaica.

[Begin recording] When you are dealing with HIV and
AIDS, you are dealing with something that is sometimes
difficult to speak about because you are speaking about
sexuality and sex, and in the Caribbean, that is still a
sensitive thing to talk about. People have developed
severe hostility to AIDS victims that they know about.
Some of them have been burned out of their homes.
They have lost their jobs. They have no means of support
because they are rejected even by their families, and this
is another area where we the government now have to be
supporting them because many of them who have been
very independent and self-suffcient before have now
become totally dependent on the state just for survival—
for food, for clothing, for shelter.

So we have gone through [word indistinct] schools,
through churches, through nongovernmental organiza-
tions. We launched relentless public education and we
have established in every parish in Jamaica a clinic to
deal specifically with sexually transmitted disease and
also deal with the AIDS prevention program. Our supply
of blood is safe. Every drop of blood that is donated
through our blood bank is tested for HIV or AIDS before
it is sent on at all to be transfused to anybody. [end
recording]

Easton Douglas, Jamaican minister of health.
NICARAGUA

Health Workers’ Understanding of AIDS
Examined

93WE0363A Managua BARRICADA in Spanish
13 Apr 93 p IB

[Article by Sabrina Moncada Sequeira]

[Text] Panic gripped the doctor. She had accidentally
pricked her finger with a needle when taking blood from
a patient with AIDS.

The test results are still unknown, but that experience
taught health workers a lesson.

Every day hundreds of blood samples are drawn in
Nicaraguan hospitals and the 20,488 health workers
exposed to infection do not take sufficient precautions to
protect themselves.

Dr. Freddy Meinhard, director of Karl Marx Hospital,
said: “No matter how much we require lab technicians,
doctors, nurses, and even cleaning people to protect
themselves, they do not do it.”

LATIN AMERICA 19

“They consider gloves, masks, and special caps and
shoes a nuisance,” he added.

The problem arises when patients come in who know
they have AIDS but do not say so, and are treated
without the necessary precautions. Most of the staff
protect themselves only when they are really suspicious.

“We have tried to persuade them to use sterilized
instruments, but they will only do that when there is a
major outbreak of the disease, and they will know we are
the ones running the greatest risk,” commented the
doctor.

Asymptomatic Patients and Carriers

Since 1987, 31 AIDS cases have been reported in Nica-
ragua, most of them in Managua. Of these, only three are
still alive. However, Pan American Health Organization
(PAHO) statistics say that for each HIV-positive case,
there are 50 to 100 symptom-free people who are car-
riers.

The MINSA [Ministry of Health] estimates there are
between 1,500 and 3,000 people in Nicaragua who are
still asymptomatic. This means they have the disease,
but no symptoms of the virus have yet appeared.

“No interest has been shown in using the media to
spread information telling people how to protect them-
selves from AIDS,” said Meinhard, director of Karl
Marx Hospital.

At Manolo Morales Hospital the head of the laboratory,
Yanira Roque Trujillo, said that about five or six years
ago the lab personnel protected themselves, “if possible,
by using double protections, but not now.”

Another problem is that the workers believe AIDS
affects only people who are promiscuous, homosexuals,
drug addicts, and prostitutes. “They feel immune to the
disease,” said the Karl Marx Hospital director.

Blanca Acuna, a lab worker at Manolo Morales Hospital,
said: “Not even the doctors use gloves when taking
blood, except when they know there is a probability of
infection.”

“Also, you are not only taking blood samples; there are
other jobs to do and gloves get in the way.”

Martha Montano, a lab technician at Karl Marx Hos-
pital, confirmed that statement. “With gloves on, the test
tubes tend to slip, and I lose sensitivity when taking
samples. Also, the masks are not good quality,” she said.

AIDS tests are not done when a patient goes to the
operating room, which places the doctors, nurses, and
anesthesiologists at greater risk. But “we cannot do the
test without the patient’s consent, and the patient can
refuse a request to be tested,” added the director of Karl
Marx.



IPRS-TEP-93-016
28 June 1993 4

INTERNATIONAL
WHO Reports 14 Million Infected With HIV Worldwide {Paris AFP, 21 May 93] ...



16 LATIN AMERICA

Jorge Hormazabal also works with REOSS. Together with
eight friends, among them theater students, he acts out
street skits depicting risky situations, for the purpose of
educating the youths. The presentations are made princi-
pally in Conchali, but they are considering extending them
to other areas of Santiago.

A Black Future

Although according to the Health Ministry, “Chile is still
capable of resisting the epidemic’s progress and control-
ling its effects,” global projections are alarming.

The WHO calculates that by the year 2000 there will be 20
million AIDS cases in the world, with 40 million people
infected. Moreover, since the disease affects precisely that
group of people who are of childbearing age, “it is possible
that the epidemic will succeed in decimating the labor force
and irretrievably retarding the development of countries.”
This is in addition to the damage to families, as a total of
some 10 million children under the age of 10 would be left
orphans.

It is alarming to think that it is possible that, despite the
desperate search for a medicine, the only things that have
yet been found are formulas to treat the occasional infec-
tions, or with luck, partially reduce the patient’s suffering.

Dr. Michael Merson, Director of the WHO's Global Pro-
gram Against AIDS, states, “At least one million people per
day will die of AIDS by the end of the decade, close to half
the population of Africa and a quarter that of Asia. The
death of close to one-fifth of all young and middle-aged
adults and their descendents during a short period will lead
to social disorder, economic disruptions and even economic
destabilization in many countries.”

With these semi-apocolyptic visions of our situation, it is
hoped that the Chilean Health Ministry’s optimism is
appropriately based on reality, and that we still have
time to control the advance of AIDS in Chile.

Distribution of AIDS by Region in Chile, 1984 to 1992
(per 100,000 inhabitants)

Region Rate
IT 2.75
0 4.34
pit 0.99
Iv 1.84
v 8.33
VI 0.45
Vil 1.05
VII 1.44
Ix 0.37
x 0.85
RM. 10.93
Country 3.59

JPRS-TEP-93-016
28 June 1993

Causes of Death Among AIDS Patients in Chile, 1984 to
1992

Cause Proportion
Infections 55%
Bleeding 18
Tumors

Unknown

Neurological

Suicide

Hepatitis

Cardiovascular
Digestive Bleeding

vi rirtrolulao

Causes of Infection in Chile, 1984 to 1992

Cause Proportion
Sexual 87%
Blood 6
Unknown 6
Vertical (Mother to Child) 2

Projected Cases by 2025

93WE0367B Santiago LA NACION in Spanish
14 Apr 93 p 8

[Article by Leticia Soto]

[Excerpts] [Passage omitted] According to a study car-
ried out in the Metropolitan Region by experts from the
Catholic University, based on a simulation or projection
model of the disease, if there are 6,000 cases of infection
and 2,000 with AIDS in the region today, the number of
deaths by AIDS would be 10,000 in the year 2005 and
76,000 by 2,025. The rate would be equivalent, then, to
a full National Stadium at a game between Colo Colo
and the University of Chile.

The study, led by Miguel Alfaro, which takes as obser-
vation groups homosexuals, bisexuals, heterosexuals,
pregnant and nonpregnant women, and prostitutes, clas-
sified by the number of times they have sex and their
probable number of partners—between 10 and 13—took
as its simulation period the years from 1985 to 2025.

With respect to the prevalence, if only hypothetical, of
the disease among homosexuals, who are equal to 2
percent of the sexually active population, if condoms are
used in 80 percent of their sexual relations from the
second half of 1992, the epidemic would start to disap-
pear in a linear trend beginning in 1995. Alfaro pointed
out that this result would also hold if the population in
general were to use condoms at that same rate.

He also emphasized the hypothesis that the prevalence of
the disease is particularly well-established among homo-
sexuals because they are a closed group, and that it will
inevitably increase among the heterosexual population.
The projected number of cases of infection in this case



2 CENTRAL EURASIA

Kazakh AIDS Program Seeks Sponsors

93WE0321B Almaty KAKAVAN in Russian 8 Jan 93
pd

[Article: “*Anti-AIDS’ Is Looking for Sponsors”]

[Text] In the context of a month-long campaign associ-
ated with the struggle against and prevention of the
plague of the 20th century, the Karaganda Oblast Asso-
ciation Anti-AIDS is planning to conduct testing of the
populace with the help of local newspapers. After having
first answered in more detail a number of other, related
questions, the readers will be asked to answer the ques-
tion, “Am I threatened by AIDS?” The association staff
members have called upon their fellow citizens to avoid
casual sex in order to avoid the fatal disease. After all,
according to the statistics, every second AIDS patient
dies.

And although only three of the republic’s 18 cases of HIV
infection have been recorded in Karaganda Oblast, one
can understand the medical profession’s alarm. After all,
only a small number of citizens have undergone the
testing. It’s possible that among the rest of the citizenry
who have not been “tapped” by the test, there may be
unsuspecting HIV-infected individuals walking around.
Especially since 70 Karaganda residents have had a
positive reaction to the AIDS test. That’s from among
those tested, of course.

The new treatment-prevention base for the oblast center
for the prevention of AIDS will help to correct the
situation. Right now, repair work is about to be finished
in the polyclinic and the hospital. A course of treatment
for one patient in that hospital will cost 2,000 rubles [R].
To guarantee its patients more effective treatment, the
center needs to acquire a Finnish apparatus for AIDS
diagnosis. Its cost—R6 million.

The medical people don’t have that kind of money. Their
only hope is for help from well-to-do sponsors.

Chelyabinsk Committee To Combat STDs, AIDS
93WE0321G Moscow TRUD in Russian 12 Mar 93 p 1

[Article: “Chelyabinsk: Yet Another Misfortune”}

[Text] An interdepartmental committee to combat STDs
and AIDS has been revived in Chelyabinsk. That is a
result of the fact that here, in the last two months, the
number of individuals with syphilis has risen fivefold.
The city’s chief venereal disease specialist, Lyudmila
Buylanova, called the situation threatening. Specialists
link the outbreak of syphilis with growing unemploy-
ment and the large number of homeless, reports the
EUROPEAN-ASIATIC NEWS.

Latest AIDS Figures for Ukraine Reported
934K0994A Kiev URYADOVYY KURYER
in Ukrainian 13 Apr 93 p 8

{Unattributed report: “AIDS Knows No Borders”)

IPRS-TEP-93-016
28 June 1993

[Text] Data from the Ukrainian Center for the Preven-
tion of and Fight Against AIDS indicate the following:

From 1987 through January 1993, 303 cases of HIV
infections were discovered in Ukraine; included among
these were 191 foreigners and 112 Ukrainian citizens.

Among the HIV-infected Ukrainian citizens 15 were
children; nine of them caught the disease from their
mothers, one child caught it from a blood transfusion
containing HIV, and five caught it in connection with
medical procedures.

During this same period 12 persons were discovered to
be ill with AIDS; among them were five children. Nine
persons died: four children and five adults.

Carriers of the virus were discovered in 21 Ukrainian
oblasts, the Republic of Crimea, and the cities of Kiev
and Sevastopol. The worst oblasts with regard to HIV
infections were as follows: Odessa (43 cases), Donetsk
(9), Dniepropetrovsk and Kharkov (6 each), Transcar-
pathia (5), and the city of Kiev (18). There were also
persons with this infection in other regions.

There is evidence and suspicion that this epidemic
process will continue to intensify. Thus, for example,
beginning in 1989, there has been a yearly increase in the
number of HIV infections among Ukrainian citizens: in
1989-16, in 1990-19, in 1991-21, and in 1992-30 cases.

The principal path for transmitting this infection is
sexual (66 percent), from mother to child (0.8), in
connection with medical procedures (7.1 percent), and in
connection with blood transfusions (4.5 percent),

Among the carriers of the AIDS virus there is a predom-
inance of persons between the ages of 20 and 39 years.

During the 1987-1992 period HIV infections were most
frequently discovered among persons who had sexual
contacts with persons suffering from AIDS or who had
venereal diseases, but rarely among blood donors or
pregnant women.

During the first quarter of this year eight HIV infections
have been registered. Three of them were discovered in
Kiev, and one each in Kirovgrad, Nikolayevsk, and
Chernovets oblasts.

Georgia: Doctors Establish ‘Anti-AIDS’
Association

AU0106170193 Tbilisi NOVAYA GAZETA in Russian
No. 18 May 93 p 2

[Unattributed article: ““Anti-AIDS’ in Georgia”]

[Text] Is the problem of AIDS a topical one for Georgia?
It is in the view of Georgian doctors specializing in
infectious diseases who have recently formed the associ-
ation “‘Anti-AIDS.”

The plague of the 20th century, as journalists like to call
this disease, resembles a time bomb. The new associa-
tion—whose founders, in addition to doctors, are people
of other professions—intends to counter this bomb with
a system of defensive measures that are mostly of a


18 LATIN AMERICA

A crucial decision of far-reaching importance was made
when the first cases were detected. Faced with a disease
that quickly and inevitably led to death, the country’s
leadership spent more than $1.7 million in freely con-
vertible foreign currency to purchase drugs and diag-
nostic equipment to tackle the situation at that juncture.

Then, those whom various tests had shown to be HIV-
positive were placed on a health-maintenance regimen.
What an international hubbub there was about Cuba’s
action! It was hypocritical to heatedly criticize the
strategy of prevention and care that Cuba was pursuing
thanks to the few patients, the condition of its health-
care system, its adequate budget, and above all its
humanist policy.

How could other countries do likewise when they had
tens of thousands of HIV-positive cases and inadequate
health-care budgets? How could they insure special diets
and immediate medical care when they were unable to
guarantee their populations other basic needs?

Here we did more than just prevent the virus from
spreading into the healthy population, which needed to
be protected. HIV carriers were surrounded with various
kinds of specialists to prevent fatal complications and to
alleviate their deep depression stemming from an aware-
ness of their imminent death.

Once the ways in which the HIV virus are transmitted
became known, a bold step was decided on: destroying
20,000 vials of plasma to prevent the contamination of
those who would unavoidably need it (hemophiliacs,
post-operative patients) and administering only safe
blood to the people.

The strategy of prevention, treatment, and education
that had been pursued from the start was honed. At the
same time, the country’s scientists undertook the task of
combating AIDS. They developed Cuban reagents, thus
cutting the cost of diagnostic exams. Then they devel-
oped the Ultramicroanalytic System (SUMA), which
enabled these tests to be administered en masse. Today
they are working hard to find a vaccine against the
disease.

The blood of all pregnant women, hospital admittances,
internationalists, and high-risk groups was able to be
tested. To date, an impressive 13 million tests have been
conducted in the country over the years.

We cannot help mentioning another upshot of our
humane policy toward HIV carriers. Can anyone who is
subject to the stresses of daily life and who is suddenly
told that he is HIV-positive possess the emotional bal-
ance to keep living a normal life and protect himself
from the slightest infection, which would quickly lead to
death? A stay in a specialized center, without being
rejected by the medical or other staff, improves one’s
psychological state considerably.

The population did not panic when the disease appeared.
Education about the need for appropriate sexual
behavior was begun. Moreover, when patients visited

IPRS-TEP-93-016
28 June 1993

their families, they were accompanied by support staff
who reassured the patients themselves and society.

Today, even amid the trying economic conditions that
are known to all, new centers have been built to keep
patients close to their homes. The costly drugs that help
the HIV-infected to survive are being purchased, and
medical and dental services are still guaranteed, thus
delaying death. What is more, in an effort to further hone
the treatment program, certain patients whose sexual
and social conduct is appropriate may receive outpatient
treatment after all of their characteristics are evaluated.

How disgraceful it is to play upon the human rights of
AIDS patients in an attempt to distort the meaning of
their stays in sanatoriums! Isn’t it the state’s duty to
safeguard the supreme right to life of the entire popula-
tion? Isn’t it also an elementary duty to provide special-
ized care and special diets (between 4,000 and 5,000
calories a day) to human beings who are apt to die from
an infection that would not harm a healthy individual? Is
it reasonable to argue against Cuba’s position by hiding
behind a patient’s supposed right to calmly spread his
disease?

Cuba is pleased with what it has accomplished. Every
individual, regardless of political affiliation, religion, or
social status, receives free care, which if he is HIV-
positive costs $14,000 in a sanatorium and, if he has
AIDS, some $24,000 in a hospital.

The Notimex cable mentioned above emphasized in its
last few lines that ‘the most successful case of combating
AIDS has been Cuba.” The revolution’s humane and
heroic policy to safeguard the health of its people is a fact
and its results can be displayed to the world.

HONDURAS

AIDS Case Total Reaches 2,549

93WE0391A Tegucigalpa LA TRIBUNA in Spanish
3 Apr 93 p7

[Excerpt] With the 160 cases reported in March, the
number of cases of acquired immune deficiency syn-
drome (AIDS) reached a total just prior to Holy Week of
2,549,

In this connection, epidemiologist Cesar Antonio Nunez
said that “the preliminary report indicates that the 160
new cases do not represent a massive increase, but rather
an accumulation of previously unreported cases.”

The fateful figures have been increasing at an alarming
rate in 1993, since in the first quarter of the year alone,
300 cases were reported, the majority of them in Cortes.

Between the time the disease first appeared in 1985 and
the end of 1992, the total number of cases reported was
2,189.

Reports of AIDS cases are provided to the health regions
as confidential information, and are placed in a file
established for the purpose of monitoring this disease.
[passage omitted].



JPRS-TEP-93-016
28 June 1993

REGIONAL AFFAIRS

Caribbean HIV, AIDS Infection Among Highest
in World

FL1606005293 Bridgetown CANA in English
1955 GMT 15 Jun 93

[Text] Bridgetown, Barbados, June 15, CANA—The
Caribbean has earned the unpleasant distinction of
having one of the highest rates world-wide of infection
with HIV and the disease, AIDS, according to the
Caribbean epidemiological centre (Carec).

And a 10-year review of the 4,138 AIDS cases since
1982, presented in Berlin at the ninth international
AIDS conference, revealed AIDS transmission is now
predominately by heterosexual contact, shifting away
from largely homosexual and bisexual spread in the early
years of the epidemic. Women and children are falling
victim to the human immunodeficiency virus (HIV),
which causes AIDS, at a rapidly increasing rate, as
infected women give birth to children who later develop
HIV disease. According to the review, 97 percent of
HIV/AIDS children up to age 14 were infected by
mother-to-child transmission of the virus.

Judging from the people who walk into the region’s
clinics seeking treatment for conventional, sexually-
transmitted diseases (STDS), Carec suggests that more
people who suffer from an STD are at a higher-than-ever
risk of being infected by HIV. STDS are a known
gateway to HIV disease as the virus finds an easy route
into the body through genital lesions during sexual
intercourse.

Heterosexual contact, which had accounted for 12 per-
cent of Acquired Immune Deficiency Syndrome (AIDS)
cases in 1985, rose to 78 percent by 1992.

“Of cases reported in 1985, 47 percent were homosexual
and bisexual men,” the report stated. “By 1992, this
proportion had declined to 22 percent.” However, Bar-
bados, Trinidad and Tobago, and Guyana were among
the countries where there is still “a significant number”
of homosexual cases.

Infection with HIV caused through the sharing of intra-
venous drug needles is largely absent in the English-
speaking Caribbean, except in Bermuda, where 30 per-
cent of the total number of cases was linked to dirty
needles, but the report added that this figure is declining.
Blood transfusion accounts for less than one percent of
cases, Carec said, “reflecting, in part, the widespread
implementation of screening of donor blood for HIV
antibody.”

Said the report, co-authored by Carol Gayle of the
Trinidad-based Carec: “Although these figures may
appear modest by global standards, rates of HIV infec-
tion and AIDS in relation to the populations of some
countries are among the highest in the world. Taken
together with the influx of tourists to the region, as well
as the high level of (movement by travel) of significant

LATIN AMERICA 13

portions of Caribbean population, AIDS in the Carib-
bean is recognised as having a potential impact far
beyond the geographical bondaries of the region.”

Up to the end of 1992, of the 4,138 cases of AIDS
reported in the English-speaking Caribbean, 2,627 men,
women, and children had died of AIDS. The Pan-
American Health Organisation is forecasting that by
1995, between 27,000 and 60,000 Caribbean people will
be infected with HIV.

BRAZIL

AIDS Official Not Authorized To Decide on
Vaccine Tests

PY1206135893 Brasilia Radio Nacional da Amazonia
Network in Portuguese 1000 GMT 12 Jun 93

{Text] Lair Guerra de Macedo, coordinator of the pro-
gram for sexually-transmitted deseases and AIDS, is not
authorized to decide on Brazil’s participation in testing
anti-AIDS vaccines. This statement was made by Health
Minister Jamil Haddad who expressed surprise over the
World Health Organization decision to choose Brazil as
one of countries where the anti-AIDS vaccines will be
tested in large scale.

Minister Haddad had said that Brazilians cannot be used
as guinea pigs.

CHILE
AIDS Cases, Government Policies Detailed

Health Ministry Figures, Campaign
93WE0367A Santiago EL MERCURIO in Spanish
11 Apr 93 pp D10-12

[Article by Soledad Miranda Herrera]

[Text] “With the AIDS epidemic, the world will experi-
ence something similar to what occurred with the black
plague of the 14th century, when a third of humanity
perished. This worldwide problem has practically com-
pleted its infection of the initial risk groups and is being
propagated silently among heterosexuals (male-female
relations), who do not realize that they are also a risk
group.”

This statement is by National Foundation Against AIDS
(Funacs) President Dr. Juan Bernal. “Many people dis-
miss my view of the problem as catastrophist, but all the
optimistic points of view have failed, giving credence to
those who see in this epidemic the worst natural disaster
that has faced humanity,” says the author of the book
How To Love in the AIDS Era.

The WHO [World Health Organization] calculates that
according to the speed of growth of the disease at the
world level, someone becomes infected with AIDS every
20 seconds, resulting in more than 4,000 new cases per
day. In Dr. Bernal’s view, “there are a million and a half
cases in the world, of which 500,000 are children.” On
his part, Dr. Michael Merson, Director of the WHO’s



JPRS-TEP-93-016

28 June 1993 SUB-SAH.

It is estimated that in Kampala, where one can see child
beggars, there are 1,500 street children. The orphans also
end up in dismal conditions in juvenile prisons.

AIDS Heavy Burden on Population

In part, AIDS is responsible for thwarting the Govern-
ment’s attempts to get the economy back on its feet.
“AIDS primarily kills economically active people in the
prime of life,” noted Prof. Helder Martins, the WHO
representative in Kampala.

“A greater proportion of educated people are felled by
the disease, because their sexual behavior is freer and the
men can afford prostitutes. This is a tremendous loss for
a country, which even without this suffers from a
shortage of educated workers,” said Martins.

For instance, in the area of Rakai, where AIDS was first
recorded in Africa in 1982, the disease has erased entire
villages.

The Mulago Hospital’s AIDS Clinic’s courtyard serves as
a waiting room, and the benches are full. The patients are
strong and healthy looking men and women, but many of
them have only a few months to live. “We can only treat
illnesses caused by AIDS, such as malaria, skin diseases,
and tuberculosis,” Elly Katabira, a physician, told us.
“The AIDS drug AZT [Azidotimidine] is a luxury which
Uganda cannot afford,” she added.

Other Countries Secretive

Uganda, however, does not deserve the reputation as the
African country where AIDS is most widespread.
“Uganda is only the best known because the country
openly acknowledges the problem which many other
countries are keeping secret,” said Professor Martins.

Uganda’s campaign against AIDS, which in part is
financed through development aid, is know as one of the
most successful in Africa. Everyone has been recruited to
spread AIDS information, from ministers, teachers, and

N AFRICA 5

theaters, to local authorities and members of the parlia-
ment. Everyone knows at least something about AIDS
and how it spreads.

In many towns, AIDS information centers perform free
AIDS tests. Clinics belonging to the AIDS organization,
TASO [expansion not given], provide free treatment to
AIDS patients. According to Professor Martins, con-
doms are readily available, and almost all blood avail-
able from blood banks has been tested. The home care
system, which was developed because of the shortage of
hospital beds and where physicians or health care
workers visit the AIDS patients in their homes, covers a
large portion of the country.

“There are even brothels which include condoms in the
price of a room,” Martins noted with some wonderment.

Uganda has developed a philosophy to help AIDS vic-
tims go on with their lives. They are encouraged to use
their remaining time well, to secure the future of their
children and to spread information about AIDS.

AIDS sufferers are discriminated against less and less.
Spreading information also changes behavior, albeit very
slowly. “This has been proven in many regional studies,”
said Martins. “For example, a couple intending to get
married may decide to take an AIDS test before the
wedding. People decrease the number of sexual partners
they have,” Martins continued.

“The spread of AIDS has already slowed down,” said
Marble Magezi, a spokesperson for TASO. He rejects the
notion that polygamy would be responsible for the rapid
spread of AIDS in Africa.

“Traditionally polygamy was strictly regulated,” Magezi
noted. “But as traditions are crumbling, it has become an
excuse for free sex. The only option is for people to
become monogamous, Although the Catholic Church
has been against condoms, it also helps by promoting
monogamy,” stated Magezi.



28 INTERNATIONAL

WHO Reports 14 Million Infected With HIV
Worldwide

AU2105100193 Paris AFP in English 0938 GMT
21 May 93

[Text] Geneva, May 21 (AFP)—Some 14 million
people worldwide are infected with the Human
Immune-deficiency Virus (HIV), the precursor of
AIDS, the World Health Organisation (WHO) said
Friday.

IPRS-TEP-93-016
28 June 1993

Eight million of those infected live in sub-Saharan
Africa.

In some towns in central and eastern Africa one in three
adults is infected, the WHO said.

Meanwhile, the epidemic of Acquired Immune Defi-
ciency Syndrome is spreading in parts of southern and
south-eastern Asia as fast as in Africa.

The WHO calculated that by 2000 the total number of
people infected with HIV would reach 30-40 million.


JPRS-TEP-93-016
28 June 1993

Three HIV Groups

In this country and in other European countries, three
new HIV-positive groups are affected by the new defini-
tion.

Women with cervical cancer, persons with tuberculosis
of the lungs, or persons who, in the course of one year,
repeatedly catch pneumonia caused by specific bacteria.
Earlier, these HIV patients have not been diagnosed as
having AIDS, but this is now happening.

More Difficult

The United States has gone further and has allowed the
AIDS diagnosis to apply additionally to HIV-positive
individuals with a low cell count, something that implies
that the patient is sick and has weakened immunity
defenses. It is especially this that will cause the U.S.
AIDS curve to dart upwards.

“From now on, it will be more difficult to compile
international AIDS statistics. With differing definitions
in the United States and Europe and with a significant
underreporting in African countries, it becomes intri-
cate,” says medical director Hasselvedt.

‘Small Effect

There are between eight and 15 HIV patients in the
infectious medicine department at Ulleval Hospital at
any particular time. Many of them have weakened
immunity defenses and a low cell count. In the United
States, they would have gotten a diagnosis of AIDS. In
our country, they are “only” HIV-positive.

“Jf the new AIDS criteria will have any effect at all here,
we probably will see this in the HIV-positive group with
frequent pneumonia. This is most widespread among
HIV-positive drug abusers,” says Prof. Johan Brunn of
the medical department at Ulleval Hospital.

Otherwise, the new demands will have little significance,
he thinks.

“But for the patients, this is not favorable. It is a greater
shock for a someone who is HIV-positive to be diag-
nosed with AIDS than pneumonia,” says Brunn.

SWEDEN

New Antibody Reduces HIV Risk for Babies

93WE0388B Stockholm DAGENS NYHETER
in Swedish 12 Mar 93 p 5

(ITT (Press Wire Service) report: “New Treatment
Reduces HIV Infection”]

[Text] Swedish researchers have developed an antibody
that reduces the amount of virus during HIV infection.

The hope in the long run is to prevent the virus from
being transferred from HIV-infected mothers to their
children.

“It is completely new that we can imitate an HIV
antibody,” says Prof. Britta Wahren at the National
Bacteriological Laboratory.

WEST EUROPE 5

However, she stresses that many questions remain to be
answered before this method of treatment reaches the
HIV infected.

The antibody treatment can also work for recently
infected persons. Finally, the antibodies can reduce the
amount of viruses late in the course of the disease for
AIDS.

Sweden First To Try Large-Scale AIDS
Vaccination

93WE0418B Stockholm DAGENS NYHETER
in Swedish 27 May 93 p 5

[Article by Kerstin Hellbom: “Promising Start for ‘AIDS
Vaccine””’]

[Text] The Southern Hospital in Stockholm has now
recruited 160 of the approximately 1,000 HIV-positive
individuals who are to be “vaccinated” against AIDS.
Sweden will be the first to conduct large-scale vaccina-
tion tests now that the first tests on a smaller scale have
yielded promising results.

“What we can say with complete certainty is that we
have not harmed anyone. And it looks as though we may
actually be able to influence the immune system in the
right direction,” says Eric Sandstrom, chief physician at
the Venereal Disease Clinic at the Southern Hospital,
which together with the National Bacteriological Labo-
ratory is conducting the tests,

It has now been 19 months since the first HIV-positive
individuals in Sweden were “vaccinated” against AIDS.
The hope then was that it would be possible to slow the
infection’s development into AIDS by strengthening the
body’s own defenses against the virus, and so far the
results have seemed promising.

The idea was to induce the immune systems of HIV-
infected individuals to produce more of the antibodies
and cells that attack the virus by “immunizing” those
patients with protein from the surface of the virus. It
sounds risky, and concern over the side effects was
therefore great. For example, it was feared that the HIV
infection already existing in the patients would be acti-
vated, and as a result, half of the test subjects also
received doses of the inhibitory drug AZT [Azidotimi-
dine].

Forty patients were recruited, all with relatively well-
preserved immume systems—that is, with more than
400 T-helper cells per microliter of blood. Over a six-
month period, they received injections of HIV’s gp 160
protein once a month.

The first thing noted was that the average number of
T-helper cells increased during the “immunization
period” and that their number then declined to the point
that after one year, it was back where it started.

It was also found that HIV antibodies—the protein
produced by the immune system to fight the “enemies”
in the body—multiplied in all the patients. The newly
formed antibodies were also seen to be of good quality;



2 SUB-SAHARAN AFRICA

Although efforts to train health workers to deal with
AIDS patients have been made, is there the will to treat
these patients compassionately and with understanding
just like any other patients in the hospitals?

Will the right authorities come up frequently with cor-
rect and right data for greater public awareness? The
conference should ponder these points.

MOZAMBIQUE

Blood Donations, Supply in Maputo Hospital

93WE0423D Maputo NOTICIAS in Portuguese
17 May 93 p2

[Text] Since last Saturday, the blood bank at Maputo
Central Hospital has had containers available for col-
lecting and storing that vital liquid, thanks to the arrival
in Maputo of a truck carrying 7,500 collectors and the
respective transfusion systems, imported under emer-
gency from South Africa.

The arrival of this material has put an end to the crisis
the blood bank faced in recent days for the collection of
blood, when it did not have available collectors for that
purpose. The most recent shortage in supplies of these
units occurred last Thursday.

As a result of the lack of bags, the blood bank has been
forced to turn away some people who had gone to the
institution to donate blood.

Currently, the blood bank estimates it needs some 80
donors per day in order to cover and satisfy the needs of
the various nursing wings of that hospital facility. The
worsening of the malaria epidemic that has been
observed not only in the city of Maputo but also in other
regions of the country has caused the number of patients
needing blood to grow considerably.

“There are many cases of anemia resulting from the
malaria,” said Jose Mondlane, a laboratory technician at
the Maputo Central Hospital blood bank, adding that he
receives some 100 requests daily for blood for patients
suffering from malaria, 70 percent of which are from
pediatricians whose child patients suffering from this
disease are being treated.

We learned that currently some 60 to 100 persons per
day come in to donate blood. Many of these citizens are
considered depositors (people who donate blood to aid a
family member).

This is the second time in less than a month that
emergency imports of bags and blood transfusion sys-
tems have had to be effected to resolve the shortage of
supplies of these materials.

Better Supervision of Blood Donors Urged
93WE0436A Maputo NOTICIAS in Portuguese

20 May 93 p 3

[Text] The lack of observance of blood donors’ rights in

some of the country’s hospitals is one reason for the
declining number of donations at these health facilities,

JPRS-TEP-93-016
28 June 1993

participants at the seminar in the capital on blood banks
claimed. Yesterday participants learned about technical
procedures necessary to ensure the quality of the blood
to be transfused in order that it not constitute a danger
for the recipient.

The lack of observance of donors’ rights, according to
laboratory technician Felisberto Afonso, who works for
the Xai-Xai provincial hospital, has already resulted in a
decline of 25 percent in the number of donors from 1990
to 1991, and 12 percent between 1991 and 1992. He said
there is a certain disparity in the observance of donors’
rights with respect to exemptions from paying for med-
ical consultations or treatment.

A passage from the law dealing with this issue, which this
newspaper possesses, states that blood donors “are
exempt from paying for medical consultations or treat-
ment in hospitals provided they can prove a minimum of
two blood donations during the prior year or one dona-
tion made in the same year as the consultation or
treatment.”

Other provisions that the decree (number 14/88 and
16/88 Bulletin of the Republic number 51, Ist series,
from 27 December), in conjunction with ministerial
decree number 325/77, confers on donors include a
subsidy of the total cost of prescribed medicines, a
medical checkup prior to every donation, and others.

The reasons for violation of the regulation, according to
laboratory technician Emilia Chemane, head of the
National Blood Transfusion Service, is in most cases a
lack of knowledge of the legislation on this issue.

According to her, one of the recommendations that
should be made by the participants at the current sem-
inar is that the documentation and legislation on the
topic be published, to prevent violations.

The reports presented by the provinces point out the
need for improvement, as well, in services provided to
the donor, particularly those involving the food served
which, according to what was discussed, leaves much to
be desired.

The deficient communication between the blood banks
and HIV-positive donors who, according to the Inham-
bane report, are treated like any other, was another issue
raised.

“The donor is not informed about his situation, but both
times we updated his record so that he would not lose his
rights, waiting for the provincial department of coun-
seling to be created,” said another participant at the
seminar.

Blood Is Still Needed

Statistics from last year provided by Emilia Chamane to
the media, indicate that 45,185 donations would be
needed annually throughout the country to be able to
satisfy the constant requests, whether in cases of emer-
gency, illness, or operations.


IPRS-TEP-93-016
28 June 1993

KENYA

Importance of National AIDS Conference Cited

93WPO168C Nairobi THE KENYA TIMES in English
22 Apr 93 p 6

[Article by David Maina]

[Text] The first national conference on AIDS, HIV
infection and sexually transmitted diseases (STDs) that
opened at the Kenyatta International Conference Centre
yesterday is of immense significance to Kenyans.

The reason is that Kenyans, and indeed most of sub-
Saharan Africans, have been slow to accept the reality of
AIDS.

Even today, after widespread public education, many
still believe that AIDS is a fabrication of the media and
the West. Lack of belief feeds the perpetuation of infec-
tion although an automatic change of behaviour is not a
guarantee even where people accept AIDS as a reality.

The conflicting facts and figures given by different
experts in Kenya about the spread of the disease notwith-
standing, the implications of the spread are open for
anybody’s guess.

For instance, it was recently claimed that a total of 1.8
million Kenyans are currently infected with the deadly
virus while over 35,000 have already died of various
diseases associated with AIDS.

But a recent survey carried out by the Ministry of
Health, the Kenya Medical Research Foundation
(KEMRI) and the Rapid IV Project said that if
unchecked, the number of those infected may shoot to
1.5 million people by the turn of the century while about
one million people may die between now and then.

The same research found that the number of orphans
caused by AIDS will increase from 30,000 in 1992 to
about one million in the year 2000 spelling disaster for
the traditional way of caring for orphans since the
numbers will be overwhelming.

The AIDS epidemic will also affect the economy at both
the national and family levels as it will cost the Govern-
ment an estimated Sh44 billion which is equivalent to 15
percent of Kenya’s annual Gross National Product
(GNP).

In terms of manpower, AIDS is also slowly causing
havoc to this important and most necessary cog to the
wheels of development. The loss of manpower years,
according to research carried out for an individual with
AIDS is estimated to be 27.1 years out of the average of
36.9 years.

Data from elsewhere indicate that the 42,000 deaths
resulting from AIDS in 1991 may have risen to 60,000 by
December last year while nearly 1.72 million people will
be HIV positive by the end of this year (1993).

Figures given by the Kenya AIDS Society estimate that
an average of 90,000 Kenyans will die of AIDS annually
between 1993 and 1994,

SUB-SAHARAN AFRICA 1

Infection, according to experts, is most prevalent among
those in the sexually active ages and among infants and
children through pre-natal transmission.

Another survey carried out at the Kenyatta National
Hospital indicates that the HIV prevalence rate of preg-
nant women was 10 percent but in some places like
Kisumu, the figure is, sadly, double.

The AIDS conference is significant to Kenyans because
more must be done to stop the deadly march of the virus
to more Kenyans than those already infected.

The rapidly expanding pool of HIV/AIDS infected and
the escalating demands upon medical services have
cropped up when the country’s economy is at its lowest
ebb ever. ‘Health facilities just cannot cope and the
Government has been forced to introduce cost-sharing in
many services including health.

The situation is worse if the sufferer happens to have
been the sole bread earner for his immediate and
extended family as is the tradition in most African
communities,

Apart from losing the income and assistance from the
sufferer, the families are forced to cope with the purchase
of expensive drugs and diet that the patient needs to
combat opportunistic infections.

As Mrs. E. Kiereine, a former chief nursing officer, told
the conference in her key-note speech, AIDS is both a
medical and social problem which needs to be tackled
from all fronts.

She said African governments must start including in the
national budgets a vote specifically to finance AIDS
related programmes in their countries if they were to
make good their promise made during a Organisation of
African Unity (OAU) summit last July.

The leaders at the summit while addressing the AIDS
issue promised that governments would inject “political
will at the highest levels” in the fight against the disease.
But has this been done? Sadly not in many countries.

Socially, the HIV/AIDS infected and their families tend
to live in an isolated world. Fear of stigmatisation and
blame within the wider society forces them to “turn
inwards” for the things denied them by the society like
understanding and affection.

They tend to dread or avoid contact even with health
providers who, and this is most unfortunate, share the
negative attitude of the wider and ignorant society. Just
visit any of the government hospitals and see the condi-
tion AIDS patients are kept in to prove me wrong or
right. ~

On the other side of the coin, medical personnel have
complained of inadequate facilities to deal with people
infected with HIV and especially those patients admitted.
with full blown AIDS.

Rarely are there gloves, drugs or enough beds, not to
mention adequate appropriate food for these special
patients.



14 LATIN AMERICA

Global Program Against AIDS, says, “by the end of this
decade, there will be 40 million people infected around
the world. This is enormous, and will explode like a
nuclear bomb.”

The Chilean Situation

Catastrophe or not, what is certain is that AIDS has been
in Chile since 1984, when the first case was discovered.
Since that time, the Health Ministry, through the
National Commission Against AIDS (Conasida), states
that there are now almost 700 AIDS cases and more than
1,000 carriers of HIV who will become sick within the
next eight years. Of course, there is also the problem of
underreporting (those who are contagious but do not
report it to the health authorities), who according to the
WHO, constitute as many as 70 percent of all cases in
Latin America.

The Health Ministry, for its part, states that the disease
in Chile is also growing. Dr. Raquel Child, Conasida
Administrative Coordinator, says, “We have some six
AIDS cases for every 100,000 inhabitants. It is expected
that within the next three years, the disease will grow by
30 percent per year, which has been its pattern so far. Of
course, long-term projections are difficult: this one could
increase, depending on the number of variables that are
considered.”

The Education Ministry’s figures indicate that the
regions most heavily affected by AIDS are, in decreasing
order: Metropolitan (rate of 10.93 cases for every
100,000 inhabitants), Fifth (8.33), and Second (4.34).
These are followed by First (2.75), Fourth (1.84), and
Eighth (1.44).

With respect to the form of transmission of the disease in
Chile, the principal means is through sexual intercourse,
with 87 percent of the cases. With respect to those
infected, they are distributed among heterosexuals (19
percent), homosexuals (47.1 percent), bisexuals (20.6
percent), and others of lower incidence.

Nevertheless, among HIV carriers who have not yet
shown symptoms of the disease, the figures show that the
epidemic has spread to the heterosexual population (25
percent), and is lower among homosexuals (46.6 percent)
and bisexuals (17.7 percent).

However, a victory that makes the Health Ministry
proud is that since 1988 there have been no transmis-
sions of the infection by blood transfusion, thanks to the
controls established at the blood banks. But the levels of
contagion via blood transmission have continued
because of the increase in intravenous drug addiction.

Similarly, Conasida’s statistics reveal that the disease
has primarily attacked men, who constitute 93.2 percent
of the cases, with a ratio to women infected by the
disease of 13.5 to 1, Nevertheless, according to the
figures, there has been an increasing number of women
infected, thus reducing the proportion of infected men.

JPRS-TEP-93-016
28 June 1993

With respect to age, those infected are primarily between
30 and 34, and the next largest age group is from 25 to
29.

From 1984, the year when AIDS first appeared in Chile,
no resources were set aside to fight the disease until
1991, when almost 36 million pesos were invested, with
another 35 million the following year. In addition,
during these years, Conasida took up a financial study
for the WHO of some 64 million pesos, to implement the
National Medium-Term Program for the Prevention and
Control of AIDS in Chile. During that same period, the
private sector donated almost 37 million pesos. In addi-
tion, foreign assistance is constantly being sought for the
financing of national plans.

The Government Campaign

This week, millions of Chileans saw on television the
second stage of a massive Government communications
plan to control the impact of AIDS. The first step in the
strategy began in 1990 with an opinion poll to under-
stand Chileans’ perception and level of awareness of
AIDS.

As the results revealed that the issue was distant, that
many were not even concerned, and had insufficient
information, the first campaign was planned. This con-
sisted of three stages: Awareness (where well-known
people declared, “I am affected by AIDS”); Information
(“This is how you get AIDS, this is how you do not get it,
and this is how you prevent it.”); and Commitment
(common situations are depicted in which the family and
children commit to a form of prevention).

Dr. Raquel Child explains that this campaign was eval-
uated and they obtained very good results, consistent
with the objectives. “In two telephone surveys in the
Metropolitan Region, more than 90 percent of the
people were in agreement with the content and form of
the campaign. Their knowledge had increased in terms of
the basics, but it was necessary to give them more
detailed information and tools to apply the data to their
personal lives. Besides, the information and activities
that the community is requesting of Conasida has
increased by more than 2,000 percent.”

Dr. Child evaluated the first campaign: “It was the way
of initiating a public discussion on AIDS in Chile. To
speak of AIDS is something that now occurs frequently,
in the family, at work, at play.”

That is how, in January, during the First National
Meeting of Youth and AIDS, “Down with AIDS,” they
agreed to create the Youth Coordination for the Preven-
tion of AIDS, to work with the issue in every environ-
ment involving youth.

The Network of Life

The new campaign is planned for six months. It is based
on 45 mini-programs, of one minute each, in which
situations from daily life, “as common as possible,” are
depicted, dominated by the dialog between children and


4 SUB-SAHARAN AFRICA

He saw the retreat not merely as a public statement but
an honest desire to discover how cabinet can help and
enhance the Kingdom’s ability to limit the spread of the
AIDS virus.

“While it may be true that no affected country can yet
claim victory against AIDS, I honestly do believe that
this epidemic can be stopped,” he challenged.

Mr. Dlamini warned that unless appropriate action is
taken at the highest level of government, there was every
danger of the scourge translating into a Swazi version of
The Holocaust.

“Cost to the country in terms of premature loss of
human life and financial resources will be phenomenal,”
warned the Premier.

Declaring the fight against AIDS a national priority, Mr.
Dlamini challenged His Majesty’s present and future
governments to place AIDS prevention and control
activities high on their priorities.

He spurred cabinet ministers to make the AIDS epi-
demic a gospel in all their speeches to reflect the impor-
tance and urgency of informing the populate about this
deadly syndrome.

He said the real battle was however at personal and
individual levels where the country can hope to win the
war against AIDS.

Mr. Dlamini said there was a need for individuals to
change their behavioral habits, warning that if they did
not modify their behaviour patterns and attitudes
towards this disease, all inputs would have been wasted.

The Premier emphasised the need to act collectively to
counter the spread of AIDS, saying the private sector had.
an important role to play especially in these days of ever
diminishing foreign donors.

He called for a unified and coordinated effort between
government, private sector, interest groups, local com-
munities and individual citizens.

Mr, Dlamini said there was also an urgent need for
government to strengthen the country’s health institu-
tions to provide amongst other services, care to those
who will eventually develop AIDS.

He then thanked all those who have assisted the National
AIDS Programme since its inception in 1987, in partic-
ular the World Health Organisation (WHO), the Euro-
pean Economic Commission (EEC), the Canadian Inter-
national Development Agency (CIDA), the United
States Agency for International Development (USAID)
and the Overseas Development Administration (ODA).

He also paid tribute to Shell Oil Swaziland for what he
termed the radical position they, have taken in rein-
vesting their profits in the youth of this country, further
challenging other local companies to follow suit.

“The AIDS problem has not yet been overcome, we will
therefore look forward to continued support from both
local and international donor agencies,” he concluded.

JPRS-TEP-93-016
28 June 1993

UGANDA

WHO Official on AIDS’ Economic Impact

93WE0398A Helsinki HELSINGIN SANOMAT
in Finnish 21 Apr 93 p 13

[Article by Sinikka Tarvainen: “Ugandans Learn To
Live With AIDS”]

[Text] Children are playing on the stairs of Ugandan
Rose Bwanika’s cement house, which stands among
splashes of green from banana trees and vegetable gar-
dens, in the residential area of Makindye in the vicinity
of Kampala. The youngest of the children are only able
to crawl, while those of school age are trying the bal-
ancing act of standing on their hands.

Of the eight children at Rose’s, four are her own. “One is
my niece; my sister’s daughter. Three are orphans who
lived with me at the school while I worked as a teacher,”
32-year-old Rose told us.

The parents of the orphans living at the school, Rose’s
sister and her husband, as well as Rose’s five other
siblings, have all died of AIDS. “Only my old mother
and I are left,” said Rose. “A child of one of my siblings
lives with my mother. Ten others are staying with aunts
and uncles, The ones staying with their aunts spend a lot
of time with my mother. Poor Mother! She brought up
her children as a widow, facing hard times, and now, in
her old age, she must take care of her grandchildren,” she
continued.

Rose’s husband also died of AIDS. Rose was saved from
the disease, as her husband left her a few years before his
death.

Every Sixth Adult HIV-Positive

Rose is employed in a development aid project spon-
sored by the Free Finnish Foreign Mission, within the
framework of which she is able to help more than 60
AIDS orphans with, among other things, school tuition
and food. “In my neighborhood there are many people
suffering from AIDS,” said Rose. “They are foisting
their children upon me, in the hope that I will care for
them after the parents die,” she continued.

According to the World Health Organization (WHO),
which is under the jurisdiction of the UN, of Uganda’s
16.5 million people, 1.5 million are carrying the HIV
virus. Every sixth adult has the HIV virus. According to
many estimates, about 230,000 Ugandans have devel-
oped AIDS. AIDS is the primary cause of death among
adults.

AIDS turns children into heads of households and grand-
parents into providers for large families. AIDS and the
aftermath of the war have left Uganda with an estimated
1.5 million orphans. The traditional system, according to
which relatives will assume responsibility for orphans, is
cracking under the onslaught of AIDS.

Aid organizations and local authorities are trying to
place the AIDS orphans anywhere, from foster homes to
boarding schools, But many have ended up on the street.


IPRS-TEP-93-016

20 LATIN AMERICA 28 June 1993

In addition, the Health System does not include AIDS
testing among its requirements for people seeking
jobs. “It would be enormously expensive to test
everybody. MINSA cannot afford that,” said Blanca
Acuna.

This disease, with its aura of fatal illness, mystery, taboo,
blame, and religious scruples, forces its carriers to keep
their condition a secret to avoid discrimination. Still,
they do not realize that with their silence they may be
marking the lives of other people.


JPRS-TEP-93-016
28 June 1993

Foreicn

Broapcast

| INFORMATION
Service

PRS Report—

Epidemiology

AIDS

DUMIGTTON ERDENT A
Bumored tor oS

DTIC QUALITY INSPECTED 2

AEPRODUCED BY

U.S. DEPARTMENT OF COMMERCE
NATIONAL TECHNICAL INFORMATION seRVICE
SPRINGFIELD, VA 22161

C00 62012661



JPRS-TEP-93-016
28 June 1993

should emphasize the following: “Strengthening pro-
paganda, expanding monitoring, and unifying admin-
istration.” To strengthen propaganda involves work
on many different levels. It requires not only to
develop leadership, but also to enhance the training of
medical personnel for diagnosing and treating AIDS.
Additionally, it involves the mass media educating
people on AIDS prevention to enable the public to
protect themselves. As far as monitoring is concerned,
close watch over sexual deviates and drug addicts
must continue. In the meantime, the scope of inspec-
tion of overseas returnees and blood donors must be
broadened. A definitive diagnosis must be made on

CHINA 7

each individual who is suspected of having AIDS or
being HIV infected. To unify administration, the
clinically-confirmed AIDS patients will be centrally
admitted by contagious disease treatment facilities
for quarantined treatment. The HIV infected will be
confidentially tracked by public health and epidemic
prevention agencies. They will be educated to take
measures to reduce the risk of harming others. The
AIDS diagnostic drugs will be carefully selected based
on their specific property, high sensitivity, and low
cost. The drugs will be centrally and systematically
supplied by the public health and epidemic preven-
tion agencies,



6 CHINA

Progress in Using Chinese Herbal Medicine To
Treat AIDS

93WE0401B Beijing YIYAO XINXI LUNTAN [CHINA
MEDICAL TRIBUNE] in Chinese Vol 19 No 11,
25 Mar 93 pp 1,7

[Article by Lu Weibo [0712 4850 2672], Research Staff,
Institute of Traditional Chinese Medicine: “Progress of
Treating AIDS With Chinese Traditional Herbal Medi-
cine”)

[Text] Recently, the world began to attach importance to
developing traditional Chinese medicine and Chinese
herbal medicine (CHM) for the treatment of AIDS. In 16
different countries and regions, including China, Hong
Kong, Japan, and the United States, more than 1,000
researcher are now engaged in the research of treating
AIDS with CHM. The research generally falls in the
following three categories:

(1) Compound drugs study: Japanese scholar Ono and
others discovered that the ancient prescription decoction
of bupleurum chinense composita inhibits the activity of
reverse transcriptase in 70-90 percent of the patients. In
the decoction, scutellaria root is most effective. The
HPLC (high pressure liquid chromatography) test indi-
cates that the root consists of scutellarianin and scutel-
larianidin. Intravenous dripping of scutellarianidin can
reduce the p24 antigen, and increase the counts of T,
cells. Other CHMs such as ginseng decoction, Hongbao,
prescription 89111, and compound drug red sage root
liquid for injection are studied with various progress.

(2) Single-element drugs study: The greater number of
studies are on CHMs for clearing away heat and toxic
material as well as for invigorating qi and strengthening
the spleen. For his purpose, U.S. scholar Zhang Siman
[1728 0138 3341] cultured 27 different CHMs for
clearing away heat and toxic material with H9 cell. He
discovered that in this group of CHMs as many as 11
herbs can inhibit HIV; among which herba violae and
prunella spike are outstandingly effective with indices
higher than that of AZT. The immunological investiga-
tion of gi-tonic milkvetch root, ginseng, Chinese cater-
pillar fungus, lucid ganoderma, and licorice root dis-
closed that these CHMs can increase the plaque forming
cell, specific rose-forming cell, interleukin-1 and inter-
leukin-2. Some of the qi-invigorating CHMs can also
inhibit HIV.

(3) Investigation of CHM effective ingredients: Yang
Xianrong [2799 7359 2837] of Hong Kong and McGrath
of the United States discovered that the Q-substance, a
purified protein extracted from the trichosanthes root
(which has been used for the second trimester abortion
in China’s family planning for years) can inhibit the
synthesis of protein. Thus, the Q-substance can inhibit
the reproduction of viruses and kill the macrophage.
They further discovered that the Q-substance can selec-
tively inhibit the macrophages infected by HIV and
prevent the formation of plasmodium. They have effec-
tively treated thousands of patients with the Q-
substance; however, it caused significant side-effects and

JPRS-TEP-93-016
28 June 1993

some patients discontinued the treatment. At present,
the second stage clinical trial of the Q-substance is in
progress and it is hopeful that it will be officially
approved in the near future. Next, Naoki Yamamoto of
Japan concentrated his study more on the effect of
glycyrrhizin. He found that it can inhibit many DNA and
RNA viruses. During cell culturing, glycyrrhizin can
inhibit the expression of HIV antigen and the formation
of plasmodium. Clinically, it can delay onset of AIDS
and improve patient’s immune system as well as alle-
viate side-effects caused by AZT. In addition, he also
studied balsam pear (bitter melon), hypericum chinense,
and garlic, etc.

Based on the aforementioned research results, China’s
medical personnel in Tanzania treated 158 HIV cases
with CHM (Keaike [0344 5337 0668], 801, 802, 806,
pulse-activating drink, decoction of six ingredients, etc.),
Among these cases, 108 patients (68.35 percent) had
very serious immune deficiency and lower than 200 per
cubic millimeter T, cell counts, and had already been
placed in the AIDS category. Their symptoms were
weight loss, fatigue, fever, loss of appetite, diarrhea,
cough, skin rash and lymphadenectasis. After CHM
treatment, the symptoms were strikingly improved. The
immune deficiency of a third of these patients were
improved. Especially in six cases, the antibodies in their
serum turned negative with undetectable antibody in
their blood. Follow-up visits found that their negative
states were maintained from 10 to 15 months. These
patients had a common nature: they had higher immune
levels before the treatment; and the ratio of T,/T, was
above 0.7. This phenomenon deserves in-depth investi-
gation. Keaike proves to be the most effective among the
CHMs. Among the six cases that turned negative, two
patients appeared negative after a 3-month Keaike treat-
ment. The observation of these patients is continuing.

Near-Term Focusing Points on AIDS Control

93WEO0401A Beijing JIAN KANG BAO in Chinese
4 Apr 93 pl

[Article by Zhao Lianzhou [6392 6647 3166]: “Near-
Term Focal Points To Prevent and Control AIDS in
China: Strengthening Propaganda, Expanding Moni-
toring, and Unifying Administration”]

[Text] Up to now, 969 HIV positive cases have been
identified in China, 12 of which are AIDS patients.
Recently, the Ministry of Health convened in Haikou a
National Work Conference on AIDS Prevention and
Control to discuss China’s work strategy.

According to reports of the conference, a total of
610,000 AIDS cases is now identified in 173 countries
and regions. One hundred thousand of the cases
occurred in China’s neighboring countries, India and
Thailand. In China, due to the limited area moni-
tored, it is estimated that the actual number of people
infected by HIV far exceeds the reported cases. Pin-
pointing this increasingly serious AIDS epidemic, the
conference recommends that the AIDS control policy


IJPRS-TEP-93-016
28 June 1993

figures. The total number of deaths from the disease
reached 4,675 last month compared with 4,572 in
March.

Of the 402 reported cases in Scotland 46 percent are
related to sexual intercourse between men and 31 per-
cent to injecting drug use. The comparable figures for the
rest of the UK are 77 percent and three percent, respec-
tively.

Notes to News Editors

1. Details of the process of compiling this data and the
categories used are available on request.

2. Epidemiological surveillance of the Acquired Immune
Deficiency Syndrome (AIDS) was begun at the PHLS
Communicable Disease Surveillance Centre (CDSC) in
collaboration with the Communicable Diseases (Scot-
land) Unit (CD(S)U) in 1982. The figures announced
today are the cumulative totals of cases reported. The
case definitions of AIDS compiled by the U.S. Centre for
Disease Control in Atlanta, Georgia are used for classi-
fying and recording the UK case reports.

3. Because of the nature of the reporting system, the
number of cases of AIDS reported each month does not
accurately reflect the number of cases diagnosed during
the period.

4. It should be noted however that in view of the long
interval between infection with HIV and the develop-
ment of AIDS, the trends of AIDS cases and deaths and
their distribution between risk groups are not indicators
of the current progress of spread of HIV infection.

5. News releases setting out the latest Scottish AIDS
figures are issued by The Scottish Office monthly. Quar-
terly breakdowns of known HIV antibody positives are
issued with the AIDS figures in the month which follows
the quarter to which they refer.

Report Predicts Spread of AIDS Among
Heterosexuals

BRI1I506131393 London Hermes Database in English
14 Jun 93

[UK press release from Department of Health: “Latest
AIDS Predictions Vindicate Government’s Approach”]

{Text] A new report predicting the spread of AIDS up to
the end of 1997 was published today.

The report [Footnote] [The full report, The incidence
and prevalence of AIDS and other severe HIV disease in
England and Wales for 1992-1997: projections using
data to the end of June 1992 is published by the Public
Health Laboratory Service. Previous reports on HIV/
AIDS projections for England and Wales were published
in November 1988 and January 1990.] indicates that the
number of AIDS cases will soon plateau among homo-
sexual men and that HIV infection is declining among
drug misusers, But the report also predicts a steady

WEST EUROPE 27

increase in new cases of AIDS among heterosexuals, and
that this will continue for at least the medium term.

Baroness Cumberlege, Parliamentary Secretary at the
Department of Health, said: “This report indicates that
real success has been achieved in controlling HIV and
AIDS in the UK since the disease emerged in the early
1980s. The figures vindicate the policies the Govern-
ment has put into place to fight the disease. The UK now
has one of the lowest estimated HIV prevalence rates in
Western Europe. There are around six times as many
cases in France, four times as many in Spain and three
times as many in Italy.”

But she went on: “If we are to maintain our relatively
favourable position, the UK must keep up its prevention.
work—both to remind existing generations and to teach
new ones.”

The Minister said that the strategy for dealing with the
disease would be kept under review.

“With increasing knowledge of the disease and experi-
ence of dealing with it, I believe the time is right to
examine elements of our strategy to ensure that we
continue to meet the challenge it presents.”

Key elements of that strategy will include:

—encouraging appropriate behaviour change by
increased targeting of sections of the population at
particular risk, including homosexual and bisexual
men and drug misusers;

—sustaining and improving general public awareness,
including a new “Travel Safe” campaign aimed at
those travelling abroad;

—continuing to make HIV testing facilities more widely
known, and encouraging health authorities to commis-
sion additional accessible HIV testing sites;

—continued funding for the voluntary sector. The Gov-
ernment will carry on distributing grants on a yearly
basis taking into account developing health priorities
and the ability of voluntary bodies to raise funds from
other sources for HIV/AIDS work.

“The Government’s present and future commitment to
policies in this area is demonstrated by its inclusion of -
HIV/AIDS with sexual health—along with other health
priorities such as heart disease, cancer and mental ill-
ness—as one of five key areas in ‘The Health of the
Nation’ strategy,” said Lady Cumberlege. “At the same
time the Government will continue to keep its HIV/
AIDS strategy under review in the light of the developing
scientific and medical knowledge about the disease.”

“The forecasts in Professor Day’s report show clearly
that the response by the Government, general public and
individuals has had a positive impact in reducing the
spread of AIDS and HIV. However, the long term
uncertainty about the course of the disease argues
strongly for continued vigilance and the need to avoid
any sense of complacency. The position of some of our
European neighbours shows clearly what could happen
here if the momentum of our prevention effort is lost.”



26 WEST EUROPE

they attacked not only the injected gp 160 but also the
HIV strains with which the patient was infected. Finally,
it was found that the virus population declined.

“A very encouraging result,” says Eric Sandstrom.

The result in those who had not received AZT was no
worse than in the others—perhaps the opposite. The
problem was, however, that after one year the patients
were back where they started. Tests in which the patients
were revaccinated were therefore begun four months
ago, and it turns out that the T-helper cells in most of the
patients are multiplying again to some extent.

“The very latest results show that the trend is not
negative,” says a cautious Sandstrom.

One thousand HIV-positive individuals from the Scan-
dinavian countries will now be “vaccinated” with gp
160.

Similar large-scale tests are under way in the United
States, but they have been delayed by controversies over
money. This may mean that Sweden will be the first to
answer the question of whether the method really works
as an AIDS-inhibiting vaccine.

Another method, still at the laboratory stage, is to
produce certain types of antibodies to the virus by
synthetic means and then to inject them.

Antibodies have been produced, but so far no tests have
been started, not even on animals.

‘Downward’ Curve in Number of AIDS Cases

93WE0418A Stockholm DAGENS NYHETER
in Swedish 27 May 93 p 13

[Article by Benny Oinert: “AIDS Epidemic Has Been
Slowed”—introductory paragraphs in boldface as pub-
lished]

[Text] The Swedish AIDS epidemic seems to have passed
its peak.

“In 1991 there were 140 new cases, while the number fell
to 130 in 1992,” says state epidemiologist Margareta
Bottiger. “It appears that the peak was passed last year
and that the curve is now turning downward.”

In all, 810 AIDS cases and 3,409 cases of HIV infection
have been recorded in Sweden. The figures on AIDS
cases indicate that over 50 percent of those infected in
the early 1980’s have now fallen ill with AIDS.

“The figure on new cases of HIV infection is holding
steady at around 30 per month, but the number of
infected Swedes has gradually fallen,” says Bottiger.

Two-thirds of the cases now being reported are for-
eigners. Of the 91 cases reported during the first quarter
of this year, 24 were Swedes and 47 came from Africa.

Bottiger was reporting on recent developments during a
reporter’s seminar held at the Caroline Institute in
Stockholm on Wednesday in preparation for the inter-
national AIDS conference scheduled for Berlin at the
beginning of June.

JPRS-TEP-93-016
28 June 1993

The conference will include several Swedish studies on
how it may be possible in the future to strengthen the
immune system both by preventive vaccination and by
medication of those already infected.

While the trend seems stable in Sweden, international
forecasts are all the more disturbing.

“There are big variations in forecasts,” says Bottiger. “It
is estimated that between 40 million and 110 million
people will be infected by the year 2000.”

Increase in Asia

The disease is continuing to spread most rapidly in
Africa, but the number of infected individuals is
expected to rise quickly in Asia, which may pass Africa
around the turn of the century.

“India was once an unknown quantity in this connec-
tion, but information on how women in the untouchable
class are used almost like cattle is frightening,” says
Bottiger.

Many girls disappear from the countryside and wind up
in bordellos in the cities. Often they stay only six months
in each bordello before being moved somewhere else.

According to Bottiger, the inferior status of women in
many parts of the world is a strong contributing factor in
the spread of infection.

At the conference in Berlin, Gunnel Biberfeld, who is a
professor of clinical immunology, will report on vacci-
nation tests conducted on monkeys.

Cautious Optimism

The results of those tests indicate that it is possible to
produce protective immunity in half the cases by vacci-
nating individuals with a purified surface protein from
the HIV-2 virus.

But since the virus can vary in different individuals, it is
important to produce broader immunity in people.

By infecting four monkeys with an HIV-2 strain that
multiplies for only a short time in the monkeys,
researchers have been able to produce a weakened vac-
cine.

UNITED KINGDOM

April AIDS Figures Reported

BRO0306100293 London Hermes Database in English
25 May 93

[UK press release from Scottish Office: “Latest AIDS
Figures for Scotland”)

[Text] An additional seven AIDS cases were reported in
Scotland during April making the cumulative total 402.
The figures issued by The Scottish Office also show that
six further deaths from the disease have been reported
bringing the cumulative total to 272.

In the UK the number of reported cases of AIDS has
risen to 7460—an increase of 119 over the March 1993


IJPRS-TEP-93-016
28 June 1993

What occurs, according to Emilia Chemane, is that blood
banks receive a greater number of depositors (who
donate to save a family member) than donors, which
means that hospitals do not have sufficient supplies of
the liquid.

For that reason, she said, and others of an organizational
nature at the banks, last year 5,150 requests were not
fulfilled. She stated that she did not have statistics on
how many deaths might have occurred for lack of blood.

The current seminar is aimed at defining strategies for
better administration of the country’s blood program,
and among other things, it points to the need for greater
communication with the community to overcome some
problems the sector is facing.

The seminar continues today, expecting to debate the
question of the link between the anti-AIDS program and
the blood program, with respect to the question of
quality control.

NAMIBIA

HIV Cases Show ‘Dramatic Increase’

93WP0171A Windhoek THE NAMIBIAN in English
2 Apr 93 pp I, 12

[Article by Christof Maletsky]

{Excerpt] A total of 51 percent of the 4,410 HIV cases
recorded in Namibia over a seven-year period were
reported in 1992 alone, showing a dramatic increase,
according to figures just released by the Ministry of
Health and Social Services.

HIV cases among children under five years old have shot
up by 140 percent in one year, while overall the incident
rate for 1992 shows a startling jump—up to 146 per
100,000 people compared to 0.3 per 100,000 in 1986.

The HIV Infection Report for 1992 reveals that the most
cases of HIV infection for any one month during the
seven-year period (1986-1992) were reported in
December 1992 with 253 cases.

There has been an increase of 128 percent in HIV
infections in the group of people aged 45 years and
above.

Further, 54 percent of the cases were male, 44 percent
female and two percent unknown.

HIV infection increased by 62.6 percent from 1991 to
1992 and the incident rate for HIV infection from 1992
was 146 per 100,000 people, a dramatic increase from
0.3 per 100,000 in 1986.

The report states that more deaths from AIDS are being
reported probably because the Health Information
System is now in operation.

Of the deaths from AIDS in 1992, 60 percent occurred in
the north-west region.

HIV in Namibia has reached epidemic proportions says
the report. The infection among children under five has

SUB-SAHARAN AFRICA 3

increased by 140 percent in one year which is described
as “alarming” as those children already diagnosed HIV
positive are likely to develop AIDS in the coming
decade. This emphasises the fact that more and more
children are born with the disease from infected
mothers.

Deaths were high among the under five years age group
as well as among the childbearing group and as infected
parents die the State will be left to care for many orphans
with the accompanying financial burden.

The Minister of Health and Social Services, Dr. Nicky
Iyambo said yesterday that the figures represented “only
the tip of the iceberg” because thousands of people had
never been tested for HIV.

[Passage omitted]
SWAZILAND

Prime Minister Declares AIDS ‘National Priority’

MBO0506133193 Mbabane WEEKEND OBSERVER
in English 5 Jun 93 p 1, 3

[Report by Vusi Sibisi: PM declares AIDS a top govt
priority]

[Text] Prime Minister Obed Dlamini yesterday declared
AIDS a national priority with a chilling warning that any
further neglect of this scourge could lead to the country’s
decay, undermining what it has achieved in 25 years of
independence.

Mr, Dlamini said deadly signals were flashing all over in
Africa where the killer syndrome has wiped out whole
communities, leaving immeasurable human suffering,
socio-economic decay, a trail of unwarranted graves and
countless orphans.

The Premier said this when opening an “AIDS retreat
for Cabinet” at the Pigg’s Peak Protea Hotel and Casino,
attended by cabinet ministers, health workers and edu-
cators as well as members of the diplomatic corps.

“] cannot think of any reason why AIDS should not do
here what it has done in these (African) countries,” he
said.

He said from the manner the AIDS epidemic had and
continued to unfold, it was clear that it “transcends all
spheres of human existence so its impact will without
doubt affect all of us gathered here one way or the
other.”

The retreat, he said, was being held with the backdrop of
a deteriorated AIDS situation in the country where
about 25,000 people are believed to have been affected
by the end of last year.

Most worrying the Premier was the fact that the scourge
was prevalent among the 18-50 age group who were the
most sexually active and who also formed the core of the
most economically active group in the Kingdom’s pop-
ulation. Current projections show that one in every 15 in
this group is afflicted with the virus.



SIPRS-TEP-93-016
28 June 1993

would be 2,000 by the year 2020 and 18,000 deaths in
the same period. This number would rise to 20,000 in the
year 2025.

Catastrophe Announced

Alluding to CHRONICLE OF A DEATH FORETOLD,
by [author Gabriel] Garcia Marquez, Sonia Araiz, health
demographer in the Planning and Social Studies Depart-
ment of the Planning and Cooperation Ministry, said
that this disease is also a chronicle, but “a foretold
catastrophe.” [passage omitted.]

The question that arises is, Who assumes the costs of
treating the infected? Araiz’s reasoning is that if only 25
percent of the health costs are covered by the Isapre’s
[Institutes of Public Health and Preventive Medicine],
the other 75 percent would inevitably fall on the public
system financing the government. Since this disease is a
risk to the Isapre’s, and because the majority of the
facilities do not cover the costs of medication, and the
prices of the services would rise for the group between 25
and 40 at greatest risk of infection, then the costs for this
group should also be assumed by the State.

Education Minister on Policy

93WE0367C Santiago EL MERCURIO in Spanish
17 Apr 93 p C7

[Article by Arturo Villalobos Carrasco]

[Excerpt] Valdivia—Education Minister Jorge Arrate
said yesterday here that he is considering opening a
national dialogue within the education community
about the AIDS problem, emphasizing that there is no
child in Chile without the right to an education.

The secretary of state responded thus to a question
involving possible discrimination that a child infected
with the disease had suffered in Santiago.

He noted that last Friday, with Subsecretary of Educa-
tion Raul Allard, “we sent an open letter to the educa-
tional community, discussing the problems that this
represents and what is our criteria with respect to the
issue.”

He said that he did not wish to go into more detail on the
issue until the letter had been made public. “In any
case,” he emphasized, “the issue is extremely complex;
few issues can be more complex than a new challenge for
an educational system, especially because it is an issue
that has to do with the rationality of our society’s
conduct, our society’s awareness, and human values.”

He indicated that he hoped that on this issue “we can
open a constructive national dialogue and that Chileans
will be able to have the certainty that the Education
Ministry will act on this material with care and with a
sense of justice, as we always try to do, making effective
a basic right established in the constitution, that every
Chilean has the right to be educated.”

He added that “there is no child in Chile, whatever his
circumstances, without the right to an education; but we

LATIN AMERICA 7

have to examine how we can make this right effective in
the most efficient, democratic, and humane manner.”

In the timely case of the young carrier of the disease in
Santiago, the minister reiterated that the best thing
would be for children infected with AIDS to be accepted
in normal educational establishments, “but this is an
issue that cannot be resolved with a decree. That does
not make sense. What does make sense is for us to carry
out a great public awareness campaign, to spread the
scientific knowledge that we have, which shows that
there is no risk of transmitting the disease if a child
carrying it participates normally in school activities,” he
emphasized.

CUBA

AIDS Cases, Control Strategies Reported

93WE0360A Havana TRABAJADORES in Spanish
12 Apr 93 p 10

[Article by Carmen R. Alfonso]

[Text] The number of people who are HIV-positive or
suffering from AIDS is increasing steadily, especially in
Latin America. In Argentina, Brazil, Colombia, and
Mexico alone the number of carriers was close to 2
million as of last January, Notimex has reported. And
one worrisome point is that between “30 and 50 percent
of the patients who have developed the disease have not
been reported.”

The HIV-positive rate in Cuba, however, remains at
0.009, which translates into 903 AIDS-infected persons
since 1986, 102 of whom have died. Thanks to the
medical care that is provided all over the country, the
first and last names of each and every one of these people
can be ascertained and timely treatment can be provided
to them.

How is it that a small, economically underdeveloped
country that is going through the most difficult situation
in its history can report this fact to the world? What kind
of government and people are these? What sort of
humanistic policy has been pursued and how many bold,
heroic decisions have been made to prevent hundreds of
thousands of Cubans from contracting the virus, to
provide special diets and drugs to the carriers, thus
delaying death, and to care for patients until their last
breath?

In a conversation with Drs. Jose Ramon Balaguer, a
member of the Politburo, and Hector Terry, the deputy
minister of hygiene and epidemiology at the Public
Health Ministry, we briefly reviewed the strategy that the
revolution has pursued to protect the right to life of the
healthy population and to assure the right to medical
care of those who have developed the disease.



SJPRS-TEP-93-016
28 June 1993

preventive character, something which is extremely nec-
essary today: Times of troubles have always been accom-
panied by infectious diseases.

‘No Outbreaks of AIDS’ in Hospitals

LD1905 180293 Moscow ITAR-TASS World Service
in Russian 0924 GMT 19 May 93

[By ITAR-TASS parliamentary correspondent Lyudmila
Ermakova]

{Text] Moscow, 19 May—To date “there have been no
outbreaks of AIDS within hospitals in Russia,”
according to Yevgeniy Belyayev, chief state public health
officer of the Russian Federation and chairman of the
State Committee for Public Health and Epidemiological
Supervision. He was addressing today’s sitting of the
Supreme Soviet’s Soviet of the Republic (one of the two
parliament’s chambers), presenting the federal targeted
program for the development of the state public health
and epidemiological service in the Russian Federation in
1993-95.

Thanks to the implementation of a set of preventive
measures which “have made it possible to erect a barrier
preventing the spread of AIDS within hospitals, there
has been no ‘upsurge’ in the HIV-infection,” Yevgeniy
Belyayev said. Since the registration was started, a total
of 582 cases of the HIV-positive have been registered, of
which 72 have AIDS; more than 300 of these are
foreigners, and they have been deported from the
country. The chief public health officer said an “anti-
AIDS” program is being drawn up.

Republic Registers Six HIV-Infected Patients

£D0206191893 Moscow ITAR-TASS in English
1751 GMT 2 Jun 93

[By ITAR-TASS correspondent Feodor Angeli]

[Text] Chisinau June 2 TASS—Six HIV-infected people
are now registered in Moldova, after 20 foreign students,
who had tested positive in AIDS examination were sent
out of the country and two locals died of the disease,
according to chief doctor of the republic’s centre for
prevention and treatment of the Acquired Immune Defi-
ciency Syndrome.

The parliament of Moldova passed a law on preventing
and combatting this “plague of the 20th Century”.
Starting this year, specialists have been administering
tests worked out at the French Pasteur Institute at the
central and zonal laboratories.

Some people in the republic insist that the simplification
of the border crossing procedure poses a potential threat
of further spread of the HIV infection in the republic. A
number of physicians have spoken out for the legitima-
tisation of prostitution, which, according to them, could
serve as an effective measure to prevent the uncontrolled
spreading of AIDS because many people in the danger
group would be under medical supervision.

CENTRAL EURASIA 23

Problems of AIDS Center; Sixteen Cases
Reported

AUI1506143493 Tbilisi SVOBODNAYA GRUZIYA
in Russian 5 Jun 93 p 3

[Tinatin Gviniashvili article: “Problem”: “Tomorrow
Will Be Late”]

[Excerpts] The spread of the AIDS virus throughout our
republic is rightly arousing the extreme alarm of the
medical world. According to information from the
Republican AIDS and Immunodeficiency Center, just
over the last four years 16 people infected with the virus
have been detected: Five of these were foreigners and
were deported, while the remaining 11 are our compa-
triots. Of these two have already died while the other
nine, eight of whom live in Tbilisi, are alive and in a
wholly satisfactory condition. Their ages range from 23
to 45 and one is female.

In comparison with other statistics, the situation in
Georgia regarding this problem does not seem, at first
sight, to be so alarming. However, this is only at first
sight. If we take account of the fact that each person who
has not been tested for AIDS is a potential carrier of the
virus....

As specialists have stated, it is somewhat difficult to
determine the source of the infection, particularly if the
infected person has spent a long time abroad. As for
these nine persons, they contracted the infection in
different ways: Two of them are drug addicts, several are
bisexual, and only one has been infected parenterally
(medically).

As regards the Republican AIDS and Immunodeficency
Center, it can unequivocally be said that one has to be a
real hero, almost a “kamikaze” to struggle against this
menacing disease in the conditions in which our medical
workers have to work. It does not have its own premises
but occupies part of a building where it is treated like the
poor relative and where it is terribly cramped with
people and apparatus and equipment literally on top of
each other, Yet, the most complex processes of diagnosis
and all kinds of experiments and research into the
“plague of the 20th century” are being conducted there.
The situation is made more complicated by the unstable
economic and political situation in the republic, which
creates additional difficulties regarding the procurement
of essential specimens and agents. It would not be
surprising if, in such conditions, the “condemned” (God
forbid!) doctors were themselves to be added to the
so-called “risk group.”

Nevertheless, the center is continuing its painstaking
work: It keeps the AIDS patients under observation,
maintains under its control a network of 29 laboratories
spread throughout the republic, and conducts tests on
the “risk groups” and all who want to be tested and,
naturally, those who have returned from spells abroad.
[passage omitted]



JPRS-TEP-93-016
28 June 1993 3 AIDS

NEAR EAST & SOUTH ASIA
ISRAEL
AIDS, TB Among Ethiopian Immigrants [Uri Sharon; Tel Aviv DAVAR, 8 Jun 93]
JORDAN

. 21

Health Ministry Announces 86 AIDS Cases in Country {Amman JORDAN TIMES, 19 May 93] . 21
LEBANON
Health Minister Reports 190 AIDS, HIV Cases (Paris AFP, 28 May 93] ..
CENTRAL EURASIA

Kazakh AIDS Program Seeks Sponsors /Almaty KAKAVAN, 8 Jan 93]
Chelyabinsk Committee To Combat STDs, AIDS [Moscow TRUD, 12 Mar 93] .
Latest AIDS Figures for Ukraine Reported /Kiev URYADOVYY KURYER, 13 Apr 93]
Georgia: Doctors Establish ‘Anti-AIDS’ Association (Tbilisi NOVAYA GAZETA, 18 May
‘No Outbreaks of AIDS’ in Hospitals [Lyudmila Ermakova; Moscow ITAR-TASS, 19 May 93)"
Republic Registers Six HIV-Infected Patients /Feodor Angeli; Moscow ITAR-TASS, 2 Jun 93]
Problems of AIDS Center; Sixteen Cases Reported

[Tinatin Gviniashvili; Tbilisi SVOBODNAYA GRUZIYA, 5 Jun 93 ] ....

WEST EUROPE

CYPRUS
Authorities Claim AIDS Not on Rise [Nicosia THE CYPRUS WEEKLY, 4 Jun 93] ...
DENMARK

AIDS Prevention Group: Number of HIV Cases Stable
[Kirsten Sorrig; Copenhagen BERLINGSKE TIDENDE, 25 May 93]

GERMANY

Health Minister Cites Figures on HIV Infections
[Birgit Ulrich; Berlin BERLINGER ZEITUNG, 8 Jun 93]

NORWAY

New AIDS Definition Encompasses More Patients
[Bodil Bakkab; Oslo ARBEIDERBLADET, 22 Apr 93] ...

SWEDEN

New Antibody Reduces HIV Risk for Babies [Stockholm DAGENS NYHETER, 12 Mar 93]... 25
Sweden First To Try Large-Scale AIDS Vaccination

[Kerstin Hellbom; Stockholm DAGENS NYHETER, 27 May 93] ....
‘Downward’ Curve in Number of AIDS Cases

[Benny Oinert; Stockholm DAGENS NYHETER, 27 May 93]

UNITED KINGDOM

April AIDS Figures Reported /London Hermes Database, 25 May 93] ...
Report Predicts Spread of AIDS Among Heterosexuals {London Hermes Database, 14 Jun 93] 27



10 EAST ASIA

She insisted that Thailand had not violated intellectual
property rights because Thailand had its own laws on
medicine, [Bangkok THE NATION in English on 20
June, in a similar story on page 2, added the following:
“Chiraphon said the United States’ aim is to monopolize
unregistered drugs in Thailand which have already been
on sale in other countries.”

“This, she said, would eventually affect the import of all
of the 99 anti-AIDS drugs under research worldwide.
Only importers and producers of these drugs would be
entitled to sell them in the country. Many people would
be unable to afford to pay for the drugs, thereby causing
the further spread of AIDS.”

“Chiraphon described as ‘unfair’ the US demand from
Thailand.”]

Dr. Somsit Tansuphasawatkun of Bamrungradnaradul
Hospital said a tremendous amount of money has been
spent on AZT medicines for HIV carriers.

He said it cost about 200,000 baht for each HIV carrier
to buy AZT medicines and the patient has to take the
medicine five times a day.

He said that did not cover costs to cure opportunistic
infections that could result from immunity deficiencies,
such as tuberculosis [TB], fungal infections and pneu-
monia.

In Thailand, more than half the AIDS patients suffer
from TB and have to take compulsory medicine for nine
months to recover and have to take medicine for the rest
of their lives, Dr. Somsit said.

SIPRS-TEP-93-016
28 June 1993

He said that because TB is resistant to medication, new
medicines would have to be bought, which would be very
expensive.

Public Health Ministry representative Ms. Atchara
Wararat said the Government would have to spend more
on assisting HIV carriers if pipeline, protection was
provided.

Ms. Atchara said the Public Health Ministry had a
budget of 33 million baht to buy medicines, whereas 52
million was required to buy AZT which would be
demanded by patients of all hospitals throughout the
country.

An HIV carrier whose code name was Khun Khamnung
said that sometimes HIV carriers had to ask doctors to
cut down the AZT prescription because it was too
expensive.

The director of the AIDS Counselling Centre and Edu-
cational Support Services (Access), Chon Ungphakon,
said pharmaceuticals should not be profitoriented
because it it was a basic right for people throughout the
world to be provided with medicine.

He said that when AZT was initially produced, it was to
cure cancer.

But when it was found it could help HIV carriers the
price was hiked up.

Mr. Chon said that although the price of AZT was
reduced because there were similar medicines, it was still
expensive and sold for profit.

Government organisations lack coordination in pro-
viding medicines especially to HIV/AIDS carriers,
according to a seminar participant.


12 EAST EUROPE

Vutkovski: We use the tests developed by the Abbott
Company. They are used in the United States and
Germany. They are a 100 percent reliable.

OTECHESTVEN VESTNIK: Do you have any hopes
that the center will acquire a new building?

Vutkovski: We had plans that would have cost millions
of leva but all of this has remained on paper only. The
Denitsa-2 furniture house was built on the lot which had
been allocated for the center. Now we have a new plan
for three million leva’s worth of construction, but the
assigned builder was the Plovdiv building organization.
Who is about to leave his home and family and come and
live in mobile homes for a few years! They took the lot
and the money, and now we have no possibilities what-
soever.

Numbers, Location, Average Age of AIDS Patients

93WE0415A Sofia KONTINENT in Bulgarian
17 May 93 p3

[Article by Valeriya Marinova: “The Average Age of the
113 Bulgarians With AIDS Is 23, There Are No Infected
Drug Addicts”)

[Text] Sofia, 16 May. There are 113 HIV-positive cases,
of whom 20 are sick, and 18 deceased Bulgarians and 90
HIV-positive foreigners who were extradited, according
to the latest data on the spreading of AIDS. This was
reported by Dr. Radka Argirova from the Central AIDS
Laboratory on the occasion of the international day of
struggle against that disease.

Over the past two years, in Bulgaria the disease has been
transmitted mainly heterosexually, and the number of
HIV-positive pregnant women is expected to increase.
This is confirmed by several cases in which the newborn
were natural carriers of the virus.

For the past three years there have been no “imports” of
that infectious disease, professor Argirova pointed out.
The disease has been localized and its biggest center is
Gabrovo. Most carriers are discovered when they donate
blood. The difficulties are caused by the squeamishness
of the sick and the fact that AIDS tests are voluntary.

At the present time efforts are being made to introduce
mandatory testing at the skin and venereal disease
centers so that the most likely carriers of the disease may
be tested.

Unfortunately, we cannot detect all the carriers and the
sick and, in all likelihood, they are 10 times more than
those on record, according to Dr. Argirova. We have still
not identified a single sick drug addict but this category
will soon become a problem for the physicians. The age
of AIDS carriers is also steadily dropping—currently it is
23.

SIPRS-TEP-93-016
28 June 1993

CZECHOSLOVAKIA

Report Cites Most Recent AIDS, HIV Figures

AU1905133393 Prague CTK in English 1232 GMT
17 May 93

[Text] Prague May 17 (CTK)—A total of 35 people have
been diagnosed with AIDS in the Czech Republic, of
whom 23 have died so far, a spokeswoman for the
National Laboratory for AIDS of the State Health Care
Institute told a press conference today.

The spokeswoman said 149 HIV-positive cases had been
diagnosed since 1986, Three million blood samples have
been analysed so far, most coming from blood donors,
she said. She added that the number of AIDS cases
would likely increase, as those infected with the virus in
1986-87 would soon develop the disease.

Cases of sexually-transmitted diseases are also increasing
in the Czech Republic, especially among those between
15 and 20 years of age, she noted, adding that the Czech
Republic had Europe’s highest rate of sexually-
transmitted diseases in this age category.

The World Health Organisation reported at the end of
last year that 600,000 people were infected with AIDS
worldwide, of which half had already died.

Thirty-Nine People Registered as HIV Positive

AUI1106195893 Bratislava HOSPODARSKE NOVINY
in Slovak 9 Jun 93 p 2

{TA SR report: “AIDS in Slovakia”)

[Text] On 31 May 1993, 39 people in Slovakia were
registered as HIV positive. Dr. D, Stanekova from the
Institute of Preventive and Clinical Medicine in Bratis-
lava made this statement yesterday in an interview for
TA SR. Of this number, 25 are Slovak citizens, most of
them are young people between the ages of 25 and 29.
There are two women and 18 homosexual men among
the infected. The disease has already developed in five of
them.

HUNGARY

Health Institute Releases AIDS Statistics

AU2106134193 Budapest MTI in English 1339 GMT
18 Jun 93

[Text] Budapest, 18 Jun (MTI)—A total of 373 HIV
infections have been registered in Hungary to date, with
124 actual illnesses, mainly men, the National Health
Care Institute reported on Friday {18 Jun].

Sixty-seven people have died of AIDS so far, the officials
told the press.



IPRS-TEP-93-016
28 June 1993 2 AIDS

EAST EUROPE
ALBANIA
‘No Signs’ of AIDS Reported After ‘10,000’ Tests /Lindita Karadaku; Tirana ATA, 30 May 93] .. 11
BULGARIA

Handling of Blood, Testing for AIDS [Sofia OTECHESTVEN VESTNIK, 6 May 93] .....
Numbers, Location, Average Age of AIDS Patients

[Valeriya Marinova; Sofia KONTINENT, 17 May 93] 12
CZECHOSLOVAKIA
Report Cites Most Recent AIDS, HIV Figures [Prague CTK, 17 May 93] 12

Thirty-Nine People Registered as HIV Positive
[Bratislava HOSPODARSKE NOVINY, 9 Jun 93]

HUNGARY

Health Institute Releases AIDS Statistics /Budapest MTI, 18 Jun 93] ....
LATIN AMERICA
REGIONAL AFFAIRS
Caribbean HIV, AIDS Infection Among Highest in World (Bridgetown CANA, 15 Jun 93] ses 13
BRAZIL

AIDS Official Not Authorized To Decide on Vaccine Tests
[Brasilia Radio Nacional da Amazonia Network, 12 Jun 93] ...

CHILE

AIDS Cases, Government Policies Detailed _....
Health Ministry Figures, Campaign
[Soledad Miranda Herrera; Santiago EL MERCURIO, 11 Apr 93] . 13

Projected Cases by 2025 Leticia Soto; Santiago LA NACION, 14 Api 16
Education Minister on Policy
[Arturo Villalobos Carrasco; Santiago EL MERCURIO, 17 Apr 93] ..... 17
CUBA
AIDS Cases, Control Strategies Reported
[Carmen R. Alfonso; Havana TRABAJADORES, 12 Apr 93]... 17

HONDURAS
AIDS Case Total Reaches 2,549 (Tegucigalpa LA TRIBUNA, 3 Apr 93] ....
JAMAICA

Health Minister Discusses Government AIDS Programs

[Bonaire Trans World Radio, 11 Jun 93] .. 19
NICARAGUA
Health Workers’ Understanding of AIDS Examined
[Sabrina Moncada Sequeira; Managua BARRICADA, 13 Apr 93] 19



JPRS-TEP-93-016
28 June 1993

ISRAEL

AIDS, TB Among Ethiopian Immigrants
TA0806150493 Tel Aviv DAVAR in Hebrew 8 Jun 93
ps

[Report by Uri Sharon]

[Excerpts] A medical examination of 13,934 of the
50,000 Ethiopian immigrants in Israel, has found that
243 are carrying the AIDS virus. Their condition may
deteriorate and they may contract the disease. Of them,
115 are between the ages of 31 and 50. The data was
presented by Professor Shim’on Pollak of Rambam
Hospital at a seminar held yesterday on illnesses among.
the Ethiopians. [passage omitted]

Among those examined, the percentage of carriers of the
virus is 1.75 percent compared to 0.04 percent among
the general Israeli public. [passage omitted]

[Jerusalem Qol Yisra’el in English at 1000 GMT on 8
June reports that “some 120 cases of tuberculosis have
been detected among Ethiopian immigrants in several
caravan sites. Health officials say many more have
apparently not been detected yet.”]

JORDAN

Health Ministry Announces 86 AIDS Cases in
Country

JN1905100093 Amman JORDAN TIMES in English

19 May 93 p3

[Excerpt] Amman—The Health Ministry Tuesday
announced that the number of people who are registered

NEAR EAST & SOUTH ASIA a

as HIV positive or infected by the AIDS (Acquired
Immune Deficiency Syndrome) virus since 1986 has
reached 86.

The cases include 67 Jordanian citizens and 19 non-
Jordanians, according to Sa’d Kharabishah, director of
the Health Ministry’s Department for Combating Dis-
eases,

Out of the total number, 56 were infected by the virus
outside Jordan and 30 inside the Kingdom, said Dr.
Kharabishah at the opening of a Health Ministry-
organised workshop on AIDS in Jordan.

In December 1992 Health Minister ’Arif al-Batayinah
reported that the number of people registered as HIV
positive in Jordan stood at 79, and noted that mostof the
cases resulted from blood transfusions conducted
abroad. [passage omitted] “

LEBANON

Health Minister Reports 190 AIDS; HIV Cases

NC2805211893 Paris AFP in English 2025 GMT
28 May 93

[Text] Beirut, May 28 (AFP) - Lebanon has documented
190 cases of full-blown AIDS symptoms and infections
of the Human Immuno-deficiency Virus (HIV) which
causes AIDS, Health Minister Marwan Hamadah told
AFP Friday.

Hamadah, who called for registration of each new case,
said six prison inmates were among those infected.

However, he could not say how many of the 190 sufferers
had full blown AIDS, and now many were HIV positive.

He told reporters after a meeting of the government’s
National Committee to Combat AIDS that two new
bodies had been formed, one charged with educating the
public about AIDS and the other to draw up legislation
dealing with the disease.



Epidemiology
AIDS

JPRS-TEP-93-016 CONTENTS 28 June 1993

[This EPIDEMIOLOGY report contains material on AIDS.]
SUB-SAHARAN AFRICA
KENYA

Importance of National AIDS Conference Cited
[David Maina; Nairobi THE KENYA TIMES, 22 Apr 93] .....

MOZAMBIQUE

Blood Donations, Supply in Maputo Hospital /Maputo NOTICIAS, 17 May 93]
Better Supervision of Blood Donors Urged {Maputo NOTICIAS, 20 May 93] ...

NAMIBIA

HIV Cases Show ‘Dramatic Increase’
[Christof Maletsky; Windhoek THE NAMIBIAN, 2 Apr 93] ......

SWAZILAND

Prime Minister Declares AIDS ‘National Priority’
[Vusi Sibisi; Mbabane WEEKEND OBSERVER, 5 Jun 93]

UGANDA

WHO Official on AIDS’ Economic Impact
[Sinikka Tarvainen; Helsinki HELSINGIN SANOMAT, 21 Apr 93] .....

CHINA
Progress in Using Chinese Herbal Medicine To Treat AIDS
[Lu Weibo; Beijing YIYAO XINXI LUNTAN, 25 Mar 93] ..
Near-Term Focusing Points on AIDS Control /Zhao Lianzhou; Beijing JIAN KANG BAO, 4 Apr 93]
EAST ASIA
INDONESIA
AIDS in Jakarta Found Mostly Among Male Office Workers (Jakarta KOMPAS, 12 Apr 93] .
JAPAN
Report on New Cases of AIDS, HIV Cases in March, April /Tokyo KYODO, 25 May 93]... 8
SOUTH KOREA
Company Develops Gene Recombinant HIV Diagnostic Test (Seoul YONHAP, 8 Jun 93]... 8
THAILAND
Government Adopts National Policy on AIDS [Bangkok BANGKOK POST, 4 Jun 93]

Drug Patent Protection, Effect on AIDS Prevention Viewed
[Bangkok THE SUNDAY POST, 20 Jun 93) ....

aa



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4 WEST EUROPE

CYPRUS

Authorities Claim AIDS Not on Rise

NC0406081693 Nicosia THE CYPRUS WEEKLY
in English 4 Jun 93 p 5

[Text] Health authorities said yesterday they had identi-
fied two new cases of AIDS in May, but added that the
trend of new cases of the disease did not appear to be on
the rise.

Astatement from the Ministry of Health said this did not
justify complacency because the figures are believed to
give only a partial indication of the real picture.

They said two new cases of AIDS involved a 49-year old
Cypriot man and a foreigner who had come to the island
to work.

There have been nine cases of AIDS in Cyprus so far this
year—six foreigners, who have since left the island, two
Cypriot men and a 39-year old Cypriot woman.

The total number of AIDS cases identified here so far is
139, 74 of whom were Cypriots, 66 men and eight
women.

Of the 74 Cypriots, 10 have died from AIDS and two
from other causes. Fourteen carriers live permanently
abroad.

DENMARK

AIDS Prevention Group: Number of HIV Cases
Stable

93WE0416A Copenhagen BERLINGSKE TIDENDE
in Danish 25 May 93 p 7

[Article by Kirsten Sorrig: “AIDS Infection Under Con-
trol”]

{Text] The spreading rate of AIDS in Denmark has
stabilized. The doomsday prophecies of an uncontrol-
lable contagion did not pan out, although 200 Danes
acquire AIDS every year and every single day a new
HIV-positive is found.

“It is a good sign that the number of new cases is no
longer rising. Still, 200 is an unreasonably high number,”
said the chairman of the AIDS Foundation, Dr. Jens Ole
Nielsen, yesterday at the foundation’s annual meeting.
At the meeting he rejected all demands for tighter
registration or stiffer measures for handling the infected.

“We are tired of the constant proposals for laws and
punishment. You cannot contro! people’s sex lives with
laws and punishment and there are many indications
that here in Denmark we have approached the matter
sensibly,” he said.

“For example, there has never before been so few
instances of sexual disease in Denmark. Syphilis is
largely exterminated.”

Nielsen criticized officialdom for having cut appropria-
tions to AIDS research so drastically, among other

JPRS-TEP-93-016
28 June 1993

things, cutbacks in appropriations to the National
Health Sciences Research Council.

GERMANY

Health Minister Cites Figures on HIV Infections

AU1406170193 Berlin BERLINER ZEITUNG
in German 8 Jun 93 p 10

[Birgit Ulrich report: “Seehofer: All-Clear Signal Unjus-
tified!”]

[Excerpts] Berlin—At the Ninth International AIDS
Congress, which opened in Berlin yesterday, FRG
Health Minister Horst Seehofer (Christian Social Union)
came out against any kind of compulsory tests for AIDS.
[passage omitted]

Since AIDS became known about 10 years ago, about
60,000 people in Germany have been infected by the
HIV virus, the German health minister reported. The
disease has broken out fully in about 10,000 Germans.
Half of them have already died.

The situation in the new laender is considerably more
favorable: Only 0.6 percent of the German citizens
infected with the deadly virus live there.

In total, however, the curve of the spreading of AIDS in
Germany has been considerably “less steep” than pre-
dicted by experts in the middle and at the end of the
1980's, Sechofer said. He traced this fact back to a
successful national AIDS policy. [passage omitted]

NORWAY

New AIDS Definition Encompasses More
Patients

93WE0410A Oslo ARBEIDERBLADET in Norwegian
22 Apr 93 p 20

[Article by Bodil Bakken: “New AIDS Definition”—
introductory paragraph in boldface as published]

[Text] Beginning with the New Year, the definition of
AIDS has been broadened. The result is that Norway and
the rest of Europe now have different illness criteria than
the United States.

Tens of thousands of HIV-positive Americans will be
added this year to the statistics of AIDS sufferers. The
reason is that the United States has changed the diag-
nostic criteria of what AIDS is.

As of the New Year, the definition of AIDS has also been
changed in Norway and Europe. We have not gone as far
as the Americans however.

“With us, the new criteria will hardly lead to any
dramatic increase in the AIDS figures,” Public Health
medical director Vigo Hasselvedt tells ARBEIDER-
BLADET.


8 EAST ASIA

INDONESIA

AIDS in Jakarta Found Mostly Among Male
Office Workers

93WE0412A Jakarta KOMPAS in Indonesian
12 Apr 93 p 8

[Text] Jakarta (KOMPAS)—Most of the 54 people in the
Jakarta area who as of March 1993 had been recorded as
suffering with AIDS or infected with AIDS were not
prostitutes but male office workers.

Dr. Zubairi Djoerban, member of the AIDS Special
Study Group at the FKUI/RSCM [Medical Faculty of
the University of Indonesia/Cipto Mangunkusomo Hos-
pital] revealed this to KOMPAS on Saturday, 10 April.

He said that AIDS sufferers are not limited to people
whose everyday “work” is prostitution or to those who
often associate with prostitutes. The disease, for which
there is still no cure, can also be contracted by people
who occasionally “relax” with high-risk groups like
homosexuals and prostitutes. For that reason, everyone
needs to be aware of the possibility of contracting this
dangerous disease.

In Jakarta, 20 people with AIDS and 34 people infected
with AIDS have been recorded. Most of those with AIDS
have died. Some of them were cared for at the RSCM by
the FKUI/RSCM AIDS Special Study Group until their
deaths. Most of those who are infected with AIDS but do
not yet show clinical signs of the disease are provided
counseling between 1200 and 1400 hours every day.
“Because of the risks they bear, we keep their identities
secret,” Dr. Zubairi said. :

Serious Potential

Zubairi said that because many Indonesians do not know
much about AIDS and how it is trarismitted ‘they ostra-
cize people who have the disease, despite the fact that the
disease is not easily transmitted. “For example, if a
person with AIDS or infected with AIDS coughs near us,
we will not catch the disease,” he said.

He said that anyone can contract AIDS, whether a
doctor, a reporter, or a person in any profession. That
can happen, for example, when a person traveling out of
town “relaxes” at a massage parlor or with a prostitute.

Zubairi sees serious potential for the spread of the
disease in Indonesia because of the large number of
homosexuals and prostitutes. At this time, very little
research is being done on these groups. Furthermore, the
growth of tourism has resulted in inadequate adherence
to health measures in sexual activity. Because their only
consideration is the economic one, they cannot always
compel their sex partners to use condoms.

“We must be constantly alert to developments related to
this dangerous disease. Therefore, we urge the domestic
mass media to persist in providing information about
AIDS, because the fate of the nation is involved,” Dr.
Zubairi declared.

IPRS-TEP-93-016
28 June 1993

JAPAN

Report on New Cases of AIDS, HIV Cases in
March, April

0W2505145693 Tokyo KYODO in English 1359 GMT
25 May 93

{Text] Tokyo, May 25 KYODO—Seventy-four people in
Japan were newly identified as AIDS patients or as
HIV-positive in March and April, the Health and Wel-
fare Ministry’s AIDS surveillance committee said
Tuesday [25 May].

The bimonthly figure brought the total number of those
confirmed to be infected with the human immunodefi-
ciency virus (HIV) in Japan to 1,181, the committee
said.

Of the 74 new cases, 12 were suffering from AIDS itself
while 62 tested positive for HIV, it said. The number of
new cases in the period marked an increase after six
months of declines on the bimonthly basis. In the Janu-
ary-February period there were 61 newly reported cases.
The highest bimonthly figure ever was 100, posted for
July and August last year.

The latest figure includes 30 Japanese men, five Japa-
nese women, and 13 men and 26 women from abroad,
the committee said. Of the 74, 33 people were infected
through heterosexual contact, 13 men by homosexual
contact, while the other 28 were not sure or were infected
through nonsexual means, it said. The committee
reported two cases infected through blood transfusions
abroad.

Of the total 1,181 now reported to be infected, 560 or
47.4 percent caught HIV through heterosexual contacts,
the panel said.

The committee urged people to use condoms to avoid
being exposed to HIV, saying the pace of the infection
has not yet passed its peak. Of the 12 people newly
identified .as AIDS patients, 10 people were directly
reported as having AJDS—without being reported as
HIV positive.

The patients were unaware of the infection before they
became ill, the committee said. The committee cau-
tioned that the numbers of latent AIDS patients and
unaware HIV-infected people could be a lot higher.

SOUTH KOREA

Company Develops Gene Recombinant HIV
Diagnostic Test

SK0806051893 Seoul YONHAP in English 0236 GMT
8 Jun 93

[Text] Seoul, June 8 (YONHAP)—A highly sensitive
AIDS diagnostic kit that uses gene recombinant tech-
nology will go-on sale in Korea this month, its makers
announced Tuesday.

Tong-a Pharmaceutic Co. and the Gene Engineering
Research Institute said their second generation elisa kit



IPRS-TEP-93-016
28 June 1993

ALBANIA

‘No Signs’ of AIDS Reported After ‘10,000’ Tests

AU3005142993 Tirana ATA in English 1019 GMT
30 May 93

[Text] Tirana, May 30 (ATA)—Lindita Karadaku writes:
The developments of the recent years in Albania, its
opening to the world and the mass emigration (about
500,000-600,000 emigrants out of 3.3 million inhabit-
ants of Albania) brought about some negative phe-
nomena such as prostitution, alcoholism, initial prob-
lems with drugs, sexual abuses, etc. One of the most
dangerous questions is AIDS, which although still there
are no signs of this disease after 10,000 checkups made
for this purpose.

Nevertheless, in order to prevent AIDS in Albania, the
Ministry of Health and Environmental Protection, with
the support of the World Health Organization and its
technical assistance, has specialized epidemiologists,
specialists on virulency, specialists on blood donation. In
the mean time the blood controls in general and that of
blood donators in particular have been continuous.
Through a resolution, the government adopted the intro-
duction in the 8 form school program of sexual educa-
tion.

Albanian mass media has devoted attention to preparing
programs, interviews, articles, concerts contributing to
this question. In October last year, the national confer-
ence for the AIDS control and fight was held in Tirana.
It adopted the national combined strategy against AIDS
infection in the future.

BULGARIA

Handling of Blood, Testing for AIDS

93WE0415Q Sofia OTECHESTVEN VESTNIK
in Bulgarian 6 May 93 p 6

[Interview with Dr. Vutkovski, chief physician at the
Republic Blood Donor Center, by unidentified reporter;
place and date not given: “One Lev and 50 Stotinki Per
Liter of Blood”)

[Text] Reserves currently total 1,008 units, and about 200
units are needed on a daily basis.

“We will not catch up with France. That country has four
million blood donors, almost one-tenth of the country’s
population. To give blood is a matter of honor both in
France and in Japan. In our country, after the moral crisis
that occurred, it would be excessively daring to hope that
we shall make advances in this area.”med

This is a quotation from Dr. Vutkovski, chief physician at
the Republic Blood Donor Center. We talked to him after
the latest appeal made by the journalists on television, the
KLUB M periodical, and Radio Express, who appealed to
others to follow their example. They donated their blood.
At the present time the center has 1,008 units of blood,
and the daily needs average 200 units. Useful shelf life is
between 20 days to two weeks. The needs of Sofia and the

EAST EUROPE 11

rest of the country are much greater. In 1985, voluntary
blood donors in Sofia numbered 60,000 and there were
450,000 throughout the country. Today there are 35,000
blood donors in the capital and 210,000 throughout the
country and their number continues to decline.

OTECHESTVEN VESTNIK: What is the price per liter
of blood?

Vutkovski: One leva and 60 stotinki. The price is ridic-
ulous. No other product in Bulgaria costs so little. Even
lemonade costs eight leva and the cost of giving blood,
taking into consideration inflation, is about 700 leva.

It is only after our country begins to develop normally
that we would be able to speak of normal blood giving.
We have become a country of pensioners and who
among those 2.7 million people could give blood? Which
of the 600,000 families that are suffering from the crisis
would come to us?

OTECHESTVEN VESTNIK: Are there legislative rea-
sons for this situation?

Vutkovski: This dates from 1986. According to Article
157, Paragraph 1, Item 3, blood donors are given the day
off when they give blood and the next day as well. No
member of the legislation has deemed it necessary to ask
for the opinion of the specialists. I, for example, have
another question: If we go to a shop where 100 healthy
men are at work and 90 of them would like to give blood,
according to this meritorious legal provision they should
not work both that day and the next. The shop would be
paralyzed for 48 hours. If it drops out of the assembly
line, the entire combine would stop work. That is why
when we go to the enterprise, the director welcomes us as
follows: “If the workers do not give blood no one would
fire me. But if I fail to fulfill the production plan, the
workers would not be paid and I would be kicked out of
the enterprise.”

OTECHESTVEN VESTNIK: In your view, are the
Bulgarian people confident that giving blood is a harm-
less procedure?

Vutkovski: I believe that not everyone knows that the
entire process is sterile; the implements are used only
once and then burned.

OTECHESTVEN VESTNIK: But fear of AIDS and
hepatitis remains.

Vutkovski: This is because we are not given a platform
from which to tell the truth. For example, the rumor was
spread through some newspapers and the BTA [Bul-
garian Telegraph Agency] that a hepatitis A epidemic
had broken out asa result of giving blood. Once again the
people withdrew; they were frightened. When we are
allowed to speak on the radio and the television it is
usually for 40 to 50 seconds. What could one say in such
a short time?!

OTECHESTVEN VESTNIK: Do we have reliable AIDS
tests?