14 EAST ASIA

SOUTH KOREA

More AIDS Cases Brings Total to 167

SK3011032491 Seoul YONHAP in English 0250 GMT
30 Nov 91

[Text] Seoul, Nov. 30 (YONHAP)—Five people were
found to be infected with the virus that causes AIDS in
November, increasing to 167 the number of Koreans
who are HIV positive, the Health and Social Affairs
Ministry said Saturday.

Of the 167, 15 have died, one is overseas and eight have
full- blown AIDS (acquired immuno-deficiency syn-
drome).

The ministry said 80 people (48 percent) were infected
through unsafe sex with foreigners in foreign countries,
14 through unsafe sex with foreigners in Korea, 57
through unsafe sex with Koreans in Korea and 16 from
blood transfusions.

It said 79 had worked abroad, 144 are men, and 23 are
women. Only 15 are homosexuals and none are intrave-
nous drug abusers.

MALAYSIA

Over 300 HIV Carriers Discovered Monthly

BK1111040391 Kuala Lumpur NEW STRAITS TIMES
in English 8 Nov 91 p 10

[Text] Serdang, Thurs.—The number of human-
immunovirus (HIV) carriers in the country has increased
by more than 300 a month over the past two months and
the situation is “quite alarming,” Health Minister Datuk
Lee Kim Sai said tonight.

As at the end of October, 2,087 people have been
confirmed to have contracted the virus compared with
1,365 and 1,715 at the end of August and September
respectively.

“The rapid increase is quite alarming and the situation if
left unchecked will pose a serious threat to the nation,”
he told reporters after opening a three-day AIDS Forum
and Exhibition in Seri Kembangan here.

The carriers were detected following extensive blood
screening carried out by the Ministry on three target
groups—dadah [drug] addicts, prisoners and prostitutes.
Ninety percent of those confirmed as HIV carriers were
dadah addicts.

The HIV causes the deadly Acquired Immune Defi-
ciency Syndrome disease.

Datuk Lee said the number of foreign women involved
in vice activities found with the virus was also on the
increase. Last month, 30 out of 39 women confirmed as
carriers of HIV were foreigners.

SPRS-TEP-91-025
9 December 1991

He appealed to the public to report any vice activity to
the police to help curb the spread of the disease.

“Although not much can be done for those who have
been infected by HIV, we want to ensure those who have
not been infected will always be free from the virus.”

Earlier, he said the people should be informed and
educated on the dangers of AIDS.

“The Government regards the threat posed by the dis-
ease as critical to the nation’s socio-economic structure,”
Datuk Lee said.

Thirty-three AIDS Cases, 2,087 HIV Carriers
Detected by Oct

BK2611141291 Kuala Lumpur Radio Malaysia
Network in English 1330 GMT 26 Nov 91

[Text] Dewan Rakyat [House of Representatives] was
told the government will continue to protect the identi-
ties of AIDS patients to safeguard the interests of family
members. Deputy Health Minister Encik [Mr.]
Mohamed Farid Ariffin said it was feared that if the
identities were known, the patients and the family mem-
bers might be shunned by society.

Winding up the debate on the budget and replying to
Points raised affecting his ministry, he said there was no
specific policy to isolate AIDS patients from society. He
told the House that as long as society is not open-minded
about the disease, the government will continue not to
reveal the names of AIDS patients. He said that up to
October this year 33 AIDS cases and 2,087 HIV carriers
were detected in the country.

THAILAND

Chiang Mai AIDS Update
92WEOO06E Bangkok SIAM RAT in Thai 24 Aug 91
pp 1, 16

[Excerpt] [passage omitted] Dr. Wichan Withayasai, an
expert in the AIDS field who works at the Maharat
Hospital in Chiang Mai City, discussed the AIDS situa-
tion in Chiang Mai. He said that to date, 21 people have
full-blown cases of AIDS, and another 5,000 have con-
tracted the virus but do not yet show any symptoms.
These figures are based on people who have been tested.
The actual number may be even higher, because it is
impossible to check everyone. The incidence of AIDS in
the north is one of the highest in the country. The above
figures were not obtained from a sample. Rather, they
are based on the figures reported to provincial officials
by hospitals throughout Chiang Mai. At the Chiang Mai
City Hospital, there are 100 people with full-blown cases
of AIDS. [as published] Officials are now considering
how to clear and prove this.

Dr. Wichan said that the reason why the rate of AIDS
infection has increased so rapidly in Chiang Mai is that
Chiang Mai is a rather small province. And when people


SJPRS-TEP-91-025
9 December 1991

BELGIUM

Government Presents AIDS Research Program

914N0544 Groot-Bijgaarden DE STANDAARD
in Dutch 11 Sep 91 p7

[Article signed HVDE: “State Secretary Derycke Pre-
sents AIDS Research Program; Walloons More Gen-
erous Than Flemish”]

[Text] Antwerp—Belgium’s top AIDS researchers are to
receive a fair amount of money during the next 4 years.
To maximize the funding of AIDS research, a coopera-
tion agreement was reached between the national author-
ities and the Flemish and Walloon communities,
resulting in a total budget of 381 million Belgian francs
(BFr). This was announced yesterday at the Institute of
Tropical Medicine (ITG) by Erik Derycke, state secre-
tary for research policy.

This is the first time that the authorities coordinate their
support to AIDS research in Belgium, a country which
had already succeeded in gaining worldwide recognition
for its AIDS research. Derycke said that “it can no longer
be tolerated that these top researchers have to make do
with foreign and private funds; the time has come for the
authorities to accept their responsibilities in the area of
public health.”

The Ministry of Research Policy contributes BFr 180
million, of which 45 percent (BFr 81 million) is for
French-speaking researchers and 55 percent (BFr 99
million) for their Dutch-speaking counterparts. The
Flemish community has added another BFr 99 million
while the French-speaking community is BFr 3 million
more generous and has contributed 102 million. In total,
this amounts to BFr 198 million for researchers of the
Dutch-speaking community and BFr 183 for the French-
speaking.

BFr 341 million of the total of BFr 381 million have
already been allocated. The remaining BFr 40 million
will be made available following the second call for
Proposals to Dutch-speaking researchers for projects in
the areas of AIDS prevention, patient care, and the legal,
ethical, and economic consequences of being infected.

In Flanders, most of the budget (BFr 128.5 million) is to
be put into basic research. Peter Piot of the ITG is to
receive funds for his research into the variability of
AIDS viruses in Africa and Belgium; his colleagues
Guido Van der Groen and Martine Peeters for the study
of chimpanzee viruses which are akin to the HIV virus
found in humans.

A research proposal submitted by Erik De Clercq of the
Leuven-based REGA institute has also been accepted.
De Clercq is the world’s leading specialist in the field of
development and testing (in test tubes) of drugs against
the AIDS virus. De Clercq cooperates with Peter Piot of
the ITG for clinical testing. Other basic research projects
that were accepted were submitted by following

WEST EUROPE 35

researchers : Borremans and Vandekerckhove (Univer-
sity of Ghent); Wijns, Thielemans, and De Baetselier
(Free University of Brussels); and Huygen (Pasteur Insti-
tute).

In the field of epidemiological research, Maria Laga of
the ITG has been allocated BFr 8 million, i.e., more than
5 percent of the total budget for Flanders. Laga is
conducting research into the role of other venereal
diseases in heterosexual transmission of the AIDS virus
in Africa. She seeks to develop methods to protect
African women from the AIDS virus and other venereal
diseases during sexual contact without being dependent
on men, which is the case when a condom is used.

Eight percent of the Flemish budget (BFr 13.2 million) is
to be used for research into high-risk behavior.
Researchers Van Hove (UIA, University Institute of
Antwerp) and Casselman (Association for Alcohol and
Other Drug Problems) are investigating the correlation
between sexually riskful behavior, illegal drug use, and
AIDS. Finally, researchers Damen (UIA) and Van Oost
(RUG, State University of Ghent) will receive BFr 8
million for research related to the behavioral influence of
school and for “research into the effects of a multifaceted
AIDS prevention program on adolescents and young
adults.”

Strategy for Combating AIDS

92WE0034A Brussels LE SOIR in French 11 Sep 91
pis

[Article by Jacques Poncin: “Belgium (Finally) Dis-
covers AIDS”]

[Text] Over the next four years, Belgium is going to
spend 381 million Belgian francs [FB] on AIDS research.
Undoubtedly not a fabulous amount, and that “effort”
still does not place us among the best in the world in this
area. But beyond the figures, we should doubtless salute
not only this first step in implementing the often reiter-
ated intention of the authorities to make the fight against
that epidemic a real priority but also the fact that it
constitutes something of a first in the institutional field,
since this program links the central government and the
communities.

It was Eric Derycke, secretary of state for scientific
policy, who kicked off the program on Tuesday at the
Institute of Tropical Medicine in Antwerp, where the
virology lab is headed by Prof. Peter Piot. He explained
that Belgium was finally going to fulfill the moral obli-
gation that every scientifically developed country has to
combat the scourge in question, which is infinitely worse
in the poor countries and in Africa in particular. More-
over, our government authorities finally seem to have
realized that we have research teams deserving of sup-
port.



SPRS-TEP-91-025
9 December 1991

The AIDS pathogen, as with other lipid-containing
viruses, loses its virulence and its sensitivity to everyday
disinfectants (ethyl alcohol, heat treatment, etc.) rela-
tively quickly when it leaves the human body and makes
its way to objects of our environment. In spite of its
relatively low stability in the environment, it can main-
tain its virulent properties at room temperature (20-
22°C) for 10 days in a dry environment or a damp
environment. In solutions containing stabilizers (pro-
teins, carbohydrates, peptides), the stability of HIV
increases substantially. Its residual “infectivity” is espe-
cially pronounced in dried protein-containing materi-
als—blood, sperm, saliva, etc. (Barre-Sinoussi J. et al.,
1985).

HIV is comparatively resistant to UV and is relatively
resistant to ionizing radiation (gamma radiation). Like-
wise, neither human saliva nor lacrimal fluid has suffi-
cient virus-inhibiting activity (Daniels G. V., 1986).

‘When a virus-containing material has a moisture content
of less than 1.0%, total inactivation of HIV does not
come for 30 minutes at 60°C (“AIDS and Blood Trans-
fusion,” 1986). Spontaneous elimination of viral activity
in such materials at room temperature takes place after
10 days. For example, at 25°C, the activity of the virus in
dried samples can maintain itself for up to two weeks; at
37°C, for 11 days. To inactivate HIV in those cases (at
60°C), the virus-containing material must be heated for
1,5-2 hours. In connection with that, foreign firms every-
where use a technology for disinfecting blood plasma of
the virus, with the production of factor VIII and others
by means of heating to 80°C for seven hours (“AIDS:
The Safety of Blood and Blood Products, 1987).

The AIDS pathogen is quickly eliminated (within min-
utes) in aqueous solutions of 0.5% neutral calcium (or
sodium) hypochlorite, chloramine (1-2%), formaldehyde
(2%), hydrogen peroxide (4%), phenol (5%), lysol (1%),
and, among other things, 40-70% ethyl alcohol. The
temperature factor (boiling, saturated water steam, cal-
cination) also completely inactivates the virus very
quickly. The generally used regimes of chamber disinfec-
tion that use a gas-vapor or a formalin-vapor method in
mobile disinfection units (DDA-66, DDA-2, DDA-3,
and DDP-2) or stationary disinfection units provide
complete disinfection of HIV-contaminated bedclothes
or underwear, robes, clothing, etc. (OST 42-21-2-85).!

It should be kept in mind that the detergents and soap
usually used for laundry are not, as a rule, sufficiently
active against the virus, but in a concentration of 0.1% of
the active ingredient, they quickly (within 20-30 min-
utes) inactivate the pathogen. Organic solvents (30%
isopropyl alcohol, acetone, dichlorethane, ether, chloro-
form, etc.) produce a similar effect. In smears fixed with
Nikiforov mixtures or equal mixtures of alcohol and
acetone, total inactivation of the virus comes after 10
minutes (Ivanov N. R. et al., 1987).

HIV is totally inactivated in the process that destroys the
hepatitis B virus (boiling in 0.5% solution of soda for 1-2

SOVIET UNION 31

hours, a presterilization regime, disinfection and steril-
ization of instruments, strict observance of the tech-
nology for obtaining blood and its preparations, hepatitis
B vaccine, etc.). Blood preparations and vaccines do not
contain live vibrions of HIV and do not present a danger
of infection (Korolyuk A. M. et al., 1987; Shevelev A. S.,
1988).

Of especial significance in the complex of measures to
protect against HIV infection is the observance of per-
sonal prophylaxis measures and the requirements of the
sanitary and epidemic-control regime by personnel of
treatment-and-prevention facilities (Pokrovskiy V. I. et
al., 1988). For example, when the risk of HIV infection is
elevated (during the nursing or treatment of AIDS
patients or virus carriers, when conducting diagnostic or
other invasive tests, when taking blood from a vein,
when performing surgery, etc.), medical personnel must
work in protective clothing—a surgical gown, surgical
cap or head covering, rubber gloves, four-ply gauze face
mask, protective goggles; they must also use a plastic
shield. Disposable syringes, disposable plastic laboratory
dishes, and disposable dressing material must be intro-
duced universally, in all military medical treatment-
and-prevention facilities.

Measures of personal safeguards should be followed
strictly during work, especially in procedures involving
cutting or piercing instruments, so as to prevent the skin
becoming contaminated with blood and especially to
prevent the skin being broken. Blood for HIV testing
should be drawn, when possible, not in a glass vessel, but
in a polychlorvinyl vessel (such as in a micro test tube
that holds 1.5 cu cm). Turning the test tube over to mix
the blood serum must be done only if the tube has a
tight-fitting cork and the index finger is enclosed in a
protective sheath or, best of all, rubber gloves are worn.
When blood is drawn from a finger for laboratory
testing, a special disposable needle/lance and a separate
pipet should be used for each individual being tested.

The risk of infection with HIV from needle pricks is no
greater than 1%, whereas the frequency of infection is
6-30% in cases involving viral hepatitis B (“Guidelines
for the Protection of Health Care, [sic] Workers in
Caring for Persons Who Have Some Form of HTLV-
IIWV/LAV Infection,” 1986; Gerderding J. L. et al., 1987).
That is probably due to the low level of the spread of
AIDS among the population at the present time, the low
concentration of the pathogen in the blood of infected
individuals, and the comparatively weak resistance of
the pathogen to various disinfectants. At the same time,
the possibility cannot be precluded of a broad adaptation
of HIV as it mutates in its passages through the human
body. Three cases are described in which personnel
became infected with the virus when the blood of an
AIDS patient got on their skin (Ezzell G., 1987). The
infection probably occurred because the individuals had
microinjuries of the skin (that was proved in one case),
because they had no apparent injury to the skin and there
were no other explanations for the infection.



40 WEST EUROPE

to more archaic and less convenient, but safer, products,
which strategy the Lucas report recalls with precision.

At the time, the French Transfusion system preferred an
industrial and commercial strategy: As it had planned
before the epidemic started, it increased the proportion
of more convenient products, the very ones presenting
the greatest risk of being contaminated. This is very
likely the industrial choice to which the Lucas report is
referring when it entitles one of its chapters, “1981-1984:
A Threat the Unknown Scope of Which Upsets Strate-
gies and Hopes.” Further: “The organization of the
French transfusion system is presented as offering suffi-
cient protection to face the spread of the disease due to
existing conditions of safety.”

3. By the end of 1984, several countries, including the
United States, were recommending heating blood prod-
ucts in order to kill the virus. As the press noted in June,
the report quotes the very letters from foreign companies
proposing the importation of heated products.

The French transfusion system then embarked upon the
most painful period of its history. Incapable of mastering
heating techniques, refusing to import them, and failing
to take public precautions against the risk, it walled itself
in by silence and administered products it knew to be
100-percent contaminated by the AIDS virus to hemo-
philiacs. The final four months, between March 1985,
when it finally recognized the usefulness of heating, and
July, when the first “French-heated” products came on
the market, were devastating.

During those four months, the silence of the Transfusion
Center and the Ministry of Health, under whose tutelage
it worked, was deafening, four months which the Lucas
report politely calls, in terms of “the French decision-
making calendar, a certain delay.”

GERMANY

Report Cites Berlin AIDS Cases, Deaths

AU3011141891 Berlin NEUES DEUTSCHLAND
in German 27 Nov 91 p 1

[ADN report: “Already 1,000 People Suffering From
AIDS in Berlin”]

(Excerpt] Berlin—There are about 1,000 people suf-
fering from AIDS in Berlin, with an equal number of
deaths to date. This is stated in a report on care for AIDS
patients which was presented to the Senate by Health
Senator Luther on Tuesday [26 November]. Further-
more, it must be estimated that 15,000 to 20,000 HIV-
infected people live in the city. [passage omitted]

SIPRS-TEP-91-025
9 December 1991

GREECE

Alarming Increase of AIDS Cases
92P20027A Athens I KATHIMERINI in Greek 2 Oct 91
ps

[Text] This century’s scourge, AIDS, is rapidly spreading
in our country and especially among heterosexuals.
Some 36 new cases were reported in the last three
months, raising to 528 the number of individuals
affected by this terrible disease.

These data were given to newsmen yesterday by Minister
of Health Y. Sourlas, who stressed that this increase,
which has affected mainly heterosexuals, was expected,
since the new cases come from AIDS virus carriers.

Thirteen of the AIDS cases are children under 12 (six
boys and seven girls), 271 are homosexuals or bisexuals,
21 are drug addicts, four are homosexual drugusers, 34
are individuals who have undergone multiple blood
transfusions, four are individuals who became infected
by receiving blood-producing agents, 108 are heterosex-
uals, and 40 individuals cannot be categorized.

It should be noted that 102 AIDS cases are individuals
between 40 and 49, 94 between 25 and 29, 89 between 30
and 34, 89 between 35 and 39, 44 between 50 and 59,
etc. In relation to babies and children under 12, five
became infected through receiving blood-producing
agents, three from blood transfusions, and five cannot be
categorized.

IRELAND

Paper Gives Statistics on Spread of AIDS

Alarm Over Heterosexual Cases

92WE0038 Dublin IRISH INDEPENDENT in English
2 Sep 91 p3

[Article by Don Lavery: “AIDS Alarm Over Hetero-
sexual Cases”]

[Text] There has been a steady rise in the number of
heterosexuals—including women—contracting AIDS,
but how fast it spreads depends on how the heterosexual
population responds, the department of health’s leading
AIDS expert warned yesterday.

Latest figures show that between June, 1990 and July,
1991, there had been an increase of some 200 percent in
full blown AIDS cases among heterosexuals in the
Republic, with a 52 percent rise in HIV infection.

“Up to now heterosexual people have had a ‘them and
us’ attitude about AIDS. ‘Them’ being gays and drug
abusers. But it has to be gotten across to the general
public that AIDS can affect us all—rather than being an
interesting, peculiar, titillating disease they read about in
the newspapers,” said Dr. James Walsh.


8 SUB-SAHARAN AFRICA

estimated that there were between 120,000 and 180,000
people in the country infected with the AIDS virus.

Dr. Evian said that Johannesburg residents who had
tested positive could easily fill the Ellis Park Rugby
Stadium. He said that with the present high rate in the
increase of numbers, by the end of next year people who
tested AIDS positive would fill both the Ellis Park and
the Soccer City Stadiums.

SWAZILAND
Health Ministry Says Official AIDS Figures Too
Ww

MB2610112291 Mbabane WEEKEND OBSERVER
in English 26 Oct 91 p 9

[Article by OBSERVER reporter]

[Text] Twenty-nine people in Swaziland had died of
AIDS-related causes by the end of September, according
to the latest official figures. Health workers privately
concede the true figure may be much higher.

The latest three deaths were recorded between July and
September—one of them a 24-year-old male whom
health authorities believe must have been infected with
the HIV virus when he was a teenager.

Official figures compiled by the Swaziland National
AIDS Prevention and Control Programme are consid-
ered by even the Ministry of Health as representing only
the “tip of an iceberg.” A Health Ministry statement
commenting on the latest figures notes that efforts are
being made to improve on the reporting of AIDS cases.

The latest figures record 26 new cases of full-blown AIDS
in the September quarter, 16 male and 10 female. Of
these three have already died. There were therefore 42
known cases of full-blown AIDS in Swaziland at the end
of September. Some of those people may have since died.

Blood screened for AIDS during the reporting period
revealed 32 new cases of HIV positive from 1,220
samples. In all, 236 people tested HIV positive during
the quarter, including the 32 blood donors.

The total of officially recorded HIV positive persons in
Swaziland at the end of September stands at 634. But the
Ministry of Health is concerned that reporting of AIDS
cases (and HIV positive) are not truly reflected in the
Statistics kept since the introduction of the AIDS pre-
vention and control programme.

Dr. John Mbambo, Director of Health Services, noted in
a statement that the new epidemiology unit in the
ministry was endeavouring to improve the reporting of
AIDS cases “‘so that the actual magnitude of the AIDS
situation can be assessed.”

“Even these new figures represent the tip of the iceberg”,
he said, adding they would have “to be adjusted for
proper planning for future services.”

IJPRS-TEP-91-025
9 December 1991

Dr. Mbambo noted that a priority in the development of
a sound AIDS control strategy was to adopt a commu-
nity approach. This approach is designed to develop
stronger links between primary health care and the
community, the objective being largely “to support the
growing number of AIDS patients.”

“The community-based or home-based care of patients
has not been introduced in a number of African coun-
tries and is highly acceptable and, in the absence of an
AIDS cure, offers hope for the individuals, families and
communities.”

UK Donates One Million Emalangeni for AIDS
Control

MB2911163091 Mbabane THE SWAZI OBSERVER
in English 29 Nov 91 pp 1, 9

[Report by Sandile Ntshakala: ‘“‘UK gives E
[emalangeni]1m [million] for AIDS control”]

[Text] Britain has donated about E[emalangeni]! million
towards the prevention and control of AIDS in the
country.

The money was received by the World Health Organisa-
tion (WHO) in Swaziland and was released through
WHO's AID/HIV Trust Fund for the country.

A statement issued by the Overseas Development
Administration Office (ODA) for Southern Africa based
in Malawi said the United Kingdom government sup-
ports the Swaziland government and WHO in their
implementation of the Medium Term Plan (MTP) for
the prevention and control of HIV and AIDS in the
country.

“The Overseas Development Administration of the
United Kingdom continues to support WHO in its
workable strategy against AIDS and has committed
E45.5 million towards the core budget of the global
programme on AIDS.

“An additional E18 million has been pledged for multi-
bi-funding. The British government has also contributed
to the European Community’s AIDS programme for
developing countries in excess of E5 million in grants for
over six years and has given grants to the International
Planned Parenthood Federation to help family planning
association develop their AIDS related work.”

Another E7m has been committed by ODA so far to
support research into demographic, social and economic
aspects on AIDS in the developing world.

Swazis can make maximum use of training awards
available within the ODA Technical Cooperation
Training Programme for AIDS related training.

Applications to getting these study awards should be
made by the Ministry of Health within the content of the
British government’s Scholarship Award Programme.


18 EAST EUROPE

BULGARIA

Data on Spread of AIDS

AU0511165891 Sofia BTA in English 1641 GMT
5 Nov 91

[Article: “AIDS: Five Years Behind Western Europe”—
BTA headline]

[Text] Sofia, Nov 5 (BTA)—Bulgaria is still in an early
stage of the spread of the HIV infection, a stage in which
Western Europe was five years ago. Bulgarians do not
believe that AIDS is a very serious problem and this
makes it impossible to conduct a broad and effective
public education campaign. These are the findings of a
team of World Health Organization (WHO) experts who
came to Bulgaria to see whether the WHO one-year
AIDS control and prevention programme is being imple-
mented.

The WHO experts presented a new three-year pro-
gramme which relies mainly on health education. The
Programme sets 50 main objectives with over 300 spe-
cific tasks. The experts believe that in Bulgaria there are
many people belonging to the risk groups who have to be
convinced that their safety is in their own hands.

The WHO experts welcome Bulgaria’s decision to give
up mass screening because it does not check the spread of
the infection. Moreover, the greater part of the risk
groups usually do not take the test. Reportedly, there are
96 HIV-positive in Bulgaria. Twelve of them developed
the full-blown symptoms of the disease and nine have
died. The remaining three AIDS patients are in good
condition and live at home. However, Ministry of Health
experts say that the figures do not reflect the real state of
affairs.

AIDS Specialist Warns Against Complacency

AU2811170591 Sofia BTA in English 1555 GMT
28 Nov 91

[Text] Sofia, November 28 (BTA)—“The small number
of AIDS cases is not reassuring. This country is in the
first epidemic phase of the AIDS pandemic, when the
infection is still latent,” Dr. Radka Argirova, head of the
Central AIDS Laboratory with the Medical Academy,
told a news conference today.

“Four million AIDS tests have been performed since
1986. There are 98 HIV-positive Bulgarians. Nine out of
the 12 AIDS patients have died,” Dr. Argirova said.

The transmission of the AIDS virus from abroad was
checked in 1987 but from 1988 it has been spreading
within the country. AIDS incidence used to be highest in
the 35-40 age group, while now it mainly affects young
people aged between 18 and 22. Burgas and Gabrovo
have the greatest number of AIDS cases.

A new ordinance on the regime and conditions of con-
ducting AIDS tests was presented. Every Bulgarian can

SJPRS-TEP-91-025
9 December 1991

have such a test done under guaranteed medical secrecy
and anonymity. AIDS cases will be put down for regular
medical check-ups at their request.

The testing of all banks of donated blood will continue.
This measure, introduced in Bulgaria in 1987, has been
carried out under control by world renowned companies.
There have been no cases of AIDS blood transmission in
Bulgaria so far. Compulsory tests will extend to all
donors of sperm, organs, tissues and mother’s milk, as
well as foreigners coming to Bulgaria to work or study.

The five children born to HIV-positive mothers are
under surveillance. Three of them have not contracted
AIDS, one is HIV- positive and the fifth one is still being
tested.

The AIDS Combat Programme Council with the Med-
ical Academy is seeking to effectively check the spread of
AIDS and to conduct scientific research. However, no
funds have been allocated for this purpose in 1991.

The members of the programme council were opposed to
the decision of the Ministry of Health Care to import
tests for AIDS and hepatitis B from the Finnish Lapsys-
tems Company in the next three years. In their capacity
as members of a commission with the ministry on the
tender for such tests they unanimously recommended
the tests of Diagnostiv Pasteur of France.

The deputy minister in charge of financial matters
argued for the decision of the Ministry of Health Care.
The Finnish tests cost 32 percent less. Lapsystems also
offers to train personnel to work with the equipment,
humanitarian aid to the amount of 50,000 U.S. dollars in
medicines, joint production of such tests in Bulgaria and
their sale in third countries.

CZECHOSLOVAKIA

Number of AIDS Cases Increases

LD2011221391 Prague CSTK in English 1432 GMT
20 Nov 91

[Text] Bratislava Nov 20 (CSTK)—Over 200 people
infected with AIDS (Acquired Immune Deficiency Syn-
drome) are registered in Czechoslovakia, 24 of whom
already show symptoms of the disease, Slovak Deputy
Health Minister Margita Sulcova told journalists on
Wednesday.

She said by 1995, the number of infected is expected to
reach about 1,000 people with 100 of them developing
the disease.

Sulcova called growing drug addiction as one of the main
causes of the spread of the deadly disease.

The danger of transfer of the disease in transfusion is
non- existent in Czechoslovakia where all blood donors
are tested for AIDS, Sulcova said.


36 WEST EUROPE

In any case, that abundance of gray matter was verified
as soon as the program was announced, since the secre-
tariat was literally inundated with requests whose com-
bined budgets would exceed FB! billion! All those
projects were submitted to a jury consisting exclusively
of foreigners, who ranked them and marked 60 percent
of them “excellent”! The obvious result was the need to
be particularly selective, it being understood, further-
more, that we are in Belgium and the need to mix things
in certain proportions is unavoidable. In addition, the
international experts were asked to “review” the
requested budgets, the specific result being that it was
possible to shave 25 percent off their total.

To carry out the program, the national government—
that is, the Secretariat of State for Scientific Policy—
contributed FB180 million distributed according to the
traditional formula: meaning FB99 million for Flanders
and FB81 million for the French Community. The latter,
being generous, threw FB102 million into the kitty, while
Flanders was content to contribute FB99 million. The
result was FB183 million on the French-speaking side
and FB198 million for the Flemings. The latter, who had
14 projects accepted, are supposed to contribute another
FB40 million. A large share of that money will go to the
Institute of Tropical Medicine and the team headed by
Prof. Erik De Clercq (KUL [Flemish Catholic University
of Louvain}), an internationally recognized expert on
antiviral medicines.

The French speakers had 10 projects accepted. Those
budgets will go to Professors Arsene Burny and Ruyss-
chaert (ULB [Free University of Brussels}) for basic
research into the mechanisms by which the virus enters
cells; Urbain (ULB) for analysis of the mechanism by
which an infected individual’s immunity is lowered;
Portetelle (UCL [Walloon Catholic University of Lou-
vain]) for an approach to the role of the HIV virus in
regulating immune cells; Van Snick (UCL) for a descrip-
tion of the activation of white corpuscles in the presence
of the virus; Boniver (Liege University) for research
concerning the phase during which the virus seems
inactivated; Moonen (Liege) for a biological description
of the HIV’s attack on the nervous system; Levy (ULB)
for a clinical and psychosocial approach to transmission
from mother to infant; Stroobant (Institute of Hygiene
and Epidemiology) for a project for monitoring the virus
in a population of individuals with other sexually trans-
mitted diseases; and, lastly, Hubert (University Faculty
of Saint Louis) for work on sexual behavior in response
to the threat of AIDS.

Amsterdam To Replace Boston

It is not yet official, but it might as well be: The next
international conference on AIDS will be held in
Amsterdam.

The big meetings held every spring by all the AIDS
experts from around the world are scheduled far in
advance. For example, it has already been agreed that the
meeting will take place in Japan in 1993 and in Berlin

IJPRS-TEP-91-025
9 December 1991

the year after that. But for 1992, things are different.
Until a few months ago, everything was settled. The
meeting was supposed to be held in Boston, the home of
two of the most prestigious U.S. scientific institutions,
MIT [Massachusetts Institute of Technology] and Har-
vard. In fact, it was the latter university which was
playing the biggest role in organizing the meeting under
the leadership of Prof. Max Essex. But the U.S. Govern-
ment took all necessary steps to discourage the scientists,
who had already come close to boycotting a previous
meeting in San Francisco, by sticking to its immigration
tules, which are a model of their kind when it comes to
excluding seropositive individuals. In the face of Wash-
ington’s stubbornness, the International AIDS Society
decided to cancel its 1992 conference. But the people in
Boston felt that they could not accept such a muddle and
appointed one of their own, Prof. Jonathan Mann, the
former “Mr. AIDS” of the WHO, to find a city that
would agree to welcome the organization.

According to our information, the Dutch authorities
have decided to accept the challenge. So since Boston is
out, Amsterdam is in.

FINLAND

Kuopio Cuts Funds for AIDS Center

92WE0055C Helsinki HELSINGIN SANOMAT
in Finnish 21 Jun 91 p 5

(Unattributed article: “Kuopio Evicts AIDS Center”)

[Text] The Kuopio AIDS Center has been evicted from
its office space due to economizing actions by the city
health department. The continuation of the center is
questionable because, according to its statement, it does
not have the funds to rent new office space. Eastern
Finland’s only AIDS center has been in operation less
than five years in a space at the health department in
Kuopio. The department plans to sell the space, and the
center will have to leave by the end of July. Up until
now, the city has provided the space free of charge.

AIDS Carrier Who Endangered Others
Imprisoned

Two-Year Sentence

92WE0048A Helsinki HELSINGIN SANOMAT
in Finnish 2 Oct 91 p 5

{Unattributed article: “Man Gets Two-Year Sentence for
Knowingly Spreading AIDS; Infected Friend Dies
During Trial”)

[Text] An Espoo man was sentenced on Tuesday in
Helsinki City Court to two years in prison for knowingly
infecting his male friend with AIDS. The sentence does
not qualify for probation. The court held that the man
had committed aggravated assault and involuntary man-
slaughter at the same time.



IPRS-TEP-91-025

9 December 1991 4 AIDS
GRENADA
HIV Cases Number 47, AIDS 29; of These, 21 Deaths Bridgetown CANA, 28 Nov 91] . 20
ST. LUCIA
Health Association Issues List of AIDS Risk Groups [Bridgetown CANA, 20 Nov 91] ..... . 20
NEAR EAST & SOUTH ASIA
ARMENIAN AFFAIRS
Anti-AIDS Measures /L. Vrtanesyan; Moscow TRUD, 17 Jan 91] .... . 21

ALGERIA
Statisitics on AIDS Carriers [Algiers Radio Algiers Network, 1 Dec 91]
BANGLADESH

AIDS-Infected Workers Return From Dubai

[Dhaka THE BANGLADESH OBSERVER, 11 Aug 91] .... . 21
INDIA
AIDS Widespread Expected, Underreporting Noted
[Sumit Mitra; Madras INDIAN EXPRESS, 23 Sep 91] ...... 21
Experts Score Complacency Over AIDS [Madras THE HINDU, 12 Oct 91] 22

IRAN

Health Minister Cited on 186 AIDS Cases in Country
[Tehran Voice of the Islamic Republic of Iran First Program Network, 1 Dec 91]

ISRAEL
Half of 160 AIDS Victims Died ‘So Far’ [Jerusalem Qol Yisra’el, 19 Nov 91]
Health Ministry Releases AIDS Statistics
[Dvora Namir; Tel Aviv YEDI’'OT AHARONOT, 2 Dec 91]
JORDAN
Health Ministry Says 66 AIDS Cases in Kingdom {Amman JORDAN TIMES, 28-29 Nov 7 | eee 24
MAURITANIA
Number of AIDS Cases Noted Nouakchott ORTM Radio, 1 Dec 91] ......
PAKISTAN
Rapid Spread of AIDS Feared .....
Awareness of Disease Low /[Shouket Ali; Karachi DAWN, 25 Sep 91]
Statistics Released /Samina Mehdi; Karachi DAWN, 25 Sep 91] .....
Health Official Says Number of AIDS Cases Rising /Hong Kong AFP, 12 Nov 91]
SOVIET UNION
Buryat SSR Prepares to Fight AIDS _/V. V. Vasil’ev; MEDITSINSKAYA GAZETA, Dec 90]
Mandatory AIDS Testing Decreed {Moscow MEDITSINSKAYA GAZETA, Dec 90] 1...

Anonymous AIDS Testing in Kharkov
IA. Plagnyuk; Moscow KOMSOMOLSKAYA PRAVDA, Mar 91] ....

24



SJPRS-TEP-91-025
9 December 1991

during annual prophylactic medical examinations. For-
eign citizens or stateless persons who have come to the
USSR for work and other purposes are to be examined at
the directions of the receiving organizations and individ-
uals under whose aegis they have come. If the foreign
citizen or stateless person so desires, a medical worker or
representative of the consulate of the appropriate state
may be present when the blood is drawn.

8. Upon the request of citizens of the USSR, foreign
citizens, and stateless persons who have undergone lab-
oratory or clinical examination, they will be provided a
medical opinion of the established form (Form No.
082-1/u-88, approved by the USSR Ministry of Health
4/7/88) regarding its results.

9. Upon the request of citizens of the USSR, foreign
citizens, and stateless persons, their repeat examination
can be carried out at another health protection institu-
tion.

10. Diplomatic personnel of foreign diplomatic corps
and consular institutions and other individuals enjoying
diplomatic privileges and immunities on the territory of
the USSR may be examined for the identification of
infection with the human immunodeficiency virus
(AIDS) only with their agreement.

The USSR Ministry of Health will coordinate sugges-
tions to such individuals that they undergo examination
beforehand with the USSR Ministry of Foreign Affairs.

11. The question of the possibility of the examination of
personnel of international intergovernmental, nongov-
ernmental and other organizations and institutions, as
well as of those foreign representations which are accred-
ited to the corresponding ministries, departments, and
organizations is to be resolved with the participation of
those ministries, departments, organizations, and insti-
tutions on the basis of international multilateral treaties
and conventions, bilateral accords and practice.

12. Medical personnel and other individuals in the
course of the performance of their duties who have been
made privy to information regarding an examination for
the identification of infection with the human immuno-
deficiency virus (AIDS) and to its results are obligated to
keep this information in confidence.

13. The practical implementation of and responsibility
for the execution of the present Regulations are imposed
on the relevant ministries, departments, and organiza-
tions.

Director of the Main Epidemiological Administration of
the USSR Ministry of Health, M. I. NARKEVICH.

Deputy Director of the Main Administration of the
Organization of Medical Assistance of the USSR Min-
istry of Health, L. V. MAKAROVA.

Director of the Main Administration of Maternal and
Child Protection of the USSR Ministry of Health, I. A.
LESHKEVICH.

SOVIET UNION 29

NOTE. The list of diseases for which an examination for
the identification of infection with the human immuno-
deficiency virus (AIDS) is carried out was composed
with account taken of the recommendations of the
World Health Organization (WHO Bulletin, 1988, Vol.
66, No. 2).

The “Regulations for the Medical Examination for the
Identification of Infection with the AIDS Virus
(Acquired Human Immunodeficiency Syndrome)”
approved by the USSR Minister of Health, August 28,
1987, are to be considered null and void.

Anonymous AIDS Testing in Kharkov

91WE0273A Moscow KOMSOMOLSKAYA PRAVDA
in Russian 6 Mar 91 p 4

[Article by A. Plagnyuk, Staff Correspondent Komso-
molskoye Znamya: Look After Yourself! Are You
Afraid?...]

[Text] “Are you afraid of AIDS?” A group of sociologists
was stopping passersby on a central street with such a
question.

“No,” I answered firmly [the writer is a woman- Tr.].

Then I walked away a few steps and started to think, was
I right to be so categorical? True, I’m not a vagrant, not
a narcotics addict, and thank God, I don’t associate
closely with dangerous people. Doesn’t that means that
AIDS doesn’t threaten me? But after all, the children in
Elista were pure and innocent.

The only(!) confidential consulting room in the oblast
has been operating for four years in Kharkov. Here one
can be examined for AIDS. The physicians guarantee
anonymity on request of the patients.

Have many people come here? It turns out that there
have been hardly more than ten thousand. I will remind
you that Kharkov is a city of almost two million, and the
examining room is the only one.

Lecturer G. M. Parafeinik, who has worked 35 years in
the Infectious Disease Department of the Kharkov Med-
ical Institute, noted sadly:

“At first both the city health department and the police
were worried and sent us people from the risk group,
vagrants, from the reception and distribution centers.
But that didn’t last long. This year they send us only
those who have served abroad. This is to the credit of the
Military Comissariat. For the rest, all is peace and
harmony. We have tested two thousand individuals, an
infinitesimally small number.”

“Today, for instance, there were only two,” nurse L. I.
Kutsevalova chimed in.

Thank God, so far we do not have emaciated AIDS
patients. But... As G. M. Parafeinik told me, more than
30 foreign citizens, virus carriers and patients, have



JPRS-TEP-91-025
9 December 1991

talk about Chiang Mai, they are referring mainly to
Muang District, which is filled with well-known tourist
spots such as Kamphaengdin, Santitham, and Ton Pho.
People with a little money like to visit these spots. As a
result, the rate of infection has increased very quickly.
There are also many other spots such as coffee shops and
massage parlors. Thus, the statistics have skyrocketed.
But we can’t blame anyone, because the prostitutes
contract the AIDS virus from men.

“This virus was first spread by foreign tourists who
visited Chiang Mai and who used narcotics. Initially, the
disease was found only among homosexuals. But now,
AIDS is prevalent among Thai prostitutes. The figures
for the nation as a whole are very alarming. In the upper
north, about 50 percent of the prostitutes have the AIDS
virus. Thus, the disease is now being spread by Thais.
And Thais have now infected many foreigners,” said Dr.
Wichan.

Dr. Wichan said that the reason why many prostitutes
have this disease is that many men like to use their
services. Thus, it will be difficult to solve this problem
unless we provide correct information in order to per-
suade men to stop visiting prostitutes. But if they still
want to do so, they should use a condom. Today’s figures
are very alarming. The figures show that only 4 percent
of the Thai men in the city have the virus while 14
percent of the men in rural areas have the virus.

On 22 August, the National Blood Center of the Thai
Red Cross held a seminar on “Teachers Must Know
About AIDS and the Donation of Blood.” Instructors
from vocational education institutes attended the sem-
inar. Dr. Siwilai Tanprasoet, the deputy director of the
National Blood Center and one of the experts at the
seminar, said that the spread of AIDS is no longer
confined to a particular group. This disease is spreading
among all groups, particularly among the nation’s
youths, including students. The rate of AIDS infection
among students has increased greatly, with the rate now
at 0.3 percent. [passage omitted]

AIDS in Army Recruits, Survey on Sex Practices

92WE0006D Bangkok BAN MUANG in Thai
26 Aug 91 pp I, 20

[Excerpt] [passage omitted] Dr. Wirasit Sithhitrai, the
deputy director of the Thai Red Cross AIDS Program,
said that a study entitled “The Incidence of AIDS and
Sexual Practices of 21-Year-Old Thai Men in the North”
was conducted by the 3d Army Region in cooperation
with the Thai Red Cross. It was found that 10.3 percent
of the new recruits in the north had the AIDS virus. This
is a very high rate of incidence, because the rate of
infection among recruits nationwide is only 2 percent.

This study showed that more than half of those in the
sample had sex when they were 13-16 years old. The first
sexual encounter of 73.4 percent of these men was with a
prostitute. Only 2 percent were virgins when they got
married. The others had had sex for the first time with

EAST ASIA 15

other women besides a prostitute or their wife. It was
found that 97 percent of the men in the sample had had
sex with a prostitute. Of these, only 40 percent used a
condom. And most of the men had had sex with prosti-
tutes who charged between 50 and 100 baht.

Dr. Wirasit said that 21.7 percent of these Thai men had
had sex with young girls, most of whom were 12 or 13
years old. It was also found that 39.1 percent of these
men had had sex with female students. The places used
most frequently for having sex were, in order, in a
dormitory, at home, at school, in a public park, on the
school grounds, in a school bathroom, and in a class-
room. Almost 10 percent of those sampled had had sex
on school grounds, particularly on evenings during
school functions or in the evening after school. It was
also found that 4.6 percent of the men in the sample had
raped a girl.

Dr. Wirasit said that the AIDS situation in the north is
very alarming. It was found that approximately 70
percent of the prostitutes there have the AIDS virus, and
30 percent of the men who had been checked for a
venereal disease have the virus.

This study was conducted among 21-year-old Thai men
from the north who had reported for induction (three
groups of new recruits) within the 3d Army Region. That
is, the study was conducted among the 944 men who
reported for induction in November 1989, among the
3,066 men who reported for induction in May 1990, and
among the 3,334 men who reported for induction in
November 1990.

The state must implement urgent measures to control the
spread of AIDS in the north. That is, it must give
rewards or fines to the owners of brothels. The provincial
public health officials, the provincial governors, and the
police must work together to encourage the owners of the
brothels to have their employees use condoms every time
they have sex. Prostitutes should have sex only with men
who use a condom.

“Education alone will not quickly change people’s
behavior. To change people’s behavior, steps must be
taken that will encourage the desired behavior. This is a
very complex matter. This will take time, and we may
not be able to keep up with the spread of AIDS. Thus, we
must implement urgent measures in order to solve this
problem,” said the deputy director of the Thai Red Cross
AIDS Program.

Singburi AIDS Infection Rate Increases

92WE0006C Bangkok THAI RAT in Thai 30 Aug 91
pill

[Excerpt] Dr. Somchai Wirikanokwilai, the Singburi
provincial public health officer, said that based on the
efforts to monitor and control AIDS among people in the
at-risk groups in Singburi Province during the period
1988 to 1991, it has been found that the spread of AIDS



IJPRS-TEP-91-025
9 December 1991

ARMENIAN AFFAIRS

Anti-AIDS Measures
91WE0272A Moscow TRUD in Russian 17 Jan 91 p 1

[Article by L. Vrtanesyan, Erevan: “Without AIDS, but
With Benefits”]

[Text] “This disease practically does not exist on our
territory,” reported A. Mayrapetyan, Chief Sanitary
Physician of Armenia. “Nevertheless, the local govern-
ment has taken a number of steps to assure the social
protection of persons infected with the virus or ill with
AIDS.”

If, God forbid, the “disease of the century” appears in
Armenia, minor child patients will be allocated a state
pension in the amount of the minimal wage. Benefits are
also provided to the parent who is caring for the sick
child; under certain conditions the parent’s job seniority
will be maintained...

As has been reported at the Ministry of Health of
Armenia, only two cases of AIDS have been identified in
the republic: a foreign student, who was quickly sent
home, and a Soviet employee in one of the African
countries. Both of the carriers of the virus, fortunately,
have been found to be without clinical signs of AIDS. In
the last 3 years 600,000 blood tests have been performed
in Armenia, and in all cases a negative result was
obtained. Constant monitoring of risk groups among
permanent and temporay residents of Armenia has been
established by local physicians.

ALGERIA

Statisitics on AIDS Carriers

LD0112150891 Algiers Radio Algiers Network in Arabic
1200 GMT I Dec 91

[Excerpts] The national seminar on combating AIDS,
which coincides with the international day for com-
bating AIDS, opened at Medea today.

For more details, here is our correspondent:

[Unidentified correspondent] The seminar is being held
under the slogan: International Day for Combating
AIDS. [Passage omitted]

According to the latest figures supplied by the Minstry of
Health, 92 cases of AIDS have been recorded in Algeria,
of which 69 cases were among males and 23 among
women.

The majority of those suffering from AIDS ranged
between 20 and 39 years old: 54 cases among the men
and 10 cases among women.

As to those recorded as AIDS virus carriers, the latest
figures show that they number 268 cases, of which five
cases were among children. The men were the largest

NEAR EAST & SOUTH ASIA a

section—181 cases were registered among men. Twenty-
eight cases of virus carrying were reported among
women. The remaining cases have not been identified in
terms of sex. [Passage omitted]

BANGLADESH

AIDS-Infected Workers Return From Dubai

91WE0556 Dhaka THE BANGLADESH OBSERVER
in English 11 Aug 91 pp 1, 10

[Text] Sylhet, 10 August—Three AIDS patients have
been detected in Kanaighat upazila under Sylhet district
recently.

One of the patients is Alimuddin, 27, of Uzanipara
village under Kanaighat upazila was caught by the police
and sent to Dhaka for treatment on Saturday night under
police escort.

The other two patients Kashem Ali and Nasiruddin of
Kanaighat upazila are absconding.

All the three persons were working in Dubai. Alimuddin
was checked by the doctor in Dubai and diagnosed him
as an AIDS patient. Later Kashem Ali and Nasiruddin
were also detected by Dubai doctors as AIDS victims.

The Dubai Government sent these three AIDS patients
to Bangladesh in the first week of June and since then
they were staying in their village home.

After returning to Bangladesh these three patients did
not disclosed their disease. However, it came to the
knowledge of the local people and the local authority
sent police to catch them. Receiving the information two
AIDS’ patients Kashem Ali and Nasiruddin managed to
escape and Alimuddin was caught by the police and he
has been sent to Dhaka for treatment.

INDIA

AIDS Widespread Expected, Underreporting
Noted

92WE0056A Madras INDIAN EXPRESS in English
23 Sep 91 p 1

[Article by Sumit Mitra: “Bombay Will be Entrepot for
AIDS”]

[Text] New Delhi, Sep 22—Dr. A. S. Paintal, the
renowned expert on the future spread of AIDS in India,
who retired this month as the Director-General of the
Indian Council of Medical Research (ICMR), now pre-
dicts Bombay would emerge as the entrepot for an
incursion of the deadly virus “within three years.”

Dr. Paintal’s prediction, which is doubted by the ICMR
authorities now, points at the grisly scenario of ‘every
third housewife’ in Bombay to show positive Human
Immuno-Deficiency Virus (HIV) result at ante-natal



IJPRS-TEP-91-025
9 December 1991

Two Percent of Army Recruits Test HIV-Positive

BK3110005591 Bangkok BANGKOK POST in English
31 Oct 91 p 3

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

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

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

In the 17 northern provinces there are 1,290 known
places where a total of 10,241 “service women” are
available. These include 235 places and 2,608 women in
Chiang Mai, 223 places and 1,629 women in Chiang Rai
and 88 places and 680 women in Lampang, he said.

Third Army commander Lt.-Gen. Phairot Chan-urai in
Phitsanulok tomorrow will chair a meeting of local
authorities on AIDS dangers and how to prevent the
virus spreading. Prime Minister’s Office Minister
Michai Wirawaithaya and Public Health Ministry Per-
manent Secretary Uthai Sutsuk will take part. [passage
omitted]

Restriction on Entry of AIDS Victims To Be
Relaxed

BK0611095991 Bangkok Radio Thailand Network
in Thai 0530 GMT 6 Nov 91

[Text] Michai Wirawaithaya, minister attached to the
Prime Minister’s Office, told reporters at Government
House this morning that the screening committee on
security and foreign affairs has approved the Public
Health Ministry’s proposal on a draft ministerial regula-
tion attached to the immigration bill to drop AIDS from
the list of prohibited diseases whose sufferers are denied
entry to Thailand. The decision is expected to be for-
warded to the Cabinet for consideration some time next
week.

The minister explained why the ban on entry of AIDS
patients into Thailand was being lifted, saying that
various countries do not refuse entry to AIDS patients,
and the World Health Organization has also established
a similar principle.

EAST ASIA 17

Moreover, at present, the AIDS situation has changed.
Preventing AIDS victims from entering the country may
not be fully effective. For one reason, it is hard to know
whether a person has contracted the AIDS virus. For
another reason, there is a considerable number of AIDS-
infected people in the country. It can be seen that such a
restriction against AIDS victims would not be as effec-
tive as it should be. Therefore, it is appropriate to drop
AIDS from the list of diseases whose sufferers are
prohibited entry into Thailand, said the minister.

AIDS-Infected Persons No Longer Denied Entry

BK2711074091 Bangkok Radio Thailand Network
in English 0000 GMT 27 Nov 91

[Text] The Cabinet at its meeting yesterday endorsed the
interior ministerial decree to be attached to the Immi-
gration Act deleting AIDS from the list of forbidden
diseases.

AIDS has been added to the list in accordance with the
interior ministerial Decree No. 11 in 1986. However,
with more information about the disease available at
present, it has become clear that detection of AIDS
cannot be done effectively and that contraction of the
disease is not possible through other means than sexual
intercourse and blood transfusion.

The lifting of the ban on AIDS-infected persons is in
accordance with international practices and will benefit
the country in the long run, with foreign assistance
expected to pour in to help Thailand deal with AIDS
problems.

VIETNAM

Committee Launches Anti-AIDS Campaign

BKO0212053791 Hanoi VNA in English 0609 GMT
30 Nov 91

[Text] Hanoi VNA Nov. 30—The national anti-AIDS
committee and the Hanoi anti-AIDS committee on
November 29 and 30 organized here meetings to launch
anti-AIDS compaigns, responding to World AIDS Day-
1991 themed ‘Sharing the Challenge’.

Thousands of representatives of various public offices,
organizations, schools, hotels... Attended the functions.

Concrete measures were worked out to prevent and
combat this killer disease.



30 SOVIET UNION

already been deported to their home countries. Since
these are mainly students, it is difficult to state with
certainty that they have lived a monastic life style. How
many contacts did they have, with whom? And now, who
can anwer these questions?

“The serenity of our authorities surprises me,” says
Grogorii Mitrofanovich. “You see, I have read the
materials of our oblast party conference. What didn’t
they talk about: about the ruined state of the economy,
the party budget, etc. But nowhere, not once did I here
that the party was disturbed about the scandalous immo-
tality, the lack of culture of our people.

“In our huge city, you will not find publicity, not even
the usual notice about the confidential consulting room.
How many times have I turned to the city health
department- no one needs anything, AIDS is somewhere,
not here, there’s no AIDS yet. Not yet...”

As I was leaving, the third visitor of the day was
dropping into the consulting room.

“Are you afraid of AIDS?”, I asked.
The young fellow was offended:

“What do you take me for? The Military Commissariat
is forcing us.”

Organizing the Prevention of HIV Infection in
Treatment-and-Prevention Facilities of the Soviet
Army and Navy

91WE0459 Moscow VOYENNO-MEDITSINSKIY
ZHURNAL in Russian No 3, Mar 91 pp 42-45

[Article by Col. Med. Serv. N. B. Belgesov (candidate of
medical sciences), Col. Med. Serv. (Res) V. I. Dmitriyev
(professor), Col. Med. Serv. (Ret) M. A. Zolochevskiy
(Docent), Lt. Col. Med. Serv. V. V. Sheybak (candidate
of medical sciences]

UDC 616.9-097[-02:6 16-08:725.511]-084:355

[Text] The epidemiological significance to the military
of acquired immune deficiency syndrome, the pathogen
of which is the human immunodeficiency virus, stems
from the pandemic spread of the infection in recent
years. WHO experts feel that, in light of the absence, to
date, of specific means of treating or preventing that
lethal illness, the most effective means of fighting it
consist of protective measures aimed at explaining the
causes of the disease and the mechanisms of its trans-
mission; the proper behavior of the individual in his
personal life; and the recognition by the individual of his
tesponsibility for preserving his own health and the
health of those around him. As essential role in the fight
against the disease belongs to the adherence to preven-
tive measures by the population as a whole, by ill
(infected) individuals, and by medical personnel in treat-
ment-and-prevention facilities (Rytik P. G. et al., 1988;
Vorobyev A. I., 1989).

SPRS-TEP-91-025
9 December 1991

According to the available data, primary infection and
subsequent long-term persistence of HIV takes place not
only in the T lymphocytes and macrophages, but also in
the cells of, for example, the central nervous system and
the epithelium of the mucosa of the large intestine. The
pathogen is isolated in the sperm and the vaginal con-
tents, as well as in mothers’ milk, the saliva, lacrimal
substances, urine, and feces. It is also contained in the
blood and spinal fluid. In addition, the epidemiological
significance of certain transmission factors is rather
high, whereas for the rest it is low. For example, 0.01 ml
of blood is enough to infect a healthy individual (““AIDS:
The Safety of Blood and Blood Products, 1987”). Con-
sequently, there is a real threat of contamination with
HIV not only for individuals belonging to risk groups
(drug addicts, promiscuous individuals, homosexuals,
bisexuals, blood and blood-product recipients, venereal-
disease patients, etc.), but also for individuals who
receive infusions of blood or blood products that have
not been checked for HIV antibodies or who undergo
surgery or various procedures performed with nonsterile
medical instruments that are used to violate the integrity
of the skin or mucosal membranes.

As a result, special attention should be devoted to the
prevention of HIV infection and to the observance of
epidemic-control measures in treatment-and-prevention
facilities, including those in the Armed Forces and
primarily in surgical, resuscitation-anesthesiology, gyne-
cology, dental, laboratory, and children’s departments
and, among others, blood-transfusion departments and
stations.

That conclusion is confirmed by the tragic events that
took place in the republic children’s and infectious
hospitals in Elisty, where, in January 1989, doctors
identified multiple instances of HIV contamination that
affected, according to incomplete data, 73 children and
10 adults (Dikun Ye., 1989). The intrahospital infection
was the result of multiple intravenous transfusions with
syringe systems contaminated with the blood of a patient
who was a Virus carrier, something that is considered the
grossest violation of the regulations for the sterilization
and use of medical instruments.

At the same time, we must now also consider the
possibility of the direct infection of the medical workers
themselves who are treating or nursing individuals who
have not been tested for blood-borne antibodies to HIV,
as well as medical workers who are performing surgery
on those individuals. A number of published researchers
estimate the level of transmission of HIV to medical
personnel from AIDS patients (or virus carriers) to be at
0.1% of the total number of those tested; at the same
time, when procedures involving blood are performed,
the risk of the medical workers becoming infected rises,
as might be expected, to 2.7% (Gerderding J. L. et al.,
1987). Consequently, there is, from that standpoint also,
an urgent need for regulations that are stricter and more
rigid when it comes to the protocols for medical per-
sonnel working in that area.


12 CHINA

First AIDS Counselling Clinic Opens 28 Nov

HK3011054691 Beijing CHINA DAILY in English
30 Nov 91 p 3

[Article by staff reporter Hong Xia: “AIDS clinic estab-
lished to educate and counse!”]

[Text] “Will a person probably be infected with AIDS if
he or she is bitten by mosquitoes?”

This question was raised anxiously by a woman at
Beijing’s first AIDS counselling clinic when it opened to
the public on Thursday.

The clinic received two telephone calls and four visits in
the first two days after it was open, said its adminis-
trator, Yang Guanglu, a member of Experts Counselling
Committee on Venereal Diseases with the Ministry of
Public Health.

Statistics released by the World Health Organization
(WHO) showed that of the eight to 10 million HIV
carriers worldwide, 1.5 million have developed AIDS.

The number continues to grow, and although China is
among the countries with the lowest number of reported
AIDS cases worldwide, it is certainly still a country at
risk.

According to the Ministry of Public Health, 493 people
in China tested HIV positive and five had AIDS between
1985 to 1990. Eighty- three of the 493 and three of the
AIDS patients were foreign.

However, many people in China remain ignorant about
AIDS and some lack even common knowledge, such as
how the disease is transmitted, Yang pointed out.

So it is imperative to educate more people as soon as
possible.

The clinic aims to help disseminate accurate information
about AIDS through literature and counselling on its
transmission, symptoms and prevention, Yang said.

The clinic will also offer testing and treatment for AIDS
and venereal diseases. Visitors to the clinic are guaran-
teed anonymity; their names, addresses and medical
records will be strictly confidential, Yang said.

“We also hope some people’s hazardous behaviour can
be transformed as a result of the counselling, but we will
never force anyone to do anything,” he added.

The clinic is located in You’an Hospital, opposite the
Grand View Garden, in Fengtai District.

Besides Yang, six other experts will offer AIDS counsel-
ling from 8 am to 3 pm except on Sundays. People with
questions can also call the clinic at 3291114, extensions
215 and 217.

SJPRS-TEP-91-025
9 December 1991

Further on Public Health Ministry, AIDS Virus

0W3011163691 Beijing XINHUA in English
1447 GMT 30 Nov 91

[Text] Beijing, November 30 (XINHUA)—China dis-
covered 122 people infected with the AIDS virus in the
first 11 months of this year, after conducting serum tests
among more than 300,000 people, according to Chen
Minzhang, minister of public health.

As tomorrow is “World AIDS Day”, a forum was held
today by China’s Public Health Ministry to report on the
AIDS situation in China and seek ways to combat the
disease.

According to the minister, since 1985 some 615 AIDS
cases have been reported in the country, eight of these
were AIDS patients and the others were cases of people
infected with the human immunodeficiency virus (HIV)
which causes AIDS. Only three of these cases involved
Chinese citizens.

It is reported that most of these newly-found cases
involve people in China’s southwestern area who have
been infected with HIV as a result of drug injections and
people in coastal areas who have returned from abroad
after visiting relatives and friends. The patients also
include prostitutes and venereal disease patients in
China’s big cities.

The spread of AIDS in China is by way of sexual
relations or blood products injections, no mother-infant
infection cases have been reported in China so far.

Heilongjiang Reports Work of AIDS Monitoring
Center

SK0212044191 Harbin Heilongjiang People’s Radio
Network in Mandarin 1000 GMT I Dec 91

[Text] Heilongjiang has achieved notable results in pre-
venting and controlling AIDS. No HIV carrier had been
discovered in the province as of 25 November.

Since its founding in 1988, the Heilongjiang AIDS
Monitoring and Examination Center has invested
50,000 yuan to conduct physical checkups for the group
of highly endangered people in the province. More than
4,000 samples of blood serum have been checked so far,
and files have been established for the people who had
the physical checkups.

In line with the requirements of the Ministry of Public
Health, this center has also conducted strict examination
on the blood products imported by the medical depart-
ments at all levels throughout the province, thus effec-
tively controlling the major channel for spreading AIDS.



4 SUB-SAHARAN AFRICA

Stressing the need for sex education by trained per-
sonnel, he said that if education were to bring about the
fundamental changes in sexual behaviour required to
stop sexually-transmitted diseases and AIDS, such coun-
selling would have to “address the fundamental religious
and moral dimensions of human sexuality”.

He said projections indicated that the number of HIV-
infected black South Africans aged between 15 and 49 at
the end of 1990 was between 119,000 and 168,000. This
figure is expected to rise to 317,000 and 446,000 by the
end of this year.

Figures in May 1991 for recorded cases of sexually
transmitted HIV-infection indicated that 95 percent of
infected whites were homosexual or bisexual while 99
percent of blacks were heterosexual.

Dr. Grazioli said black HIV carriers were typically
young, with a low standard of education, occupational
status and income levels. They lived in poverty in urban
and semi-urban townships, were increasingly politicised
and suffer extreme disruption and lack of security in
their lives.

“It is under these perilous conditions that an awareness
of AIDS, personal motivation, behaviour to prevent
infection and strategies to combat the disease have to be
established.”

Dr. Grazioli said the spread of AIDS in South Africa
could only be stemmed by broadly-based and contextu-
alised sex education, programmes to promote healthy
family dynamics and closed relationships and biomed-
ical safer sex education.

Research Program Head Notes Projected AIDS
Figures

MB3010182091 Johannesburg Radio RSA in English
1500 GMT 30 Oct 91

[Text] The head of the National AIDS Research Program
of the South African Medical Research Council, Dr.
Malcolm Steinberg, says South Africa will have between
750-930,000 AIDS orphans in 20 years time. Speaking at
aconference on child health priorities in Cape Town, Dr.
Steinberg said projections indicated that by the year
2010 between 20,000 and 31,000 children would have
the HIV virus. He said the existing health services were
not coping with the AIDS burden and a new health
system would be needed.

National Health Department Refutes U.S. AIDS
Report

MBO111060891 Johannesburg SAPA in English

2147 GMT 31 Oct 91

[Text] Johannesburg Oct 31 SAPA—Predictions that
AIDS will wipe out three-quarters of South Africa’s
population by the year 2010 are “ultimately irresponsi-
ble”, says the Department of National Health and Pop-
ulation Development.

IJPRS-TEP-91-025
9 December 1991

The department reacted on Thursday to a medical report
by the Population Research Institute, an American-
based international monitor of global population trends.

The report predicted that an AIDS holocaust will depop-
ulate South Africa, with as many as 12.8 million people
infected by the end of 1995, and quoted Johannesburg,
physician and public health administrator Dr. Claude
Newbury as saying: “AIDS will almost certainly depop-
ulate this country and probably reduce our population to
less than one quarter of its present size by the year
2010.”

Dr. Newbery was also highly critical of South Africa’s
approach to AIDS. He accused authorities of “fiddling
with dubious statistics...” While “the impending AIDS
epidemic threatens to decimate the nation’s popula-
tion”,

The department dismissed Dr. Newbury as someone
“not widely known in the RSA for his involvement in
AIDS” and suggested the report was “a mishmash of
reasonable facts and unfounded, rather unscientific spec-
ulation”.

Although the department agreed with Dr. Newbury’s
claim that there were 100,000 South Africans infected
with the HIV virus at the end of last year, and that this
figure would double to 200,000 before the end of 1991, it
disputed his estimation that the number of HIV infected
people would double every eight months.

“On the basis ongoing studies the doubling time is
probably closer to 12 months.”

Furthermore, Dr. Newbury had failed to take into
account the effect of anti-AIDS programmes “expected
to make dramatic changes in the extent of the pandemic
in the future”.

It was presently impossible to state, as Dr. Newbury had,
that 12.8 million South Africans would be infected by
AIDS in four years time, because it was not possible to
quantify all the variables governing the growth of AIDS.

Dr. Newbury was also “obviously unaware” of the extent
of HIV- prevention activities being undertaken in South
Africa.

Predictions like those he was prepared to make “are in
the category of gazing into crystal balls and are ulti-
mately irresponsible”, the department said.

SADF Introduces AIDS Testing for Permmenant
Force Recruits

MBO0611150791 Johannesburg SAPA in English
1426 GMT 6 Nov 91

[Article by Ada Stuijt]

[Text] Johannesburg Nov 6 SAPA—The South African
Defense Force [SADF] has introduced AIDS testing to
its permanent force recruits.


JPRS-TEP-91-025
9 December 1991

Buryat SSR Prepares to Fight AIDS

91WE0251a Moscow MEDITSINSKAYA GAZETA
in Russian 16 Dec 90 p 3

[Article by V. V. Vasil’ev; Staff Correspondent “MG”,
Ulan-Ude: AIDS: Know It and Combat It; The Virus
Crosses Baykal]

[Text] Yet another point, Ulan-Ude, has appeared on the
map of the distribution of HIV infection in our country.

“A married couple, the M.’s, have been found to be
carriers of the HIV infection,” says Deputy Minister of
the Buryat SSR Ministry of Health. “The head of the
family was working abroad on contract. Last year his
wife was also there with him. Upon their return they
were examined in Moscow, where the virus was found to
be present in their blood. A secondary, more in-depth
examination, carried out at our request unfortunately
cofirmed the initial diagnosis.”

“In our turn, we ourselves carefully checked the contacts
of the M.’s. All their close acquaintances were healthy. It
was clarified that neither the husband nor the wife
during this half year visited the usual medical institu-
tions, that is, the danger of infection transmitted through
scalpel, syringe, etc., was excluded.”

“How is the republic preparing for the encounter with
the encroaching ‘plague of the twentieth century’? A
republic center for the prevention of and campaign
against AIDS has been created in Buryatiya; two anon-
ymous offices in which about 120 thousand people have
been examined have been opened. But this is clearly
inadequate.”

“The problems are the same as everywhere in the
country: there are not enough test systems; medical
services in the republic have been supplied with dispos-
able syringes only to the extent of 10 percent of what is
needed; special gloves are completely lacking.”

“There is yet another difficulty: inadequate experience
in communicating with foreign guests. Only two years
have passed since Ulan-Ude became an open city for
foreigners. In that short period of time thousands of
tourists from various countries have visited here. A
center for representative observers from the USA, who
are monitoring the liquidation of medium-range rockets
at one of the Siberian proving grounds, has been located
in the capital of Buryatiya. The ‘Michigan-Baykal’
Soviet-American ecological forum took place here in the
summer. And the flow of guests will grow in the future,
because this rich region will elicit ever greater interest in
foreign businessmen. For this reason the government of
Buryatiya has undertaken the program ‘Urgent Measures
for the Prevention of and Campaign Against HIV Infec-
tion on the Territory of the Buryat SSR’, which includes
a plan of expeditious measures of both a medical and an
economic character.”

SOVIET UNION 21

Mandatory AIDS Testing Decreed

91WE0248A Moscow MEDITSINSKAYA GAZETA
in Russian 14 Dec 90 p 2

[Article: REGULATIONS for Medical Examination for
the Identification of Infection with the Human Immun-
odeficiency Virus (AIDS)]

[Text] I. M. Denisov, USSR Minister of Health,
approved the “Regulations for the Medical Examination
for the Identification of Infection with the Human
Immunodeficiency Virus (AIDS)” on October 4, 1990.

By decree of the USSR Supreme Soviet, “The Procedure
for Putting into Effect the USSR Law ‘On the Prophy-
laxis of AIDS”, the Law and Regulations were put into
effect starting January 1, 1991.

1. The present regulations have been published on the
basis Article 3 of the Law of the Union of Soviet Socialist
Republics dated April 23, 1990, “On the Prophylaxis of
AIDS”, and establish the following procedure for the
medical examination of citizens of the USSR, foreign
citizens, and stateless persons living or present on the
territory of the USSR, for the identification of infection
with the human immunodeficiency virus (AIDS).

2. The following are subject to examination:

2.1. Donors of blood, blood plasma, and other biological
fluids and tissues at the time of each donation.

2.2. Citizens of the USSR who are returning from
service, business, or private trips abroad longer than 3
months in duration.

2.3. Foreign citizens or stateless persons who have come
to the USSR for study, work, or other purposes, 10 days
after arrival, taking due account of the provisions of
para. 9 of the present Regulations, with the exception of
foreign citizens or stateless persons arriving from coun-
tries whose certificates of examination for antibodies to
the AIDS virus are recognized in the USSR.

2.4. Citizens of the USSR going abroad to countries
according to the requirements of which a certificate
regarding the passing of an examination for infection
with the human immunodeficiency virus (AIDS) is nec-
essary.

2.5. Citizens of the USSR and foreign citizens who have
had sexual contact with AIDS patients or AIDS virus
carriers, and who have been identified through epidemi-
ologic examination, are examined once in 6 months for a
year.

2.6. Those ill with the following clinical indications:
- febrile more than 1 month;

- with lymph node enlargement of two or more groups for
more than 1 month;

- with diarrhea lasting more than 1 month;



4 NEAR EAST & SOUTH ASIA

It is worth noting that in the West, the AIDS virus was
first noticed in 1981 among five young American homo-
sexuals in California, United States.

ISRAEL

Half of 160 AIDS Victims Died ‘So Far’

TA1911173691 Jerusalem Qol Yisra’el in Hebrew
1700 GMT 19 Nov 91

[Text] Some 160 Israelis have so far become infected
with the AIDS virus, and more than half of them have
died; one-third of them were hemophiliacs. This was
reported by Prof. Avraham Morag from the Hadassah
Hospital in Jerusalem, during a seminar in the Soroka
Hospital in Beersheba. Prof. Morag said he believes that
the number of Israelis who carry the AIDS virus will not
rise significantly. He reported that one of the reasons for
the contraction of the disease is blood transfusions
Israeli tourists receive abroad.

Health Ministry Releases AIDS Statistics

TA0212110891 Tel Aviv YEDI'‘OT AHARONOT
in Hebrew 2 Dec 91 p 9

[Report by Dvora Namir and the ITIM correspondent}

[Excerpt] The fourth International AIDS Day was
marked yesterday in 160 countries worldwide. In Israel
to date, 162 people have contracted AIDS, of which 106
have died.

The Health Ministry argues that for each diagnosed
patient, there are 10 others who have not yet been
identified. Based on data from abroad, Israeli experts
believe that there are 5,000 carriers who are still healthy
but who have been passing the disease to others.

Only 174 of the 785 carriers diagnosed in Israel are
homosexuals; 30 are heterosexual and nine are children
born to a parent diagnosed with AIDS. An astonishing
fact is that 395 of the carriers do not belong to any of the
high-risk groups and the source of contagion is unclear.
[passage omitted]

JORDAN

Health Ministry Says 66 AIDS Cases in Kingdom

JN2811110191 Amman JORDAN TIMES in English
28-29 Nov 91 p 3

[Excerpt] Amman (J.T.)—The Health Ministry
Wednesday revealed that the total number of AIDS cases
in the Kingdom since 1986 has now reached 66, 59 of
whom are Jordanians.

Of the Jordanians infected with the disease, 14 have
already died, one of whom passed away last week, said
the ministry in a statement prior to the World AIDS
Day, 1991, which is to be observed Sunday.

SJPRS-TEP-91-025
9 December 1991

Only one AIDS patient out of the seven foreign nationals
died in the Kingdom, the statement said. The rest have
been repatriated, said the ministry’s statement, carried
by the Jordan News Agency, Petra.

The Ministry of Health has been able to control the
spread of the AIDS disease through strict monitoring of
the blood transfusion processes and through stringent
precautionary measures, including laboratory tests, the
statement said.

All blood banks in Jordan conduct tests on the blood of
donors to ensure that they are safe, especially if the
donors had undergone surgical operations abroad. At the
same time, Jordan restricts the importation of any
amount of blood from other countries, the statement
added.

Jordan is considered among the first few countries of the
region to take precautionary measures against the spread
of the AIDS disease. According to World Health Organ-
isation (WHO) estimates, there are between eight and 10
million men, women and children around the world who
are infected by this disease and that more than 5,000 are
infected by AIDS daily.

The ministry statement noted that Jordan, through the
continued efforts of a National Committee to Combat
AIDS, has been implementing a wide-scale campaign to
spread education among the young people against the
killer disease and ways to protect themselves from it.
[passage omitted]

MAURITANIA

Number of AIDS Cases Noted

£D0112234191 Nouakchott ORTM Radio in Arabic
2030 GMT 1 Dec 91

[Excerpt] [passage omitted on seminar marking World
AIDS Day] It is worth mentioning that by mid-April of
this year, 16 AIDS cases had been recorded in the
country. This is, thank God, a small number in compar-
ison with the number recorded in some neighboring
African countries such as Algeria, where 45 cases have
been officially recorded, and Zaire, which has 95 cases.

PAKISTAN

Rapid Spread of AIDS Feared

Awareness of Disease Low
92WE0044A Karachi DAWN in English 25 Sep 91 p 9

[Article by Shouket Ali, Secretary-General of the Paki-
stan AIDS Prevention Society: “Creating Awareness”]

[Text] Over the years a number of medical researchers
have come to realise that AIDS will soon pose a serious
threat to Pakistan unless urgent action is taken not only


IJPRS-TEP-91-025
9 December 1991

REGIONAL AFFAIRS

WHO Official Cites AIDS Potential Impact on
Work Force

MB2711075791 London BBC World Service in English
0430 GMT 27 Nov 91

[From the “African News”]

[Text] Officials from more than 40 African countries
meeting in Namibia have been warned that the
spreading AIDS virus could soon have disastrous eco-
nomic consequences. A senior official from the World
Health Organization said that Africa’s work force could
be depleted by up to 20 percent in the next five years.

ANGOLA

AIDS Spreading at ‘Alarming Rate’
MBO0211085491 (Clandestine) Voice of Resistance of the

Black Cockerel in Portuguese to Southern and Central
Africa 0500 GMT 2 Nov 91

[Excerpt] AIDS, the disease that cannot be cured, is
spreading at an alarming rate throughout the areas where
Cuban troops had been deployed. AIDS cases have been
diagnosed in Luanda. At least four cases have been
diagnosed in Cuanza Norte Province.

AIDS was introduced in Angola by Cuban troops.
According to AFRICA CONFIDENTIAL, Cuba also
sent to our country Ugandan soldiers who had con-
tracted the disease in that country. The Kampala gov-
ernment refused to allow those Ugandans into Uganda,
alleging that there were no means to treat the killer and
highly contagious disease. [passage omitted]

GHANA

AIDS Cases Up 1.9 Percent in July 91

AB2311073091 Paris AFP in French 1940 GMT
8 Nov 91

[Text] Accra, 18 Nov (AFP)—The number of AIDS
patients in Ghana increased by 1.9 percent during the
month of July, thus bringing the total to 2,521, the local
press reported today. According to the last assessment
dating back to June, the number of people believed to
have been suffering from AIDS was 2,474. Dr. Phillis
Antwi, director of the national anti-AIDS program,
reckoned that one out of 10 regional hospitals was
equipped to detect the disease, the press reported.

[Accra Ghana Broadcasting Corporation Radio Network
in English at 2000 GMT on 20 November adds the
following: “Sixty-eight AIDS cases were recorded at the
Nkawkaw Holy Family Hospital during the first nine
months of this year. Out of the number, 61 were women

SUB-SAHARAN AFRICA 1

and the rest men between the ages of 17 and 40. The
figure is against 29 cases recorded by the hospital last
year.”]

KENYA

Over 600 AIDS Cases in Eastern Province

92WE0081A Nairobi THE KENYA TIMES in English
15 Sep 91 p 5

[Text] Health workers need proper and intensified coun-
selling so as to be able to handle, treat and interact freely
with victims of AIDS and other incurable diseases.

The observation was made by a nurse at the Embu
General Hospital during an AIDS seminar held in Embu.
Mrs. Muigai said that nobody should declare an AIDS
victim worthless since they can still be resourceful and
active members of the society.

She said that sacking an AIDS victim does not help the
society or the individual since the society ends up being
deprived of useful services while the sacked person is left
with no source of income.

She said that through proper counselling an AIDS victim
could be made to see and understand the need to change
his/her sexual behavior so as to curb the spread of the
disease.

She further stressed the need to interact with the victims
in a bid to create comfort for the patient and not to
isolate them in a ward where they are left feeling
unwanted and depressed.

Mrs. Muigai also announced that a special clinic for
proper investigations and treatment of various sexually
transmitted diseases has been launched at the Embu
General Hospital's outpatient department.

She observed that health workers out in the field had
realized that people were taking the disease for granted
and ignoring the danger behind it.

On the control of AIDS, the nurse said there was need to
give proper health education to people of all ages. She
said that the use of condoms should not be stressed since
it has been found not to be a sure way of protection.
However, Mrs. Muigai felt that condoms should be used
by married couples with an AIDS problem just to pre-
vent reinfection.

And according to the Eastern Provincial Physician at the
Embu General Hospital, Dr. Francis Kimani, there were
about 663 reported AIDS cases in the province, 254
among them from Embu district.

Dr. Kimani said the hospital had so far dealt with about
70 AIDS patients, adding that half of them have already
died.



IJPRS-TEP-91-025
9 December 1991 5 AIDS

Organizing the Prevention of HIV Infection in Treatment-and-Prevention Facilities of the Soviet Army

and Navy

IN. B. Belgesov, V. I. Dmitriyev, et al; VOYENNO-MEDITSINSKIY ZHURNAL, No 3, Mar 91]
Gomel Oblast Registers Six HIV Cases [P. Radechko; SOVETSKAYA BELORUSSIYA, 3 Apr 91]
Warning Issued on Increase in AIDS Cases [Moscow TASS, 29 Oct 91] ......
First AIDS Case Diagnosed in Altay Kray /S. Vtorushin; Moscow PRAVDA, 23 Nov 91]
Medical Sciences President Reveals AIDS Statistics

[Marina Barinova; Moscow TASS International Service, 29 Nov 91]
Latvia Notes Current AIDS Statistics /Riga Radio Riga International,

WEST EUROPE
BELGIUM

Government Presents AIDS Research Program
[Groot-Bijgaarden DE STANDAARD, 11 Sep 91] .....
Strategy for Combating AIDS Jacques Poncin; Brussels LE SOIR, 11 Sep 91]

FINLAND

Kuopio Cuts Funds for AIDS Center [Helsinki HELSINGIN SANOMAT, 21 Jun 91] .
AIDS Carrier Who Endangered Others Imprisoned ....
Two-Year Sentence [Helsinki HELSINGIN SANOMAT, 2 Oct 91] ..
Paper Comments on Case [Helsinki HELSINGIN SANOMAT, 3 Oct 91] .
National AIDS Effort Outlined Helsinki HELSINGIN SANOMAT, 28 Sep 91]

FRANCE

Further Information on IGAS Transfusion Report
[Jerome Strazzulla; Paris LE FIGARO, 10 Sep 90]

GERMANY

Report Cites Berlin AIDS Cases, Deaths [Berlin NEUES DEUTSCHLAND, 27 Nov 91] .
GREECE

Alarming Increase of AIDS Cases [Athens I KATHIMERINI, 2 Oct 91] ..
IRELAND

40

Paper Gives Statistics on Spread of AIDS. ...... 40
Alarm Over Heterosexual Cases {Don Lavery; Dublin 40
Increase in Fatalities /Dublin IRISH INDEPENDENT, 10 Sep 91] ... . 41
Latest AIDS Figures, Heterosexual Cases Increase
[Tom Reddy; Dublin IRISH INDEPENDENT, 15 Oct 91] ..... . 4
SPAIN
Updated Autonomous Community AIDS Statistics
[Susana Reverter; Madrid DIARIO 16, 16 Oct 91) ... . 41
Health Ministry Officials Report ‘Worrying’ AIDS Situation
[Madrid RNE-1 Radio Network, 29 Nov 91] .... . 42
SWEDEN
Increased Debate on HIV Confidentiality Issue °
[Stefan Koskinen; Stockholm SVENSKA DAGBLADET, 3 Oct 91] . 42



SJPRS-TEP-91-025
9 December 1991

AUSTRALIA
HIV Virus Carriers Estimated At ‘More Than
15,000’

BK0112065091 Melbourne Radio Australia in English
0500 GMT I Dec 91

[Text] World AIDS Day is being marked today with
thousands of events including benefit concerts, parades,
exhibitions, and conferences. The World Health Organi-
zation estimates that by the end of the century 18 million
people will have developed the disease—a tenfold
increase on the current number.

The Australian Federation of AIDS organizations says
while the community cannot afford complacency,
advances in the treatment of the disease now allow for a
measure of hope.

More than 1,800 people have died of AIDS in Australia
over the past decade and more than 15,000 people are
carrying the HIV virus.

CAMBODIA

Health Ministry Reports Two AIDS Cases

BK2111080891 Phnom Penh SPK in French 0334 GMT
21 Nov 91

{Text] Phnom Penh 21 Nov (SPK)—Tests carried out on
2,500 blood donors over the past seven months have
revealed two positive AIDS cases, announced the Health
Ministry.

A committee for the fight against AIDS has been set up
with the cooperation of the WHO, adds the Ministry
which specifies that another AIDS Center will be set up
at the Tuol Sangke dispensary in Phnom Penh.

The anti-AIDS committee is called upon to disseminate
preventive measures against the disease, track down
suspected affected persons, and train health staff special-
ized in the matter.

HONG KONG

AIDS Incidence Among Homosexuals Rises

92WEO119A Hong Kong THE HONGKONG
STANDARD in English 25 Sep 91 p 4

[Article by Ursula Yeung]

{Text] The chances of homosexuals contracting the AIDS
virus has doubled over the past three years, according to
statistics of the government AIDS Counselling and
Health Education Service.

Between 1985 when the service began to provide HIV
screening tests and 1988, 2.3 percent of the homosexuals
who received the test were found to be infected. Over the

EAST ASIA 13

past three years the figure has risen to 4.1, said Dr.
Patrick Li, head of the service.

The service has so far identified 13 AIDS carriers, about
3 percent, among the 447 homosexuals tested, he said.

“It means that with an estimated homosexual population
of 200,000 in Hongkong, about 6,000 of them would be
HIV infected,” said Dr. Li.

Although not all homosexuals in the territory would
approach the service for assistance, the statistics col-
lected had shown an increasing risk of infection among
homosexuals, he said.

Dr. Li said two more AIDS patients, one of whom was a
homosexual, have been identified this month bringing
the total number of AIDS patients found in the territory
so far to 56.

The number of HIV carriers has also increased by five to
189 and four of the five were homosexuals, he added.

Dr. Li said the service has not recorded a rise in the
number of homosexuals coming forward for AIDS virus
test since the recent decriminalisation of homsexual
activities in the territory.

“It showed that fear of prosecution may not be the only
reason for homosexuals’ failure to come forward for
AIDS virus test,” he said.

Their hesitance might have resulted from the relief that
there is no cure for the disease and fear of discrimination
by friends and co-workers, he said.

KIRIBATI

WHO Consultant Commends National Anti-AIDS

BK2511075491 Melbourne Radio Australia in English
0500 GMT 25 Nov 91

{Text] Kiribati has been commended for the excellence
of its national plan to combat the spread of the AIDS
disease. The commendation has come from the World
Health Organization’s consultant on surveillance of dis-
eases, Dr. Donald Goodwin, who is in Tarawa to review
Kiribati’s AIDS plan.

Dr. Goodwin said the plan adopted in 1989 stresses the
importance of health education and the routine moni-
toring of blood donors. So far, two Kiribati people have
been confirmed as suffering from AIDS. Dr. Goodwin
says he will make special recommendations to the Kiri-
bati health ministry on strengthening the anti-AIDS
campaign, adding that people should practice safe sex to
avoid contracting the disease.



IJPRS-TEP-91-025
9 December 1991

[words indistinct]. The WHO in its quarterly update on
AIDS said that since the October this year a total of
418,403 AIDS cases has been reported to the organiza-
tion from 163 countries around the world. However,
taking into account delays in reporting AIDS cases, the
WHO explained that about 1.5 million people, including
half a million children, have developed AIDS.

Here in Nigeria, a good number of HIV-infected persons
have developed the disease. According to the Federal
Ministry of Health, out of 135,000 blood samples taken,
860 tested positive while 100 had developed the disease.
The number of those who tested positive as of November
1989 was 250 as against 15 in November 1987. In Lagos,
for instance, HIV infections in women [words indistinct]
rose to 14 percent in 1990 from just four percent in 1988.
[sentence as heard] These figures clearly illustrate that
the disease is spreading.

One of the factors responsible for the spread of the
disease in spite of the full knowledge of Nigerians about
the threat of the disease is attributable to indifference of
some Nigerians to warnings about the existence of the
disease. In spite of considerable efforts by the mass
media which stress the need for the use of the condom,
people still ignore the advice for inconsequential rea-
sons. What such people should bear in mind is the fact
that AIDS is no respecter of persons, race, age, or
teligion.

AIDS is not a political affair. It is a matter of life and
death, and so far has no known cure. It is transmitted
through sex, transfusion with infected blood, unsteril-
ized [word indistinct] objects like needles and syringes,
and from a mother to her unborn child. The AIDS virus
destroys the body’s immune system, thereby rendering
the victim vulnerable to almost any infection. Full-
blown AIDS is always fatal, leading to death within two
or three years of diagnosis. So far, health education has
remained the only way of tackling the spread of the
disease. But AIDS education faces the formidable chal-
lenge of changing the people’s attitudes. For instance,
sexual behavior and the use of intravenous drugs through
which the virus is transmitted are deeply rooted and not
easily altered.

Though the country is classified among the low preva-
lence countries and since we do know what causes the
infections, the future of this country still depends only
on the responsible behavior of everyone in the society.
[sentence as heard] Government, through the Federal
Ministry of Health, has so far responded decisively in
combating the spread of AIDS. It has integrated the
AIDS health education into the primary health care
system to get the message to the grassroots.

In addition to the setting up of screening sector in 21
states of the federation, including Abuja, there are three
confirmation centers established and maintained by the
Federal Ministry of Health. Also, government has pro-
vided large sums of money towards the campaign against
the spread of the deadly disease, and just yesterday, the

SUB-SAHARAN AFRICA 3

Nigerian Armed Forces and Police chapters of the war
against AIDS were launched in Lagos.

Nigerians should stop being complacent and not wait to
see an AIDS patient on the television screen before
believing that the disease exists. The ultimate success of
the fight against AIDS depends on every Nigerian.

SOUTH AFRICA

Buthelezi on Constituent Assembly, Peace Accord,
AIDS

MB2610101091 Johannesburg SAPA in English
0933 GMT 26 Oct 91

[Excerpt] Ulundi Oct 26 SAPA—South Africa did not
need a constituent assembly because the state president’s
actions could be made totally dependent on the approval
of Mr. Nelson Mandela and Mr. Mangosuthu Buthelezi.
This was said in Ulundi on Saturday [26 October] by the
Inkatha Freedom Party [IFP] leader, who was addressing
the annual general meeting of the IFP Women’s Brigade.
[Passage omitted]

Addressing the population explosion and the onslaught
of AIDS, Mr. Buthelezi said it was ironic that “sex
dominates in all developing and poor societies like ours.
It is because of this that we have population explosions
which become problematic in Third World societies, of
which we are a part. It is also because of this that we will
be more devastated by AIDS, which comes out of
heterosexual sex. It is the role of mothers to instill a
certain seriousness in our children about the dangers of
this disease to our total society. What I perceive at the
moment is that our youth treat any talks on the threats of
AIDS as some kind of sick joke. I wish to emphasise that
all of us have a duty here, be we male or female, as far as
enlightening our youth on AIDS. Women can play a
pivotal role even here.”

Doctor Discusses Medical Approach to AIDS,
Projections

MB2910205091 Johannesburg SAPA in English
1926 GMT 29 Oct 91

[Text] Cape Town Oct 29 SAPA—A biomedical
approach which focuses only on the physical causes and
cures of disease was inadequate in addressing the AIDS
epidemic in South Africa, Dr. Angelo Grazioli, director
of the South African Sex Education and Dysfunction
Unit, said on Tuesday.

Addressing a health congress to commemorate the 90th
anniversary of the Institute of Public Health (IPH), he
said a holistic strategy, which recognises the role of
sexual behaviour in the spread of AIDS, was essential.

“Sexual behaviour spreads AIDS and sexual behaviour
results from beliefs which are informed by specific
values, ethics and morality,” Dr. Grazioli, said.



SJPRS-TEP-91-025
9 December 1991

HIV Carriers Number 186; 25 AIDS Cases
Registered

AU0212124191 Prague HOSPODARSKE NOVINY
in Czech 29 Nov 91 p 4

{CSTK report: “AIDS in Our Country”)

[Excerpt] There are at present 186 persons in the Czech
Republic who have been positively screened for the HIV
virus, of whom 25 have AIDS. Most carriers of the HIV
virus are men and 69 of them are foreign nationals.

In the Slovak Republic, 30 carriers of the virus are
registered, 3 of whom have AIDS. One-third of the
carriers of the virus are foreign nationals.

The low figures should not be confused with a low
number of infected persons. Rather, they bear out that
many persons hesitate to turn to their physician with
their problem, suspicion, or fear. [passage omitted]

(Prague RUDE PRAVO in Czech on 27 November on
page 2 carries a similar 300-word “per”-signed report,
which mentions that “16 persons have died of AIDS in
the CSFR thus far.”]

EAST EUROPE 19

YUGOSLAVIA

Federal Official on AIDS Statistics

LD2911231191 Belgrade TANJUG in English
1823 GMT 27 Nov 91

[Text] Novi Sad, Nov 27 (TANJUG)}—Head of the
federal AIDS commission Professor Borisa Vukovic,
said the press here today that 242 persons had been
infected with AIDS virus, while 129 persons had died in
Yugoslavia so far. The majority of the infected have been
registered in the Republic of Serbia (162).

It is now clear that the World Health Organization’s
forecasts about finding a cure for the disease by 1995 will
not come true, Vukovic said. Fighting AIDS is still based.
on prevention, or better information on the disease.

As for information on AIDS in Yugoslavia, Vukovic said
it had been significantly improved, recalling that it was
included in biology school textbooks.

Individual prevention is much more difficult to be
carried out, he told journalists on the occasion of inter-
national AIDS day, December 1.



JPRS-TEP-9 1-025
9 DECEMBER 1991

Foreign
Broadcast

Information
Service

[ANNIVERSARY
1941 - 1991

PRS Report—

Epidemiology

E58 0 ee

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



42 WEST EUROPE

is significant is the awareness of the cases, not an
increase in their number, inasmuch as the individuals
stricken today were infected 8 or 10 years ago. Thus,
AIDS is spreading not because the number of cases is
increasing but because more people are finding out that
they have it, even though they have been ill for years.

The hardest hit communities are: the Balearic Islands, 90
cases; Madrid, 89; Catalonia, 77, and Andalusia, 68.
Castile-Leon and Navarre report one case, and Extrem-
adura, two. La Rioja and Melilla have not reported a
single case. In Cantabria the Office of Social Welfare and
in Asturias the Regional Health Ministry have not fur-
nished data; in Castile-La Mancha the Health Ministry
“does not have them available.” The data are cumulative
from 1981 to 1991, and the autonomous communities
have conducted the studies over different periods of
time; thus there are discrepancies between them and the
Health Ministry’s studies.

The Health Ministry has established an Interregional
Council to coordinate health-care activities nationwide,
inasmuch as these responsibilities have been transferred
to some autonomous communities. In the wake of the
problems that Montse Sierra, a carrier of the antibodies,
had going to school in Malaga, the council was convened
in June 1990. At the meeting it decided that it was
opposed to “discrimination against or the stigmatizing
of? individuals suffering from the syndrome, that
hygiene measures must be observed at schools, whether
or not infected individuals were present, and that due
care should be taken in vaccinating infected children.

“There are no technically valid reasons why children or
teachers who may be infected with the HIV virus (whether
they have developed symptoms of the disease or not) should
not be integrated into the school community,” the minutes
of the council meeting state. [passage omitted]

Cases of HIV-Positive Children (under age 13)

Galicia, 11; Castile-Leon, 1; La Rioja, 0; Basque
Country, 43; Navarre, 1; Aragon, 55; Catalonia, 77;
Balearic Islands, 90; Valencian Community, 34; Madrid,
89; Murcia, 4; Canary Islands, 5; Andalusia, 68; Extre-
madura, 2; Asturias, Cantabria, and Castile-La Mancha
have not furnished data.

Note: The data are cumulative from 1981 to 1991 and
have been furnished by the autonomous communities.
The overall figure differs from the total provided by the
Health Ministry, as it takes more recent studies into
consideration.

Health Ministry Officials Report ‘Worrying’
AIDS Situation

LD3011213591 Madrid RNE-1 Radio Network
in Spanish 1300 GMT 29 Nov 91

[Text] Spain’s AIDS situation is worrying but not des-
perate, according to Health Ministry officials who
reported today on the evolution of this disease in our

SIPRS-TEP-91-025
9 December 1991

country. They announced that there are currently 10,000
AIDS sufferers in Spain as opposed to 56,000 in Europe
and 1.5 million in the world as a whole. The Health
Ministry officials said that work is proceeding apace to
discover a vaccine and new medicines. They said that
research is being carried out under WHO auspices into
12 vaccine prototypes and that the Pasteur Institute, in
Paris, is most advanced in this research. It was again
stressed that the best way to fight AIDS is prevention
and to this end they reiterated the need to use condoms
in sexual relations and the need for drug addicts not to
share needles. The health officials announced that from
now on AIDS sufferers would be treated in primary
health centers.

SWEDEN

Increased Debate on HIV Confidentiality Issue

92WE0082A Stockholm SVENSKA DAGBLADET
in Swedish 3 Oct 91 p 15

[Article by Stefan Koskinen: “Spreaders of the HIV
Virus Go Free; Confidentiality Hinders Doctors and
Prosecutors from Working Together”—first two para-
graphs are SVENSKA DAGBLADET introduction]

[Text]

Imprisonment

A Finnish man was sentenced to two years in jail for
infecting his male partner with HIV, the HELSINGIN
SANOMAT reported on Wednesday. The municipal
court in Helsinki sentenced the man for infliction of
serious bodily injury which caused his death. The man’s
partner died while the trial was in progress.

According to the newspaper, the accused knew he carried
the HIV virus, which causes the immuno-deficiency disease,
AIDS. He was sentenced to pay 75,000 marks (112,000
kronor) in damages to the survivors of the deceased.

Both prosecutors and public health physicians are crit-
ical of the confidentiality which hinders them from
working cooperatively in the effort to stop individuals
who spread the HIV virus.

“Confidentiality makes it impossible for us to take a
matter to the public prosecutor or the police when it is
not a criminal violation that carries more than a two year
sentence, which in principle means only murder, man-
slaughter, or rape,” said Brith Christenson, physician
with the disease control division in Stockholm.

The question came to a head with the first criminal inves-
tigation of an HIV infected person to have casual sexual
contact without informing his partner about the infection.


6 SUB-SAHARAN AFRICA

Mr. de Beer said that recognition of the tragedy and the
need to develop realistic steps to minimise its impact
and scope were being undermined by a continuing
stream of doomsday predictions based on a combination
of bad research and outright misrepresentation.

Barring a miracle however, the spread of the disease was
going to be a major tragedy. Millions of people were
going to die and health and welfare services would be
stretched to the limit. The three common errors or myths
that clouded perceptions of the coming AIDS epidemic
were:

Error No. 1: The “Doubling-Time”

In any epidemic, the doubling-time was the length of
time it took for the number of infected people to double.
At the beginning of 1990 the doubling-time for the AIDS
epidemic was calculated as being 8.5 months.

The error made by many analysts was to project this
indefinitely into the future. A prediction was widely
published that from a base of 100,000 HIV people in
1991, the number of people infected would be 12.8
million by 1995.

The truth was that as any epidemic progressed, so the
doubling- time increased, said De Beer. Already it must
have lengthened, although it was probably still less that
twelve months. Mr. Cedric de Beer said that the centre
predicted that by 1995 the doubling time would be about
36 months. The effect of this lengthening of the dou-
bling-time on the total number of people infected was
dramatic. Thus it could be expected that by the year
1995, slightly less than one million people would have
been infected.

It is from this cardinal error, that most of the other
inaccuracies have flowed.

Error No. 2: “There Is No Limit to the Spread of
AIDS”

Mr. de Beer said that the doubling-time error created the
impression that quite soon practically the whole popula-
tion would be infected. The reality was bad enough, but
not quite so disastrous.

The epidemic would reach a steady state when the
groups most at risk were saturated and the number of
people newly infected equalled the number of people
dying of AIDS. According to the centre’s projections:

I. If there was no change in sexual behaviour, then the
epidemic would reach a plateau in about 2010. At that
stage about 27 percent of the adult population would be
infected. This appeared to be the likely upper limit.

IL. Evidence from around the world showed that some
change in sexual behaviour occurred once a significant
number of people began to die from AIDS. This should
begin to occur in 1995. If this predicted change of

JPRS-TEP-91-025
9 December 1991

behaviour occurred, the epidemic curve would reach its
plateau in the year 2005, with about 18 percent of the
adult population infected.

Error No. 3: “South Africa’s Population Will Decline
Dramatically”

A public health official has been quoted as saying South
Africa’s population would be reduced to a quarter of its
present size by the year 2010.

Again, this error had been built on the two previous
errors, said Mr. de Beer. Because the epidemic spread
more slowly than some predicted, and because there is
an upper limit to its spread, the impact on the total
population would not be as dramatic as some believed.

The evidence was that the population would continue to
grow, although more slowly than it would have without
the AIDS epidemic?

If there was no change in sexual behaviour the rate of
population growth would be reduced to about 1.2 per-
cent per year by 2010. With the expected change of
behaviour in the mid 1990’s the population would con-
tinue to grow at about 1.7 percent per year. (These
figures reflected the impact of the epidemic assuming the
fertility rate remained constant. There were, however,
other variables which could affect the population growth
rate, De Beer cautioned.)

A realistic estimate was that in the year 2005 the
population would be approximately 50 percent greater
than the population in the year 1985 (53 million in 2005
compared with 32 million in 1985).

Likely-Course-of-the-Epidemic

A conservative model projection indicated that, in the
year 2000, between 3.7 million and 4.1 million South
Africans will have been infected with the AIDS virus.
That year, about 200,000 people would die of AIDS,
bringing the total number of deaths to 600,000 by the
turn of the century.

Five years later, the total number of deaths would
increase to between 2.3 million and 2.6 million. The
reason for this sudden increase was that the period
between being infected and dying of AIDS was about 8.5
years. Thus, although hundreds of thousands would be
infected by 1995, it would take about another ten years
before the number of deaths began to reflect such a high
rate of infection.

Mr. de Beer said that the true figures were sufficiently
frightening

Impact-on-the-Health-Service

Mr. de Beer said that South Africa’s health service was at
present unable to provide adequately for the health care
needs of the whole population. The effect of hundreds of
thousands, and later of millions of AIDS-sick patients
presenting themselves for treatment was devastating.


IJPRS-TEP-91-025
9 December 1991

The medical screening by the SADF—briefly raised at a
seminar by Mr. Jurie Wessels, deputy director of the Life
Offices Association of South Africa [LOASA] on
Wednesday—was later confirmed by Brig Tristan Dip-
penaar, director of the SADF Medical Service in Preto-
Tia.

The LOASA seminar highlighted the impact of the
growing AIDS pandemic in South Africa on the life
assurance industry.

Brig Dippenaar confirmed that blood tests for the HIV
virus formed part of a large battery of voluntary medical
tests—but AIDS testing was only undertaken among
short-term and long-term permanent force [PF] recruits
who wanted to become career soldiers.

Civilian applicants and national servicemen were not
tested for AIDS.

Brig Dippenaar said any PF recruits who tested HIV-
positive were given councilling in the strictest confiden-
tiality before they were referred to one of the nationwide
AIDS training and councilling centres.

He said the SADF’s rigid medical criteria for prospective
career soldiers could not be compared with the health
requirements in civilian life.

He pointed out that any wounded HIV-infected soldiers
could also infect other soldiers and medical personnel,
the soldiers would themselves be greatly at risk from
open-wound sepsis and also would be unable to donate
blood during battlefield emergencies.

“Under the Occupational Safety Act, which requires that
the working environment be made as safe as possible,
this would be an unacceptable condition,” he noted.

Brig Dippenaar emphasised the SADF policy was not
discriminatory towards any particular population group
in its testing for AIDS among PF recruits.

“Any individuals who fail our medical tests due to
HIV-positive identification are treated under the same
medical principles as are those recruits who failed due to
poor vision,” Brig Dippenaar said.

The LOASA seminar was also addressed by Mr. Francois
Marais of SANLAM [South African National Life Assur-
ance Company], who said the industry increasingly had
to deal with a population which was “uninsurable”
because of the growing AIDS pandemic.

He pointed out that the average premiums for people
with normal health risks were R[{rand}300 annually.

If the assurance companies would be willing to under-
write people who had tested HIV-positive, their pre-
miums would be R5,000, and people with full-blown
AIDS-related diseases would have to pay at least
R45,000 annually, he said.

South Africa’s life assurance industry had developed a
voluntary policy on AIDS testing when underwriting

SUB-SAHARAN AFRICA 5

new policies. Applicants had the choice of being tested
for the HIV-virus, or accepting an AIDS-exclusion clause
in their policies without blood tests.

Mr. Marais noted that since 1984, there have only been
165 AIDS- related claims on life assurance policies
countrywide—but warned this was the tip of the iceberg.

The majority of existing policies—64 percent—were
issued since 1984 to young people before the industry
knew that AIDS could develop into such a big health risk
for this age group.

“Insurance companies must stand by the promises in
such policies and pay out, including on AIDS claims,” he
noted.

Mr. Marais did not, however, believe there was any risk
of insolvencies among insurance companies, as they had
made provisions for the AIDS projections in South
Africa.

Sanlam had created a R200 million fund to pay future
claims on existing policy holders, and other major com-
panies had taken similar precautions, he said.

Study Questions ‘Doomsday’ AIDS Predictions

MB2711165091 Johannesburg SAPA in English
1533 GMT 27 Nov 91

{SAPA PR Wire Service issued by: Bill Paterson (Pty)
Ltd, Johannesburg 27 November 1991]

[Text] Announcing today’s publication of a research
study on the imminent AIDS epidemic by the Centre for
Health Policy, Department of Community Health at
Wits [Witwatersrand] University Medical School, Mr.
Cedric de Beer said that while the South African
economy would be adversely affected by the AIDS
epidemic, it would not be disastrous.

He said that the price of gold, levels of political violence
and the succes? of constitutional negotiations were all
likely to have as great, or greater, effect on the economic
future of the country. Mr. de Beer is director of the
centre.

Qualifying his conclusion, he said that it was neverthe-
less difficult to quantify the demands on the welfare
system for support, especially for children orphaned by
the epidemic. Lost productivity caused by the with-
drawal of labour by people forced to stay home and care
for AIDS patients and losses from the seldom-computed
informal sector would all have negative effects on the
economy.

A report based on research done in collaboration with
Dr. Malcolm Steinberg of the Medical Research Council
and Peter Doyle, an actuary at Metropolitan Life, has
been prepared to dispel three myths about AIDS that
have developed.



38 WEST EUROPE

Paper Comments on Case

92WE0048B Helsinki HELSINGIN SANOMAT
in Finnish 3 Oct 91 p 2

[Editorial: “AIDS Carrier Responsible for Others”’]

[Text] According to a recent Helsinki City Court deci-
sion, it is a crime to intentionally spread a fatal disease.
An HIV carrier was sentenced to two years in prison for
aggravated assault and involuntary manslaughter. The
verdict is the first of its kind in Finland and other Nordic
countries. Elsewhere in the world, similar verdicts have
been handed down.

The court decision emphasizes a carrier’s responsibility
for other people, but the threat of a sentence is not an
adequate method of changing indifferent behavior. It
may be impossible to scare HIV carriers who know they
are infected with punishment. A human being is able to
care for others only if he himself is cared for.

Now, financially struggling AIDS support centers have
done notable work among the infected or those who fear
infection to prevent the “end of the world” mood that
leads to reckless behavior from spreading. Ten times the
number of infections have been found from samples sent
by the centers compared to other materials. Thus, the
very persons susceptible to infection seek treatment
through them. The operation of the support centers can
be evaluated and made more effective, but, for the time
being, they reach their target group best of all.

The entire AIDS policy in Finland has been built on the
basis of volunteerism, information, and responsibility,
and there is no need to change that. On the contrary, the
amount of information must be increased even more.
The HIV epidemic is still spreading, and we must not
foster the attitude of : avoiding tests and escaping respon-
sibility behind i ignorance by imposing punishments. The
infection carrier is not solely responsible. Information
about safe sex practices will constantly be necessary. In
an open, tolerant, and sympathetic atmosphere, knowl-
edge will become practice.

National AIDS Effort Outlined

92WE0048C Helsinki HELSINGIN SANOMAT
in Finnish 28 Sep 91 p 8

{Unattributed article: ‘“AIDS-Research-Program
Experts: While Lacking an AIDS Vaccination, We Must
Look for Carriers”]

[Text] “People always ask us when will we have an AIDS
vaccination, and we always answer in five years,” notes
Prof. Kai Krohn. “I’d like to add now that, during the
past two years in the world, vaccination products have
also been tried on people, and, perhaps in a couple of
years, we can start vaccinating certain population
groups, probably in Africa or in the big cities of the
United States. Only in about five years can we evaluate
the effectiveness of these vaccinations.”

SJPRS-TEP-91-025
9 December 1991

Prof. Pirjo Makela, chairwoman of the Academy of
Finland medical committee, adds: “It may take even 10
years before the vaccination is in routine use.”

Prof. Kai Krohn, Sirkka-Liisa Valle, M.D., and Assistant
Professor Annamari Ranki on Friday “discussed the
results that Finnish researchers have arrived at in AIDS
research mainly sponsored by the Academy of Finland.
In addition, Prof. Antti Vaheri has led one of the projects
the Academy has sponsored with a total of 5.5 million
markkas during the past three years.

Developing the vaccination will still take time, and there
is no cure on the horizon. None of the researchers
disagreed when Sirkka-Liisa Valle insisted on a careful
search for carriers among people close to the infected
persons. In that way, the spread could best be prevented.
Furthermore, decisions should be made in Finland about
which population groups it would be worthwhile to do
AIDS testing on in order to determine how widespread
the infection is and how fast it is spreading.

Treatment Is Beneficial

Last year, we compiled statistics on 91 new HIV cases.
Valle estimates that the number of new cases occurring
this year will rise to about 70.

If someone suspects he has contracted HIV, experts say
he should have himself tested without delay. Treatment
is already available that helps to slow the progress of the
disease in its initial phase and to lessen the symptoms.

Annamari Ranki’s group has concentrated on studying
the patients’ symptoms and the effects of different treat-
ments. Neurological research has brought up the fact that
HIV can establish itself in an infected person’s central
nervous system early on. Patients like this, still part of
the work force, have greatly benefited from the early use
of AZT—that is, zidovudine.

Treatment can improve the weakened immune response
against HIV. Unfortunately, this treatment has only a
temporary effect.

The coordinator of the Academy research program, Kai
Krohn, is also developing an AIDS vaccination with his
group. The group is working on a different basis from the
USS. researchers, who have managed to create protection
against the HIV infection for healthy chimpanzees.

“The protection is against only the virus that has been
used in developing the vaccination, and HIV is able to
mutate. We are trying to use gene technology to develop
a vaccination from living, weakened viruses that would
give broad protection,” says Krohn.

Impressive Research Document

The Academy has recently prepared a summary of its
AIDS project. There are plenty of products: The 18-
page-long publication list includes two doctoral theses,
and as many as 31 research projects have been sponsored
by the 5.5-million-markka grant.


26 NEAR EAST & SOUTH ASIA

At present there are about 19 laboratories in the country,
which are screening the blood for AIDS. Yet none of
them have the proper facilities to confirm the presence of
the HIV virus through blood tests.

In case of probable AIDS positive cases, the blood
sample is sent to the National Institute of Health in
Islamabad for confirmation. The NIH is the only place in
the country where ‘Western Blot’ test is carried out. The
‘Western Blot’ test confirms the presence of the AIDS
virus.

In the absence of a government initiative to educate the
people about the disease, it is feared that in due course
the number of AIDS cases will rapidly multiple and
given our impoverished and underdeveloped health care
system the spread of AIDS will be disastrous.

Health Official Says Number of AIDS Cases
Rising

BK1211120391 Hong Kong AFP in English 1123 GMT
12 Nov 91

[Text] Islamabad, Nov 12 (AFP)—Pakistan has regis-
tered a progressive increase in acquired immune defi-
ciency syndrome (AIDS) cases over the last five years, an
Official said Tuesday.

The country, which until 1986 was considered virtually
free of the fatal disease, has documented 104 cases of
people suffering from AIDS or infected with the virus
that causes it, Dr. Abdul Ghafoor, director of the
National Institute of Health (NIH), told AFP.

The NIH, coordinating the activities of 19 AIDS centres
across the country which offer voluntary tests for the the
HIV virus that causes AIDS, has documented reports on
more than 150,000 people which show a gradual rise of
cases “positive to the HIV virus,” Ghafoor said.

JPRS-TEP-91-025
9 December 1991

So far, 18 of the 104 carriers have developed full-blown
AIDS, he added.

Sources said 72 percent of the victims were Pakistanis
and 28 percent were foreign nationals, while the gender
ratio of viral infection was 2.6 males to one female.

Pakistanis came to know about the disease through the
death of a Tanzanian sailor, Kudo Ibrahim, in the port
city of Karachi in 1987. Since then at least 15 AIDS
patients who contracted the disease abroad have died in
the country.

In 1988, Pakistan country recorded 19 HIV virus car-
riers, but the number had swelled to 68 towards the end
of 1990.

Commenting on the trend, a leading medical specialist
here, Dr. Sarfraz Ahmed, said recent victims included
Pakistanis repatriated from the Middle East in the wake
of the Gulf war.

A new phenomenon noticed here in 1990 was the use of
AIDS patients as drug peddlers. Law enforcement offi-
cials said international drug barons “motivate patients
to make a fortune” for their families before death, one
official said, telling them they would likely be treated
leniently even if caught.

At least three foreign heroin traffickers were deported
last year on production of medical certificates proving
they suffered from AIDS, officials said.

Ghafoor said the government was doing its best to check
the rate of HIV infections.

He said the World Health Organisation (WHO) recently
developed a vaccine aimed at preventing the virus, but
added that it was inititially being tested in Brazil,
Uganda, Rwanda and Thailand, where AIDS has had a
greater impact.

Meanwhile, the Pakistan Government has tightened the
country’s health laws, and now requires foreign nationals
arriving for a stay of more than one year to provide a
certificate showing they are AIDS-free.


SJPRS-TEP-91-025
9 December 1991

Posing a Danger

A woman reported the HIV-infected man and District
Attorney Goran Soderberg conducted an investigation of
the man on suspicion of posing a danger to others.

The police later learned that during the summer of 1990 the man
had apparently had relationships in a number of instances with
women that he met at the Opera Bar in Stockholm.

The prosecutor learned that the public health physician had
personal statements from other women who had also been
exposed to the man. Further, the public health physician at
one point knew where the man could be found, even as the
public prosecutor attempted to trace him.

In that case, health and medical confidentiality forbid
the public health physician from supplying the prose-
cutor with the information he needed.

“Confidentiality decisions put obstacles in the way of effec-
tive investigation,” said District Attorney Goran Soderberg.

When individuals knowingly spread the HIV virus is the
time when public health physicians would like to help
the prosecutors.

“Tn some fashion we ought to be able to work together, in
as much as it concerns limiting the spread of the dis-
ease,” said Brith Christenson.

Review the Regulations

Last week public health physicians and prosecutors had
a meeting with Attorney General Torsten Jonsson in
order to discuss the problem.

“The public health physician felt the confidentiality
Tules were a hindrace to their work. We will review the
regulations and subsequently hold another conference,”
said Torsten Jonsson.

As to the case concerning the man suspected of commit-
ting a criminal offense for exposing others to the risk of
infection, no charges will be brought.

Strict Confidentiality

—If public health physicians were to find out that one or
more of fourteen individuals suspected of knowingly
spreading the HIV virus had behaved criminally, the
information would not be handed over to the police or
public prosecutors.

In fact, public health physicians in Stockholm have
information that 14 leading members of certain HIV
support organizations have had unprotected sex with
others, despite knowledge of their own HIV infection.

Last Wednesday SVENSKA DAGBLADET reported on
the protests against public health physicians in Stock-
holm staged by Act Up [AIDS Coalition to Unleash
Power], an interest group for HIV positive individuals.

The criticism was aimed at public health physicians for
making a request for access to certain case books at

WEST EUROPE a3

Venhalsan. Public health physicians, however, are not
Permitted to hand these over to the police or public
Prosecutors, even if they should ask for them.

Health and medical confidentiality, which covers all
doctors, is broken only in the case of suspicion of a
criminal offense carrying at least a two year sentence.
Therefore, only in the case of murder, manslaughter, or
Tape, may a doctor reveal what he knows.

In such cases, a doctor must answer questions put by the
Prosecutor; otherwise a doctor has no obligation to
report it. If a doctor obtains information concerning a
serious crime, he is not obliged to report it to the police
or to the public prosecutor, but he may do it if he wishes.

Risks Imprisonment

If someone exposes others to the risk of infection, the
nature of the crime is “posing a danger to others,” which
carries fines or imprisonment of a maximum of two
years. If someone is infected, the crime can probably be
Teclassified as serious assault, which can carry from one
to ten years imprisonment. This crime is not, therefore,
sufficiently grave to void confidentiality.

Public health physicians have, on the other hand, an
easier time obtaining information. The disease control
law gives them the right to seek information from
authorities, including the public prosecutor. In addition,
health and medical personnel are obliged to hand over
information to the public health physician.

The doctors work through the administrative courts by
requesting that individuals be placed in compulsory
quarantine. They may request this for individuals who
knowingly spread the infection or for those unaware of
what they are doing.

Request Quarantine

The administrative court hears the request, first of all,
for a three month compulsory quarantine. Subsequently,
compulsory quarantine may be extended to six months
at a time. The administrative court decision may be
appealed to the administrative appeals court and the
administrative supreme court:

The public health physician is obliged to release a
quarantined individual as soon as it can be determined
that he is willing to cease his negligent behavior.

Forego Confidentiality

A person may forego doctor confidentiality if he has been
subjected to violation from a person he believes to be infected.

If a possibility is present that the person may have been
infected by the violation, that person can demand a
compulsory testing of the perpetrator in order to ascer-
tain whether he is HIV positive.

The decision is made by the public prosecutor and he
must also inform the plaintiff of the results.



JPRS-TEP-91-025
9 December 1991

by a state-sponsored programme, but by a concerted and
combined effort of the society as a whole.

The social activists, trade groups, the teaching commu-
nity and health workers will have to launch a coordi-
nated campaign to carry the AIDS prevention message to
the people.

Realising the dire need for an AIDS awareness pro-
gramme and inspired by a conference on AIDS held in
Paris last year, under the auspices of UNESCO, WHO
and the World Teachers Organisation and a follow-up
discussion, the author worked on a plan to coordinate
and regulate the common efforts of researchers and
activists on a common platform. This was later named
the Pakistan AIDS Prevention Society.

The formation of this body reflects the awareness of the
role the NGOs can play in the struggle to eliminate and
counteract the transmission of HIV. It also highlights the
need to cater to the forgotten responsibility of defending
the rights of those who are seropositive and who suffer
from AIDS, along with their families.

The question of respect for the rights of HIV infected
persons is of utmost significance, as the present attitude
of isolating the affected persons socially is the direct
outcome of the fears and prejudices prevalent in society.
In most cases these are a result of insufficient informa-
tion and based on the fear of accidental contamination
or infection.

These fears can be overcome by imparting knowledge
about AIDS.

Pakistan AIDS Prevention Society has limited its area of
work to dissemination of information about AIDS, with
emphasis on its prevention through traditional and non-
traditional means. It seeks to promote preparation of
literature and documentaries, hold workshops and
undertake research aimed at presenting the truth about
AIDS. The aim is also to coordinate with other NGOs to
boost efforts at all levels, especially in the educational
and industrial sectors.

The Society plans to approach the high risk population
directly with the aim of modifying their high risk behav-
iour and activities through group discussions, person-
to-person contact, medical, psychological and social
help, and assistance in securing material help for reduc-
tion of risk of transmission to others.

The Society will offer counselling services for those who
are infected.

Pakistan AIDS Prevention Society needs support of all
sectors of society. Join hands with us in this common
struggle and contact us by writing to P.O. Box 9856,
Saddar, Karachi.

NEAR EAST & SOUTH ASIA 25

Statistics Released
92WE0044A Karachi DAWN in English 25 Sep 91 p 9

[Article by Samina Mehdi: “AIDS in Pakistan”)

[Text] At a time when the whole world is rocked with the
AIDS havoc, Pakistan is fortunate to have a somewhat
low prevalence of the disease in its population.

According to estimates by the National Institute of
Health (NIH), Islamabad, there are at present only 14
reported cases of AIDS in the country. The number of
HIV-positive cases is 72.

Blood transfusion without the pre-screening of the blood
for the AIDS virus is said to be the main cause of the
spread of the disease in the country.

The transmission of the disease through sexual contact,
intravenous drug abuse and from an AIDS infected
mother to her child has also been reported in the
country, but to a lesser extent.

Doctors and sociologists, however, view these figures
with scepticism. They claim that the actual number of
such patients in the country is much more than what is
officially made out to be.

They argue that inthe absence of a detailed and orga-
nised study on the subject, the statistics released cannot
be very accurate and are therefore misleading.

The accompanying table gives the break-up of the AIDS
and HIV-positive cases in the country, as released by the
NIH, Islamabad.

In the opinion of blood disease experts, patients who
received transfusion of blood products imported before
1986 have a chance of having contracted the AIDS virus.
The blood products at that time were imported into the
country without screening for AIDS.

Category HIV-Positive | AIDS cases Total
Bisexuals = 3 3
Heterosexuals 14 3 7
Homosexuals 4 2 6
Intravenous 1 1 2
drug abusers

Blood/Product 13 2 15
transfusion

Haemophiliacs = 1 1
Mother to 3 0 $
child

Not Known 35 2 27
Total 2 14 86

Lack of awareness among the masses about the disease
and the absence of adequate facilities for detecting AIDS
patients is also a cause of alarm.



2 SUB-SAHARAN AFRICA

The physician, who was addressing health workers at an
AIDS seminar in Embu town, said that out of the total
cases in Embu District, 155 were men while 99 were
women.

Dr. Kimani said through open discussion on AIDS in
various forms, health workers will succeed in turning the
shock in the public into an organized war against the
killer disease.

LIBERIA

Official Number of AIDS Cases at 12

B2311114391 Monrovia Radio ELBC in English
0900 GMT 20 Nov 91

[Text] It has been reported in Monrovia that the official
number of AIDS [Acquired Immune Deficiency Syn-
drome] cases diagnosed in Liberia is now put at 12. A
press release from the National AIDS and STD [Sexually
Transmitted Diseases]-Control Program at the Ministry
of Health says seven new cases of the deadly disease have
been diagnosed. Before this crisis, the release said, five
cases were reported.

The current report followed 500 HIV tests during the
period of May to September this year, using the WHO
guidelines. The release further said more than 95 percent
of the individuals tested were blood donors. Six of the
cases were Liberians and the other, a non- national.

Meanwhile the National AIDS and STD-Control Pro-
gram has announced that it will commence its laboratory
services on Monday 25 November in the Maternity
Hospital in Sinkor. The program was reactivated in July
this year with full financial and logistical support from
the WHO, UNDP [UN Development Program] and the
Save The Children Fund in the United Kingdom.

MOZAMBIQUE

Two AIDS Deaths in Inhambane Province

MB0112051991 Maputo Radio Mozambique Network
in Portuguese 1730 GMT 30 Nov 91

[Excerpt] Two people have died of AIDS in Inhambane
Province from January to September this year. This was
revealed by Xavier Candido, head of the provincial
department for the prevention of and fight against AIDS
in Inhambane, on the occasion of the World’s AIDS Day
due to be marked tomorrow. [passage omitted]

Health Minister Expresses Concern Over
Increased AIDS Cases

MB3011164891 Maputo Radio Maputo in English
1100 GMT 30 Nov 91

[Text] Mozambique’s minister of health, Dr. Leonardo
Simao, has expressed concern over the increasing
number of AIDS cases in the country.

SPRS-TEP-91-025
9 December 1991

Dr. Simao said that in 1985, there had been only one
case of AIDS in Mozambique but by October this year,
the number had grown to 288 and he said this figure did
not represent the real situation which is much worse.
Doctors have pointed out that because of the war situa-
tion in Mozambique it is impossible to establish the real
number of AIDS cases in the country.

Dr. Simao made his remarks at the launching last night
in Maputo of an album of songs about AIDS, part of a
national campaign aimed at preventing the spread of the
killer disease. The album available on audio cassette
contains songs by a number of Mozambique’s top
recording artists. The minister of health thanked them
for the contribution in public education on the dangers
of AIDS.

NIGERIA

AIDS Prevention Campaign Launched in Armed
Forces

AB2311112091 Lagos Radio Nigeria Network

in English 1500 GMT 20 Nov 91

{Text] All three services of the Armed Forces have been
directed to launch separate campaigns against the
Acquired Immune Deficiency Syndrome, AIDS, before
the end of this year. The minister of defense and chief of
defense staff, General Sanni Abacha, gave the directive
in Lagos today while launching the Armed Forces and
Police chapter of the campaign.

He said each service should also carry out the enlighten-
ment campaign at the formation and unit levels. Gen.
Abacha directed that the first phase of the barracks AIDS
control campaign should be completed by January next
year. He said that the Ministry of Defense had also been
given up to January to take appropriate steps to establish
a fully functional secretariat for the Transfusion and
AIDS Control Committee of the Armed Forces.

The chief of defense staff identified ignorance, compla-
cency and denial as major obstacles to AIDS control and
said that all available information and strategies must be
used to prevent and eradicate the disease.

Earlier, the director general in the Ministry of Defense,
retired Major General Olubajowa, has said that high
mobility of the military and the police within and
outside the country on duties expose them to high risk of
acquiring HIV infection.

Radio Views Increasing AIDS Threat; Advises
Public

AB2411101591 Lagos Radio Nigeria Network
in English 1800 GMT 21 Nov 91

[Champra Abawe commentary]

{Text] The disease known as Acquired Immune Disease
[as heard] Syndrome, AIDS, has since its discovery been


16 EAST ASIA

from having sexual relations, particularly with prosti-
tutes, has increased each year. During the period June to
December, it was found that the AIDS infection rate
among prostitutes increased from 12.36 percent to 20.73
percent. Only 41.56 percent of the men used condoms.
[passage omitted]

Chiang Rai AIDS Update
92WE0006B Bangkok SIAM RAT in Thai 4 Sep 91
pp I, 16

[Excerpt] [passage omitted] Dr. Suphachai Saison, the
Chiang Rai provincial health officer, talked about the
AIDS situation in Chiang Rai Province. He said that this
is now a very worrisome matter, because AIDS is
spreading like a wildfire. This is based on statistics
compiled since 1988. As of 26 August, a total of 4,946
people had been found to have the AIDS virus. Of these
82.82 percent contracted the disease from having sexual
relations. In particular, 2,481 prostitutes, or 50.16 per-
cent of all prostitutes here, were found to have the virus.

As for the use of condoms, it was found that only 62.11
percent of the men who had sex with prostitutes used a
condom. [passage omitted]

Bangkok Health Department Discloses AIDS
Figures

92WE0006A Bangkok THAI RAT in Thai 13 Sep 91
plo

[Excerpt] A news source from the Bangkok Health
Department disclosed the figures for the number people
in Bangkok who have the AIDS virus. He said that a
survey conducted by the Health Department found that
8,266 people in Bangkok have the AIDS virus. The zones
with the largest number of cases include Nong Chok with
1,624 cases, Bang Rak with 501 cases, Pom Prap with
481 cases, Nong Khaem with 428 cases, and Pung Kum
with 401 cases. These are very frightening figures. Of the
people who tested positive for AIDS, 50 have full-blown
cases of the disease. Another 120 showed related symp-
toms. [passage omitted]

Doctor Profiles AIDS Trends, Behaviors
92WE0025C Bangkok MATICHON in Thai 16 Sep 91
pig

[Article by Dr. Apason Bunpradap, DDS: “AIDS in the
School”)

[Excerpts] [passage omitted] At present Thailand has
about 300,000 people with the AIDS virus. These can be
categorized as follows: 1. drug addicts, 15,000-32,000, 2.
female prostitutes, 8,500-11,800, 3. promiscuous men,
92,000-184,000, 4. housewives, 12,300-15,000.

As for the actual figure for those with the virus, no one
knows for sure because we are not able to take blood
samples and test for the virus throughout the country,
but what is certain now is that there are people with the

JPRS-TEP-91-025
9 December 1991

AIDS virus of both sexes and of every age and profes-
sion. Rich and poor and even priests who do not observe
the religious rules can get AIDS - there are no exceptions.
[passage omitted]

According to the research at the Institute for Demog-
raphy of Chulalongkon University 57 percent of Thai
adolescent males were sexually active and of these 28
percent were sexually active with girl friends and
strangers. Of the female students in vocational schools
throughout the country 7 percent were sexually active
while in school. In some provinces this figure was as high
as 30 percent. As for male students only 7 percent were
sexually active with females who were not prostitutes.
Even worse, the research indicated that housewives had
become AIDS victims by being exposed to the virus by
the 2 million husbands who were promiscuous and the
1.5 million such husbands who did not use condoms.
This meant that 1.5 million housewives were at risk of
AIDS. Now it has been found that there are 22 pregnant
women with AIDS out of the 30,000 receiving prenatal
care each month. This is a frighteningly high incidence.

Of the upper-level male secondary students with whom I
conducted a project for a second year, 70 percent con-
fessed that they had been sexually active with female
prostitutes without using condoms and that their parents
or guardians did not know. This raises the question of
how many young people there will be left in five to 10
years to develope the country. In the future the old
people and children will be a burden for society; there
will be no one to care for them because the guardians and
parents who would have cared for them will have con-
tracted AIDS and died. By the year 2000 the Social
Welfare Department will not be able to care for all the
orphans. The priests will have to take over this role as
they have done for the orphans at the Wat Sakeo Temple
in Ang Thong Province. [passage omitted]

Chonburi AIDS Update

92WE0025B Bangkok DAILY NEWS in Thai
17 Sep 91 p 12

[Text] Mr. Chamnian Chawanaphong, the governor of
Chonburi Province, said that they had discovered 2,307
cases of AIDS in the province. Of these 23 had died.
They had discovered 2,285 with the AIDS virus but with
no symptoms. It was estimated that there were 10,000
cases of people with the AIDS virus. Most of the cases,
721, were in the municipal district. Next came Bang
Lamung District with 633 cases, Si Racha District with
410 cases, Sattahip District with 340 cases, Phanat
Nikhom District with 80 cases, Ban Bung District with
47 cases, Ko Si Chang Subdistrict with 31 cases, Phan
Thong District with 29 cases, Bo Thong District with 10
cases, and Nong Yai District with 86 cases. AIDS was
projected to increase steadily and so it had been
requested that tourists or those who were sexually pro-
miscuous either use condoms or end their promiscuity.


SIPRS-TEP-91-025
9 December 1991

the surgical, dental, and gynecological instruments—as
specified by existing requirements. The heads of facili-
ties (or departments) bear direct responsibility for that.
In addition, individuals must be appointed from among
those who perform presterilization to be responsible for
that procedure.

All these recommendations need to be clarified and
fleshed out according to the specific features of the
professional duties of the individual categories of med-
ical personnel—surgical, traumatological, resuscitation,
and child-birth teams; dentists, pathologists, and
forensic medicine experts. General safeguards in han-
dling blood and other biological fluids must be combined
with measures that deal with the specific work done by
specialists.

Footnotes

1. Sector standard No 42-21-2-85 “Sterilization and
disinfection of medical articles. Methods, systems, and
regimes.” Enacted by USSR Ministry of Health order No
770 (1985) and a 1986 USSR Ministry of Defense
Central Military Medical Directorate directive.

2. “Instruktsiya po diagnostike i profilaktike sindroma
priobretennogo immunodefitsita v Sovetskoy Armii i na
Voyenno-Morskom Flote: Instruktivno-metodicheskiye
ukazaniya” [Instructions for the Diagnosis and Preven-
tion of Acquired Immune Deficiency Syndrome in the
Soviet Army and Navy: Procedural Instructions].
Moscow, 1988, 23 pp.

References

Vorobyev A. I. “AIDS and Features of the Medical
Measures Taken for That Infection in the U.S. Armed
Forces.” VOYEN.-MED. ZHURN., 1989, No 1, pp
67-70.

Dikun Ye. “Shall We Wait Until Monday?” NEDELYA,
10-18 Apr 1989, p 20.

Ivanov N. R., Drankin D. I. “SPID” [AIDS]. Saratov:
Izd-vo Saratov University, 1987, 76 pp.

Korolyuk A. M. et al. “New Data on Acquired Immune
Deficiency Syndrome.” VOYEN.-MED. ZHURN.,
1987, No 6, pp 41-45.

Pokrovskiy V. I., Pokrovskiy V. V. “Sindrom priobreten-
nogo immunodefitsita” [Acquired Immune Deficiency
Syndrome]. Moscow: Meditsina, 1988, 48 pp.

Rytik P. G. et al. “SPID” [AIDS]. Minsk: Belarus, 1988,
128 pp.

Shevelev A. S. “SPID—zagadka beka” {AIDS—The
Riddle of the Century]. Moscow: Sov. Rossiya, 1988,
144 pp.

“AIDS and Blood Transfusion.” In “Proceedings of the
International Symposium held in Turin, 13-15 June
1985.” Turin, 1986, 227 pp.

SOVIET UNION 33

“AIDS: The Safety of Blood and Blood Products.”
Chichester, etc.: Wiley & Sons, 1987, 375 pp.

Barre-Sinoussi F. et al. “Resistance of AIDS Virus at
Room Temperature.” LANCET, 1985, Vol 2, No 8457,
pp 721-722.

“Guidelines for the Protection of Health Care, [sic]
Workers in Caring for Persons Who Have Some Form of
HTLV-III/LAV Infection.” N.Y. State J. Med., 1986,
Vol 86, No 11, pp 587-591.

Daniels G. V. “AIDS: The Acquired Immune Deficiency
Syndrome,” 2nd ed. Lancaster, etc.: MTP Press Lim.,
1986, 189 pp.

Ezzell C. “Hospital Workers Have AIDS Virus.”
NATURE, 1987, Vol 327, No 6120, p 261.

Gerderding J. L., Henderson D. K. “Division of Rational
Infection Control Policies for Human Immunodefi-
ciency Virus Infection.” J. INFECT. DIS., 1987, Vol
156, No 6, pp 861-864.

Gomel Oblast Registers Six HIV Cases

91WE0414 Minsk SOVETSKAYA BELORUSSIYA
in Russian 3 Apr 91 p 1

[Article by P. Radechko, special correspondent for
SOVETSKAYA BELORUSSIYA: “From the Maternity
Hospital With...AIDS”; first paragraph is source intro-
duction]

[Text] No, in this case the medical workers were not
guilty—the parents were. A thoughtless act by one of them
turned into a horrible tragedy not only for both spouses,
but also for the one to whom they gave life.

“HIV infection” was the diagnosis given for the newborn
child in one of the maternity hospitals in the Gomel area.

“Six cases of HIV infection have now been recorded in
our oblast,” reported L. I. Yurevich, epidemiologist for
the Gomel City Sanitary-Epidemiology Station. “That’s
a bad sign. After all, in three oblasts of Belorussia, there
has not been a single HIV infection. Such preeminence is
not flattering to the residents of Gomel or, for that
matter, to the residents of Minsk, where 13 cases have
been recorded.”

Of course, each individual is responsible for his own
behavior, his own health, and the health of the members
of his family. But with our poverty and with the lack of
necessary instruments, it’s not wise to acquire an illness
either in a hospital or in a polyclinic. How, for example,
is one to relate to the fact that, over the past year, the
Gomel City Stomatological Polyclinic No 1 has not
received a single set of forceps?



34 SOVIET UNION

Warning Issued on Increase in AIDS Cases

LD2910100491 Moscow TASS in English 0908 GMT
29 Oct 91

[Text] Moscow October 29 TASS—“We should ring all
the warning bells to get the message across about the
danger of AIDS. It attacks mercilessly and inevitably,”
said N. Sirotkina, chief specialist on AIDS of the Russian
State Committee of Sanitary and Epidemic Inspection in
an interview with the “PRAVDA” newspaper.

The Russian Federation had 502 HIV-positive cases
registered by September 1. These included 267 children,
346 foreigners and 55 cases of full blown AIDS, 33 of
which have now died.

“AIDS infection has been registered in 44 regions and
autonomous republics of Russia. But this is only an
official figure, nobody knows the real number of HIV-
positive cases,” warns the chief expert on AIDS.

“We are worried about the accelerated spread of the
AIDS virus. We now have 20 times more cases registered
than five years ago,” Sirotkina pointed out.

First AIDS Case Diagnosed in Altay Kray

PM2911140991 Moscow PRAVDA in Russian
23 Nov 91 p2

[Report by correspondent S. Vtorushin report under the
tubric “Around the Country: AIDS Reaches the Altay”]

[Text] Barnaul—The first AIDS sufferer has been
recorded in Barnaul. She is a 32-year-old mother of two.
Doctors are not ruling out any mode of infection.

The telephone is constantly ringing at the kray’s Center
for the Prevention and Combating of AIDS. Many
people want to be tested for AIDS, but that is not easy.
The conditions for that do not exist in Barnaul. The
patient spent almost a month in the hospital before the
dreaded virus was detected. AIDS was diagnosed by
Moscow physicians after receiving materials for analysis,

SPRS-TEP-91-025
9 December 1991

There are supposed to be 26 doctors and 31 nurses on the
staff of the kray’s Center for the Prevention and Com-
bating of AIDS. But there are currently just eight people
there. The center has just 16 square meters of space and
it is impossible to organize normal work in that area.

Medical Sciences President Reveals AIDS
Statistics

LD3011234991 Moscow TASS International Service
in Russian 1625 GMT 29 Nov 91

{Article by TASS correspondent Marina Barinova]

[Summary] Moscow, 29 Nov (TASS)—Valentin Pok-
tovskiy, president of the USSR Academy of Medical
Sciences, stated in a TASS interview that in the USSR as
of mid-November 672 people were HIV positive and 57
were suffering from AIDS, of whom approximately 40
have died. The struggle against AIDS in the Soviet
Union has not been helped by the disintegration of the
Union, resulting in a division of effort. However, “fun-
damental AIDS research in the USSR is on a world level.
The interaction of the virus and the cell are being
studied, molecular-biological research is being carried
out, and an original method for obtaining azidothymine
has been synthesized.”

Latvia Notes Current AIDS Statistics

LD0312034591 Riga Radio Riga International
in English 2130 GMT 2 Dec 91

[Text] Yesterday the whole world marked the day for
fight against AIDS. Currently only one man in Latvia has
died from this plague of the Twentieth Century, but at
the same time there are 528 virus carriers officially
registered by the Latvian Health Protection Authority.

According to these officials, only one virus carrier has
caught the AIDS virus, in a nonsexual way, undergoing
an operation in Africa where he worked for a while.
Statistics show that medical treatment of just one AIDS
virus carrier in Latvia cost approximately 80,000 rubles.


2 NEAR EAST & SOUTH ASIA

examination “by 1996”. In other words, by 1996, “every
third housewife” in Bombay will be a potential carrier of
AIDS.

Dr. Paintal, who is now working on a WHO-funded
project to investigate the causes of breathlessness,
became controversial during his five-year tenure as the
Chief of ICMR when he pleaded for a legislation which
would have banned Indians from having sex with for-
eigners. Though he was ridiculed by the press for his
extreme views on control of AIDS, some of his predic-
tions came quite close to the mark. In 1989, he said that
HIV seropositivity among high-risk groups in Bombay—
including prostitutes, their clients, drug-pushers and
professional blood-donors—was approaching 35 per-
cent. However, Dr. S. D. Tripathi, the new ICMR
director-general, confirmed that a recent survey has put
the figure ‘in excess of 30 percent.’ At Kamatipura, the
city’s red light area, as much as 70 percent of the hookers
tested on Elisa (the preliminary AIDS-test, the more
authentic being Western Blot) showed HIV-positivity.

Higher risk now: Dr. Tripathi also disclosed that new
sero-surveillance reports from Madras had put the figure
for the city at the same level—around 30 percent—
though the spread, according to him, is more pro-
nounced in Bombay. In 1986, only two percent of the
high-risk people were found to have HIV virus.

In Dr. Paintal’s opinion, the one-lakh-plus prostitutes of
Bombay, are causing ‘3.5 lakh infected intercourses
every day. He thinks there is one percent probability of
the infected intercourses leading to a transfer of the
virus. This means an addition of 3.500 HIV positive
people.’ The AIDS virus has an incubation period of 8 to
16 years, on the expiry of which the infection becomes
full-blown. Death is a painful certainty after that.

However, both Dr. Tripathi and Dr. Srinivas, consultant
to the Union government on hospital infections
including AIDS, think that Dr. Paintal has been painting
‘too scary a scenario,’ and that the so-called ‘infected
intercourses’ are generally confined only to the ‘promis-
cuous fringe’ of the society. Quoting government figures,
they expect the total HIV-positive population in India to
be around 150,000 now, though the WHO analysis put it
at 250,000.

The Union Health Ministry has now geared up its
attempt to monitor seropositivity at all centres, particu-
larly at the sexually transmitted diseases (STD) clinics
where the vulnerable groups report in large numbers. In
Calcutta, for example, where the last survey, conducted
way back in 1986, reported only one percent positive, a
new exercise began last week. Altogether 42 medical
practitioners, practising in STD-prone areas, have been
roped in by a central team to conduct a ‘discreet sero-
surveillance.’ In 1986, when an AIDS-carrier was
detained by police, the Calcutta High Court gave a
stricture against such identification and detention, fol-
lowing which all seropositivity surveys were halted.

SJPRS-TEP-91-025
9 December 1991

Dr. Paintal, however, points out that in a city like
Bombay, where the mobility of people in the sexually
active age group was among the highest, the spread of the
disease is likely to baffle all conservative estimates. He
argues that Bombay’s migrant labour population, and
‘the army of commercial travellers,’ have made a
mockery of the staid concept of dividing the society into
two groups-those who are promiscuous, and those who
are not. “What about those who are promiscuous while
on tour, and loyal husbands when at home?’

Eluding diagnosis: The AIDS doctors agree on one point:
that many deaths caused by the virus are going unre-
ported in India. They suspect that a good number of
apparently diarrhoeal deaths were indeed caused by
AIDS, but the patients and their relatives were eluding
diagnosis because of the social stigma associated with the
infection.

According to the Health Ministry, there were 57 patients
of full-blown AIDS—including 46 male patients, till Oct.
31 last year. They think the actual number may grow
exponentially with the possibility of the attack going up
geometrically.

Experts Score Complacency Over AIDS

92WE0096A Madras THE HINDU in English
12 Oct 91 p 10

[Article: “Complacency About Spectre of AIDS”]

[Text] New Delhi, Oct 11—The WHO (World Health
Organisation) has estimated that by the year 2000 AD,
nearly 40 million people of the entire world population
would be affected by the HIV (Human Immuno-
deficiency Virus) infection while the total number of
full-blown AIDS (Acquired Immuno Deficiency Syn-
drome) cases would add up to 12 million. It is also feared
that over 10 million children are likely to be affected by
this dreaded disease if the Governments failed to ensure
the implementation of the infection control guidelines.

While the various health agencies in India are believed to
have taken cognisance of the matter ‘much before time’
and have initiated measures to prevent the spread of
HIV infection which manifests into AIDS, it is largely
felt that the people here generally are yet to realise the
seriousness of the disease and its consequences. People
still believe that AIDS is a disease of some other country
and that it affects only specific groups.

Asymptomatic State

This belief largely stems from the fact that most of the
people carrying the HIV infection are at present in the
asymptomatic state because they acquired the disease
only in the last five or six years. It is estimated that not
less than 35 percent of the HIV infected people will
develop AIDS within the next five to seven years. But
that they are responsible for the spread of the infection
goes unnoticed, “because they look and behave nor-
mally.” At this rate, it is also estimated that within the


JPRS-TEP-91-025
9 December 1991 3 AIDS

MALAYSIA

Over 300 HIV Carriers Discovered Monthly

[Kuala Lumpur NEW STRAITS TIMES, 8 Nov 91] ..... 14
Thirty-three AIDS Cases, 2,087 HIV Carriers Detected by Oct
[Kuala Lumpur Radio Malaysia Network, 26 Nov 91] 14

THAILAND

Chiang Mai AIDS Update /Bangkok SIAM RAT, 24 Aug 91]
AIDS in Army Recruits, Survey on Sex Practices [Bangkok BAN MUANG, 26 Aug 91]
Singburi AIDS Infection Rate Increases /Bangkok THAI RAT, 30 Aug 91]
Chiang Rai AIDS Update [Bangkok SIAM RAT, 4 Sep 91] ...
Bangkok Health Department Discloses AIDS Figures "Bangiok THAI RAT, 13 Sep 91]
Doctor Profiles AIDS Trends, Behaviors

[Apason Bunpradap; Bangkok MATICHON, 16 Sep 91]
Chonburi AIDS Update /Bangkok DAILY NEWS, 17 Sep 91]
Two Percent of Army Recruits Test HIV-Positive [Bangkok BANGKOK POST, 31 Oct 91]
Restriction on Entry of AIDS Victims To Be Relaxed

[Bangkok Radio Thailand Network, 6 Nov 91] 17
AIDS-Infected Persons No Longer Denied Entry
[Bangkok Radio Thailand Network, 27 Nov 91] ..... 17
VIETNAM
Committee Launches Anti-AIDS Campaign /Hanoi VNA, 30 Nov 91] 17

EAST EUROPE
BULGARIA

Data on Spread of AIDS (Sofia BTA, 5 Nov 91] ...
AIDS Specialist Warns Against Complacency [Sofia fia BTA, 28 Nov 91] ..

CZECHOSLOVAKIA
Number of AIDS Cases Increases _/Prague CSTK, 20 Nov 91] .... 18
HIV Carriers Number 186; 25 AIDS Cases Registered
[Prague HOSPODARSKE NOVINY, 29 Nov 91] .... 19
YUGOSLAVIA
Federal Official on AIDS Statistics (Belgrade TANJUG, 27 Nov 91] . 19

LATIN AMERICA
BOLIVIA
Fifty-eight AIDS Cases /La Paz Television Boliviana Network, 24 Oct 91] ...
BRAZIL

Collor Speaks on AIDS [Rio de Janeiro Rede Globo Television, 30 Nov 91] ..
DOMINICAN REPUBLIC

Institute Reports 50 Percent Increase in AIDS Cases
[Santo Domingo Radio-Television Dominicana Radio Network, 26 Nov 91] .....

. 20



SJPRS-TEP-91-025
9 December 1991

He said Department figures showed that in June last year
there were 152 full blown AIDS cases, with six of them
heterosexual. Now there were 209 AIDS cases, with 17
heterosexual.

“T warned about this a couple of years ago—I’m not sure
anyone was listening. Given that these AIDS cases are
the end of a long spectrum of four-to-10 years after HIV
infection, the question is: will there be an explosive
spread among heterosexuals or a steady increase?”

“Since 1987, all of the Western European countries have
reported a steady, slow rise in full blown AIDS cases.
And parallel with this, female cases of AIDS have gone
up.”

Figures show that in the last year in the Republic, there
has been a 14 percent rise in AIDS babies; a 35 percent
increase in homosexuals with full AIDS, and a 48 per-
cent rise among IV drug users—with a massive increase
of some 200 percent among heterosexuals.

Figures for HIV infection show that, apart from haemo-
philiacs, who have seen no increase, other groups show
rises of between eight and 52 percent.

And a new survey by the Genito-Urinary Medicine
Clinic in St. James’ Hospital in Dublin shows that 91
percent of heterosexuals using the clinic had engaged in
unprotected sexual intercourse.

Increase in Fatalities

" 92WE0038 Dublin IRISH INDEPENDENT in English
10 Sep 91 p 10

[Text] Another Irish person has died from AIDS, it
emerged yesterday. It brings the number of fatalities in
Ireland to 90, according to Department of Health fig-
ures.

The latest victim was an intravenous drugs user. The
number of cases of full blown AIDS in the Republic has
increased by two to 211.

Latest AIDS Figures, Heterosexual Cases
Increase

92WE0109A Dublin IRISH INDEPENDENT
in English 15 Oct 91 p 11

[Article by Tom Reddy: “Heterosexual AIDS Triples”]

[Text] The number of heterosexuals who have developed
AIDS in the past year has tripled, and the figure for
heterosexuals contracting the HIV virus has increased by
45 percent.

And the latest figures, released by Dublin AIDS Alliance,
also reveal that nine out of 10 heterosexuals do not
Practice safe sex.

The figures, from a survey carried out at the St. James’
Hospital genito-urinary clinic, show an increase in AIDS
figures on last year in all categories.

WEST EUROPE 41

Intravenous drug users increased by 42 percent, with 74
cases recorded to the end of July this year. Homosexual
AIDS victims increased from 63 to 79, haemophiliacs
from 16 to 20, and paediatrics increased from seven to
eight.

The number of people who contracted the HIV virus
increased in all categories, except haemophiliacs, which
remained the same. IV drug users increased from 508 to
604, among heterosexuals from 80 to 116, among homo-
sexuals from 113 to 173, paediatrics from 67 to 76, while
there were 18 uncategorised cases for the year to end of
July last.

Last night Fine Gael’s health spokesman Richard Bruton
called on the Government to set up a specially-funded
HIV/AIDS action and education programme.

“This survey seems to confirm all the trends: HIV and
AIDS are increasingly spreading into the heterosexual
community. The Government must take action; they
must be shaken out of their complacency,” he added.

Condom legislation should be liberalised and it
shouldn’t be left to local health boards to make decisions
about condom points of sale.

SPAIN

Updated Autonomous Community AIDS Statistics

92WE0087A Madrid DIARIO 16 (CUADERNOS
supplement) in Spanish 16 Oct 91 p V

{Article by Susana Reverter: “Spain, Number Two
Country in Europe in Infant AIDS Cases”]

[Excerpt] One-hundred and ninety children have been
born in Spain with risk factors, in other words, carrying
antibodies to the AIDS virus, according to a study by the
World Health Organization (WHO). Spain is thus in
second place in Europe in terms of the number of
children affected, behind France (210 cases) and ahead
of Italy (184).

Nevertheless, according to a study by Spain’s Health
Ministry in July of this year, the number of cases has
risen to 221. Since December 1989 the total number of
AIDS cases in Europe has increased by more than 50
percent, and between September and December 1990 the
most new cases were seen in France, 3,427, and in Spain,
651. According to the Health Ministry, since 1981 279
children (ages 0 to 12) in Spain have been reported
suffering from AIDS, and 112 of them have died.

Although there has been a definite rise in the number of
AIDS patients, there has been a reversal in the trend
among children. Whereas 34 children were born with the
antibodies in 1990, only 9 were in 1991. The number of
reported cases are recorded for statistical purposes, but
there are HIV-positive people walking around without
knowing that they are (the time of infection does not
coincide with the time of notification). Therefore, what



JPRS-TEP-91-025
9 December 1991

Krohn received international recognition when he was
granted 1.5 million markkas for vaccination research by
the EC almost three years ago. Recently, Annamari
Ranki received approximately 600,000 markkas prima-
rily to study treatment for skin symptoms.

Krohn notes, however, that a neighboring shoemaker has
a greater annual budget than does his research.

“Although we are content with our work in the summary,
a certain pessimism is still bothering us,” says Krohn.
“For example, cooperation with health officials has not
been sufficient: We sometimes feel that they are avoiding
expert help. Other researchers have probably achieved
more than we have, and now new information is a matter
of hard work and money.”

Prof. Pirjo Makela is happy with the results achieved by
Finnish AIDS research. We have become knowledgeable
in the treatment and prevention of the disease, and even
basic Finnish research has been placed in such high
regard that it has gained us participation in international
Projects.

FRANCE

Further Information on IGAS Transfusion Report

92WE0009A Paris LE FIGARO in French 10 Sep 91
p28

[Article by Jerome Strazzulla: “Blood and AIDS: The
Accusatory Report”}

[Text] The first official investigation into the biggest
public health scandal in France: contraction of the AIDS
virus by over 1,000 hemophiliacs from blood products
whose manufacturers knew they contained the virus, will
be made public within a matter of hours.

LE FIGARO can now reveal the scope of the IGAS
(General Inspectorate of Social Affairs) investigation
ordered in June by Minister of Social Affairs and Inte-
gration Jean-Louis Bianco in an attempt to respond to
concern coming on the heels of the resignation of Michel
Garretta, director of the National Blood Transfusion
Center. While the report draws no conclusions relating to
individual or collective responsibility, it does generally
confirm retrospective analyses of France’s slowness and
the blood bank’s inertia vis-a-vis protecting patients
from the AIDS virus.

Anticipated in late June and then early July, the report is
being published two months later than the original
schedule. It is not easy to “make any objective evalua-
tion of the true situation or the chronology of events,”
inasmuch as this was the task of IGAS Director Michel
Lucas, who has personally taken charge of the file. His
reputation for integrity and intellectual honesty explains
why the old adage that “If you want a file buried, just
give it to an investigative commission” was not con-
firmed this time! However, at least three points explain
why his work is more than just a flash in the pan.

WEST EUROPE 39

First of all, the director of IGAS did not have access to
the record of the preliminary investigation, documenting
three years of painstaking investigations by the Gen-
darmerie. This compartmentalization between the
police, courts, and administrative departments, which is
aimed at protecting the average citizen, in this case
forced a single man to repeat in a matter of weeks what
it took a team three years to accomplish!

Silence

The second reason is that no one is required to respond
to an IGAS investigation and if there is any subject about
which people are reluctant to speak, it is definitely that
of the moral bankruptcy of a system based on ethics,
volunteers, and nonprofit. When one adds the fact that
some of the participants at the time (1983-85) are abroad
or have left the Transfusion Center, one can understand
the difficulties Lucas faced in conducting a successful
investigation.

The last reason is the extreme complexity of the subject.
The French system of transfusion was intended to be the
very example of altruism, based on donating blood for
no pay and nonprofit. If it turns out that purely eco-
nomic motives led Transfusion to use contaminated
products, then the failure is infinitely harder to accept
than for the European and American systems, which are
by and large based on the profit principle. Any investi-
gation, whether by IGAS, the IGF (General Finance
Inspectorate) or the Gendarmerie, therefore has an enor-
mous economic and political impact.

The file is also complex because the accused have chosen
a defense argument difficult to counter, one that can be
summed up in a sentence: “Do not use 1991 knowledge
to judge what happened eight years earlier; at the time,
we did not know.” The argument is traditional in
France; it was commonly used, along with others, after
1944. The final difficulty is that the facts cover over a
three-year period of time (1983-85) when knowledge did
indeed expand, but during which the response of the
blood bank, physicians, and officials in charge was
invariably flawed.

1, End of 1983: Silence-As early as this date, all Trans-
fusion officials knew their products might be contami-
nated by the AIDS virus, which the Lucas report unam-
biguously admits. However, the users of these blood
products, hemophiliacs in particular, were not warned of
the risks they were running. This silence, which would
reign until July 1985, is all the more culpable because
treatment of most hemophiliacs is not vital. “Recom-
mendations from certain agencies or officials were not
heard,” the report states, “and reassuring responses were
given, resulting in the collective support of the hemo-
philiac community.”

2. 1984: Imprudence and paralysis—During this year of
scientific uncertainties as to the gravity of the AIDS
epidemic, prudence dictated administering the fewest
blood products possible and, for hemophiliacs, returning



SJPRS-TEP-91-025
9 December 1991

To make sure that the AIDS prevention and control
programme is effective, ODA will closely monitor issues
such as:

—Recruiting of both local and international staff to help
strengthen the implementation of the medium term
plan.

—The quality, extent and impact of management advice
given by GPA, Geneva.

—The composition and work of the AIDS Task Force
and the process of planning and implementation of the
review of the second year of the Medium Term Plan
(MTP).

—The development of an effective financial manage-
ment reporting and review of the MTP, and to receive
progress reports through the Development Division in
Malawi.

Hospital Official Updates AIDS Statistics

MB3011091091 Mbabane THE SWAZI NEWS
in English 30 Nov 91 p 1

[Article by Banele Ginindza]

[Text] Twenty-nine people have died of AIDS and 79
more, mostly men, are full blown sufferers of the disease.

The deaths are nine up from last month while the sick
victims are 56 more than they were in October.

This terrifying state of affairs was stated yesterday by
Administrator of the Mbabane Government Hospital
Miss Dudu Mbuli during the launch of a National AIDS
Awareness Day at the Endzingeni Inkhundla [Tradi-
tional Community Council].

She said the number includes small children and school
children. “The AIDS pandemic is far more than just a
medical challenge, it is also a social and economic
challenge and therefore demands response from dif-
ferent government departments besides health” she said.

She said unborn children contract the disease from their
monthers and do not reach the age of five. “We should
be aware that AIDS is a dangerously divisive virus.

“Loneliness and fear of prejudice are common themes
running through all the testimonies of people with HIV
infection or AIDS or of those close to them” she said.

She said the psychological impact of the disease is
causing cracks along the ancient faultlines in society,
drawing attention to long standing inequalities between
the races, sexes, social classes and countries of the world.

“For example, prostitutes in some countries have been
singled out as a public health risk but not their clients”
said Miss Mbuli.

“In addition insensitive researchers from Western coun-
tries continue to make flying visits to areas of Africa

SUB-SAHARAN AFRICA 9

badly cut by AIDS to gather material for their own
purposes without sharing their expertise or results” she
said.

She said worldwide, an average of 5,000 people are
infected with the diseases per day.

Miss Mbuli said the World Health Organisation (WHO)
projection of people to be HIV positive by the year 2000
is 30 to 40 million.

She said among these will be the young and middle aged
whose deaths will rob society of many productive mem-
bers, that is farmers, teachers, politicians, businessmen
and people from all walks of life.

TANZANIA

Seventy Dead From AIDS This Year in
Kilimanjaro

EA2011195091 Dar es Salaam Radio Tanzania
External Service in English 1600 GMT 19 Nov 91

{Excerpt] Moshi—The killer disease AIDS has claimed a
total of 70 lives in Kilimanjaro region from January to
June this year. The regional AIDS control coordinator,
Mr. Richard Latia, said there were 159 reported AIDS
cases in the region by June this year. [passage omitted]

AIDS Said ‘Big Problem’ in Arusha

B2011181091 Dar es Salaam Radio Tanzania
External Service in English 0400 GMT 20 Nov 91

[Text] Arusha—A total of 27,500 residents of Arusha
district are said to be infected by the killer disease AIDS.
Arusha district administrative officer Ndugu [Sister]
Anna Ngowi said AIDS was becoming a big problem in
the district, and there are 550 recorded patients since the
disease broke out in the district in 1986. Records avail-
able show that 36 people have died of AIDS since 1986.
Ndugu Ngowi was addressing an AIDS control seminar
attended by religious leaders, businessmen, and govern-
ment officials. She said that Arusha municipality with a
population of 134,708, increasing by seven percent
annually, is projected to have 17,875 patients and
8,900...[announcer corrects himself] 893,750 people
with HIV (infection) by the end of the year 2000.

UGANDA

Bishops Reject Condom Use Against AIDS

92WE0051C Kampala THE NEW VISION in English
28 Aug 91 pp 1, 16

[Article by James Kigozi and Michael Sentongo: “Bish-
ops Reject Condoms”]

[Text] Church of Uganda Bishops meeting at Bishop
Tucker Theological College in Mukono for a five-day
AIDS prevention leadership conference, have protested



IJPRS-TEP-91-025
9 December 1991

congress, should be one of alternative strategies of man-
agement of the patients. He said Uganda and Africa’s
forests and savannas still conserve the largest variety of
plants and animal life, which are potential stores of
national chemotherapuetics for AIDS and other dis-
eases. He said in Uganda, the government has embarked
on research on these, and he called for international
collaboration. He stressed that ultimately we shall
depend on the concerted efforts of scientists in their
various disciplines to lead us out of what he called this
dark abyss. President Museveni again emphasized the
need for a return to our time-tested cultural practices
which emphasize fidelity and condemnation of premar-
ital or extramarital sex. I believe, he declared, that the
best response to the threat posed by AIDS and other
sexually transmitted diseases is to reaffirm publicly and
forthrightly the reverence, respect, and responsibility
every person owes to his or her partner. He said young
people must be taught the virtue of abstinence, self-
control, postponement of pleasure, and sometimes sac-
tifice. Mr. Museveni once again discouraged the use of
condoms by everybody. In countries like ours, where a
mother often has to walk twenty miles to get an aspirin
for her sick child or five miles to get any water at all, he
said, the practical questions of getting a constant supply
of condoms or using them properly may never be
resolved. I feel, he explained, condoms have a role to
play as a means of contraception, especially in couples
who are HIV-positive, but condoms cannot be the main
means of stemming the tide of AIDS. The president
expressed concern about the effects of AIDS to the
economy and social life of the country. He said AIDS is
posing a threat to the current levels of agricultural
production, especially as the agricultural activities are

SUB-SAHARAN AFRICA 11

labor-intensive. This, he said, will affect coffee produc-
tion by small holders, which accounts for over 90 percent
of the country’s export earnings. He warned that this
reduction will cause more economic strain, especially
when the coffee prices are not favorable.

ZIMBABWE

Deaths From AIDS-Related Diseases Between
Apr-Jun

MB2511185491 Johannesburg SAPA in English
1702 GMT 25 Nov 91

{Text] Mutare Nov 25 SAPA—A total of 153 people in
Manicaland died of AIDS-related causes between April
and June this year, the ZIANA news agency reported on
Monday.

Provincial Health Education Officer Samuel Tsoka said
people in and around Mutare failed to appreciate the
seriousness of the disease.

In a programme, coinciding with world AIDS week
which began on November 24, Zimbabwean health
workers are visiting local industries and schools to
highlight the dangers of the disease. .

“AIDS is the greatest challenge facing humanity and
every member of the community is being urged to get
involved in the fight against it by informing families and
friends,” said Mr. Tsoka.

“AIDS is still under-estimated and unappreciated for the
killer it is.”



SPRS-TEP-91-025
9 December 1991 2 AIDS

SWAZILAND
Health Ministry Says Official AIDS Figures Too Low

[Mbabane WEEKEND OBSERVER, 26 Oct 91] 8
UK Donates One Million Emalangeni for AIDS Control
[Sandile Ntshakala; Mbabane THE SWAZI OBSERVER, 29 Nov 91] .... 8
Hospital Official Updates AIDS Statistics
[Banele Ginindza; Mbabane THE SWAZI NEWS, 30 Nov 91] 9
TANZANIA
Seventy Dead From AIDS This Year in Kilimanjaro
[Dar es Salaam Radio Tanzania External Service, 19 Nov 91] 9
AIDS Said ‘Big Problem’ in Arusha
[Dar es Salaam Radio Tanzania External Service, 20 Nov 91) ..... 9
UGANDA
Bishops Reject Condom Use Against AIDS
[James Kigozi and Michael Sentongo; Kampala THE NEW VISION, 28 Aug 91] 9

AIDS Control Program Releases Statistics
[James Kigozi; Kampala THE NEW VISION, 6 Sep 91] ....
Museveni on Threat to National Goals From AIDS
[Kampala Radio Uganda Network, 20 Nov 91] ....

ZIMBABWE

Deaths From AIDS-Related Diseases Between Apr-Jun /Johannesburg SAPA, 25 Nov 91] ....

CHINA

12
12

First AIDS Counselling Clinic Opens 28 Nov [Hong Xia; Beijing CHINA DAILY, 30 Nov 91] ..
Further on Public Health Ministry, AIDS Virus [Beijing XINHUA, 30 Nov 91] ...
Heilongjiang Reports Work of AIDS Monitoring Center
[Harbin Heilongjiang People’s Radio Network, 1 Dec 91] ......
EAST ASIA
AUSTRALIA

HIV Virus Carriers Estimated At ‘More Than 15,000’ /Melbourne Radio Australia, 1 Dec 91] ..... 13

12

CAMBODIA

Health Ministry Reports Two AIDS Cases {Phnom Penh SPK, 21 Nov 91]
HONG KONG

AIDS Incidence Among Homosexuals Rises

[Ursula Yeung; THE HONGKONG STANDARD, 25 Sep 91] ..... 13
KIRIBATI
WHO Consultant Commends National Anti-AIDS Plan
[Melbourne Radio Australia, 25 Nov 91) ..... 13

SOUTH KOREA

More AIDS Cases Brings Total to 167 Seoul YONHAP, 30 Nov 91] ..


32 SOVIET UNION

If the skin becomes contaminated with blood or with
other biological fluids or excretions from an AIDS
patient (or virus carrier) or from someone suspected of
having AIDS, a tamponade must be used immediately to
remove what is left of the infected material, and the
contaminated part of the body must be decontaminated
(70% ethyl alcohol, 4% solution hydrogen peroxide, 3%
solution chloramine) and washed with warm water and
soap. If the skin is broken, the individual must stop
working, remove the rubber gloves, disinfect them, leave
the area, squeeze the blood from the wound, and treat
the wound with a 5% alcohol tincture of iodine. After
washing the hands, the individual must cover the injured
spot with a white patch or with a rubber finger sheath.
Depending on the injury, the work can then be con-
tinued, although such individuals should be put under
dispensary observation and must be tested for the pres-
ence of HIV antibodies three months later and six
months later.

Blood or its components or other biological fluids sus-
pected of HIV infection should be transport to diag-
nostic laboratories in plastic containers only that are
placed in well-sealed metal boxes or containers that are
disinfected with traditional means of decontamination.
Disposable micro test tubes can be used for the samples,
and the “dry drop” methods can be used, i.e., transfer of
the blood serum by means of applying it to filter paper.”
When working in the laboratory with such materials, one
should use automatic pipets only, with removable ends,
or any other automatic metering devices. Sucking with
the mouth is categorically forbidden.

Massive parenteral injections of military personnel with
vaccines or allergens is done, as a rule, by specially
trained personnel who use disposable syringes or a
separate needle and syringe for each individual. All
procedures involving suspected material (the drawing off
of serum, the decontamination of instruments and labo-
ratory ware, etc.) are done right in the workplace, on a
table that is separate from the others, over an enamel
vessel whose bottom is covered with a four-ply gauze
napkin soaked in a 3% chloramine solution or a 4%
hydrogen peroxide solution. When the work is finished,
the surface of the table, plus any other objects that could
be contaminated, is decontaminated by being wiped or
soaked with one of the disinfectant solutions. The nee-
dles, syringes, other instruments, test tubes, pipets, and
glass sticks that are used are immersed in a 4% hydrogen
peroxide solution or a 3% chloramine solution for no less
than two hours. For that purpose, laboratories and other
departments must have special containers holding a
disinfecting solution for soaking the dishware, the instru-
ments, the removable ends of the automatic pipets, etc.,
as well as for cleaning the gloves and hands of the
personnel. All departments are equipped with stocked
medicine chests.

After the dishware, the ends, and the instruments have
been soaked, they are removed from the container that
same day or the following day and are immersed for 15
minutes in a 5% cleaning solution (Astra, Lotos,

SJPRS-TEP-91-025
9 December 1991

Progress, etc.) that has been heated to 50°C; they are then
scrubbed a number of times and then rinsed carefully,
first in tap water, then in distilled water. The instru-
ments and dishware are checked for removal of biolog-
ical fluids with the reagent azopyram (OST 42-21-2-85).
If none is available, orthotoluidine or amidopyridine can
be used. Removal of the cleaning agents is checked with
0.1% alcohol solution of phenolphthalein. In clinics,
laboratories, and other departments, the senior nurse (or
senior laboratory technician) checks the instruments and
dishware at least once a week, making a note in a log for
the evaluation of the quality of presterilization. A similar
check is made once a quarter by specialists from sani-
tary-epidemiological facilities.

Depending on their heat-resistance, chemical stability,
etc., medical articles can be decontaminated by being
boiled in distilled water for 30-35 minutes, boiled in a
2% soda solution for 15-20 minutes, placed for 20-25
minutes in a steam sterilizer with a steam pressure of 0.5
kgf/cm?, or placed in a hot-air sterilizer for 45 minutes at
120°C. At the same time, sterilization is best done in
central sterilization departments (or rooms) of treat-
ment-and-prevention facilities. There, needles, syringes,
and other articles are sterilized in a steam sterilizer at a
steam pressure of 1.1 kgf/cm? (120°C) for 45 minutes or
at a pressure of 2.0 kgf/cm? (200°C) for 20 minutes. In
sterilization with the hot-air methods, the working tem-
perature must be 160-180°C for 150 minutes or 60
minutes, respectively (OST 2-21-2-85).

Rubber gloves and other low-resistance articles are
boiled (as indicated above) or are decontaminated chem-
ically by being immersed in a 1-3% chloramine solution
or a 3-4% hydrogen peroxide solution for two hours.
Expensive medical equipment (such as optical instru-
ments) and documentation are decontaminated by being
wiped with 70% ethyl alcohol.

In the event of an accident (in which blood or other
biological fluids are splashed out), the surface of working
tables and laboratory equipment are also treated with a
disinfecting solution. If the accident occurs with a cen-
trifuge, then its lid should not be opened until 30-40
minutes after it stops. The centrifuge cup with the
material and the broken glass should be immersed in a
disinfecting solution. The surface of the lid, the interior
of the centrifuge, exterior of the centrifuge, and the other
cups should also be disinfected.

When material that could be infected with HIV is being
kept in a refrigerator, measures should be taken that
prevent the contamination of the refrigerator. In such
conditions, the refrigerator must be defrosted and decon-
taminated, and the condensation water must also be
treated with a disinfecting solution.

Thus, at the treatment-and-prevention facilities, medical
stations, and infirmaries in military units and on ships,
personnel should strictly observe epidemic-contro! mea-
sures and the regulations for cleaning, washing, disinfec-
tion, and sterilization of medical instruments—above all


20 LATIN AMERICA

BOLIVIA

Fifty-eight AIDS Cases

PY2510113491 La Paz Television Boliviana Network
in Spanish 0200 GMT 24 Oct 91

[Summary] It has been reported that 58 AIDS cases have
been detected in six Bolivian departments, thirty-one of
which have been fatal. There are 22 AIDS carriers
without symptoms.

BRAZIL

Collor Speaks on AIDS

PY3011230491 Rio de Janeiro Rede Globo Television
in Portuguese 2201 GMT 30 Nov 91

[Text] In a 14-minute recorded message President
Fernando Collor discussed the growing threat of AIDS.
Collor says it is his duty to alert the nation and lead the
fight against the disease. The Health Ministry says
800,000 Brazilians now are infected with the AIDS
virus. Collor says there should be no discrimination
against or curtailment of freedom of AIDS sufferers. The
government is starting a new anti-AIDS program that
will be announced on | December—time not specified—
in a national network hookup.

DOMINICAN REPUBLIC

Institute Reports 50 Percent Increase in AIDS
Cases
¥L2611182991 Santo Domingo Radio-Television
Dominicana Radio Network in Spanish 1600 GMT
26 Nov 91

[Text] The Dominican Social Security Institute [IDSS]
has reported that the number of persons infected with
the AIDS virus has increased 50 percent. Dr. Margarita
Cruz, IDSS AIDS prevention programs specialist, said
that in the Salvador Vegodie Hospital alone, 100 new
cases were detected. She added that for the hospital, this
is an alarming number since they were registered only in
the last few weeks. The education and AIDS prevention
specialist added that the spread of this terrible disease is
caused by public lack of information. Margarita Cruz
called for a public orientation campaign to stop the
propagation of the disease.

GRENADA

HIV Cases Number 47, AIDS 29; of These, 21
Deaths

FL2811231991 Bridgetown CANA in English

1901 GMT 28 Nov 91

[Text] St. George’s, Grenada, Nov 28, CANA—Grenada
has recorded 47 cases of HIV (Human Immunodefi-
ciency Virus) infections since the disease was discovered

SJPRS-TEP-91-025
9 December 1991

here in the 1980's. According to Ministry of Health
official, Glen Noel, twenty-nine went on to develop
AIDS. Noel said 21 persons have died from AIDS, which
kills by destroying the body’s disease-fighting system.

“We believe this is only the tip of the iceberg,” Noel said
of the cases.

The Health Ministry, in an anti-AIDS programme, is
campaigning for “a moral Christmas.” The Ministry is
also promoting the use of condoms to curb the spread of
the disease in an island with a population of 98,000.

ST. LUCIA

Health Association Issues List of AIDS Risk
Groups

FL2011180491 Bridgetown CANA in English
1209 GMT 20 Nov 91

[Text] Castries, St. Lucia, Nov 20, CANA—The St.
Lucia Medical and Dental Association has released a
checklist of groups it says should be tested here for the
virus that causes AIDS. The groups were named after
doctors, pharmacists, and family health practitioners
met to discuss how they could fight the spread of AIDS
[Acquired Immune Deficiency Syndrome] on the island.

A statement from the association identified persons who
should consider testing as: men who have had sex with
other males, even once, since 1980; women who have
had sex with a man who had an affair with another man;
and persons whose sex partner has tested positive for
HIV [Human Immuno-Deficiency Virus] or AIDS. The
statement also listed anyone whose sex partner “has had
a sexually transmitted disease (STD), such as veneral
disease during the past five years” or anyone who “paid
people to have sex with them in the past ten years.” Also
suggested for testing were persons “who have shared
needles for injecting drugs or who have had a blood
transfusion between 1980 and 1985”.

Doctors involved in STD research here say that if people
falling in any of the identified categories were to take this
advice and consult their doctors, a considerable amount
of information could be collected to provide a real
picture of the HIV/AIDS situation here, and how to
better put up an effective fight.

The meeting of doctors, pharmacists, and family health
practitioners also reaffirmed that condoms offered good
protection against the spread of HIV/AIDS. The state-
ment added that doctors agreed that there are other ways
to fight the spread of AIDS, but the use of condoms
should be encouraged.


Epidemiology
AIDS

JPRS-TEP-91-025 CONTENTS 9 December 1991

[This EPIDEMIOLOGY report contains only material on AIDS. Other epidemiology topics are covered in a later
issue.]
SUB-SAHARAN AFRICA

REGIONAL AFFAIRS

WHO Official Cites AIDS Potential Impact on Work Force
[London BBC World Service, 27 Nov 91]

ANGOLA
AIDS Spreading at ‘Alarming Rate’ [Voice of Resistance of the Black Cockerel, 2 Nov 91) ...

GHANA

AIDS Cases Up 1.9 Percent in July 91 [Paris AFP, 8 Nov 91]

KENYA

Over 600 AIDS Cases in Eastern Province [Nairobi THE KENYA TIMES, 15 Sep 91] ....

LIBERIA

Official Number of AIDS Cases at 12 [Monrovia Radio ELBC, 20 Nov 91] ....

MOZAMBIQUE

Two AIDS Deaths in Inhambane Province [Maputo Radio Mozambique Network, 30 Nov 91] ..... 2
Health Minister Expresses Concern Over Increased AIDS Cases
[Maputo Radio Maputo, 30 Nov 91]

NIGERIA

AIDS Prevention Campaign Launched in Armed Forces
[Lagos Radio Nigeria Network, 20 Nov 91]
Radio Views Increasing AIDS Threat; Advises Public
[Lagos Radio Nigeria Network, 21 Nov 91]

SOUTH AFRICA

Buthelezi on Constituent Assembly, Peace Accord, AIDS Johannesburg SAPA, 26 Oct 91]
Doctor Discusses Medical Approach to AIDS, Projections /Johannesburg SAPA, 29 Oct 91)
Research Program Head Notes Projected AIDS Figures /Johannesburg Radio RSA, 30 Oct 91] .
National Health Department Refutes U.S. AIDS Report [Johannesburg SAPA, 31 Oct 91]
SADF Introduces AIDS Testing for Permmenant Force Recruits

[Ada Stuijt; Johannesburg SAPA, 6 Nov 91]
Study Questions ‘Doomsday’ AIDS Predictions /Johannesburg SAPA, 27 Nov 91]
Health Official Says AIDS ‘Gaining Momentum’ /Umtata Capital Radio, 30 Nov 91] .
Official Says 120,000-180,000 Infected With AIDS in Country

[Johannesburg South African Broadcasting Corporation Network, I Dec 91]

3 aU RROw



wis
ATTN PROCESS 103

S2e8 PORT ROYAL RE
SPRINGFIELD UA

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28 SOVIET UNION

- with unexplained loss of body weight or 10 or more
percent;

- with protracted and recurring pneumonias or pneumo-
nias not yielding to standard therapies;

- with protracted and recurring purulent bacterial or
parasitic diseases, sepsis;

- with subacute encephalitis or mental deficiency in
previously well individuals;

- with villous leukoplakia of the tongue;
- with recurring pyoderma;

- women with chronic inflammatory diseases of the
female reproductive system of unclear etiology.

2.7. Patients with a suspected or confirmed diagnosis of
the following:

- Kaposi’s sarcoma;

- lymphoma of the brain;

- T-cell leukemia;

- pulmonary and extrapulmonary tuberculosis;

- hepatitis B, the HBs antigen carrier state (at diagnosis
and 6 months later);

- cytomegalic virus disease;
- the generalized or chronic form of herpes simplex;

- recurring herpes zoster in individuals younger than 60
years;

- mononucleosis (3 months after the beginning of the
disease);

- pneumocystosis (pneumonia);

- toxoplasmosis (of the central nervous system);
- cryptococcosis (extrapulmonary);

- cryptosporidiosis;

- isosporosis;

- histoplasmosis;

- strongyloidosis;

- candidiasis of the esophagus, trachea, bronchi, or lungs;
- deep mycoses;

- atypical mycobacterioses;

= progressive multifocal leucoencephalopathy.

2.8. Children born of HIV-infected mothers at birth, and
6 and 12 months after birth.

SJPRS-TEP-91-025
9 December 1991

2.9. Patients systematically receiving transfusions of
blood and its preparations (hemophilia, Werlhof’s dis-
ease, von Willebrand’s disease, anemia of various causes,
etc.), once a year.

2.10. Pregnant women when placed on the pregnancy
Tegister and at 30 weeks of pregnancy; in case of the
absence of data from an AIDS examination or of an
obstetrical chart at the time of admission to an obstet-
tical department.

2.11. Pregnant women who are being examined for
artificial termination of pregnancy.

2.12. Children admitted to resuscitation, oncological,
thoracic, and hematological departments.

2.13. Individuals suffering from sexually transmitted
diseases when they seek medical assistance and subse-
quently as indicated.

2.14. Medical personnel working with the AIDS virus or
providing diagnostic, treatment, and direct service to
AIDS patients, once a year.

2.15. Individuals from the risk groups: those suffering
from drug addiction, toxic substance abuse, homosexu-
ality and bisexuality; individuals working as prostitutes
are to be examined twice a year.

2.16. Individuals from the risk groups entering investi-
gatory isolators, corrective-labor institutions, and treat-
ment-labor preventoria, at the time of admission and
release.

2.17 Individuals without a definite place of residence,
involved in vagrancy.

3. Citizens of the USSR, foreign citizens, and stateless
persons who have declared a desire to be examined,
including those who do wish to be examined anony-
mously.

4. The principal method of testing for AIDS is laboratory
examination of the blood. Three to five ml of blood are
taken from the vein by means of a disposable syringe (or
by multiple use syringes, provided the regulations for
their disinfection and sterilization are observed) and
sent to a laboratory engaged in AIDS testing. In children
the blood can be tested by the finger stick method.

5. The examination for the identification of infection
with the human immunodeficiency virus (AIDS) is car-
ried out only in state treatment and prophylaxis institu-
tions.

6. Citizens of the USSR who are returning from service,
business, or private trips abroad (longer than 3 months)
are sent for examination to institutions of health protec-
tion organizations which have posted these citizens.

7. Foreign citizens or stateless persons who have come to
the USSR for study are to be examined at institutions of
health protection organizations 10 days after arrival and


JPRS-TEP-91-025
9 December 1991 ’

This is the first criminal case in Finland that concerns
the conscious spreading of AIDS. According to the
victim’s lawyer, Heikki Salo, the case was also the first in
the Nordic countries, but Germany, for example, has
already issued at least three condemning verdicts.

The prosecutor and the infected man’s relatives had
demanded that the suspect be punished for man-
slaughter. The infected man died of AIDS during the
course of the trial.

The court held that the man had contracted the HIV
{human immunodeficiency virus} infection during
unprotected sexual contact with the suspect. The rela-
tionship between the men had lasted over a year, from
the summer of 1986 to the fall of 1987.

The suspect had known he was carrying HIV during their
relationship but had concealed the information from his
male friend. The court held that the suspect should have
understood that sexual contact could cause the victim to
contract a serious disease.

The court held that the male friend, for his part, had also
contributed to his infection inasmuch as he had not used
protection.

The suspect was ordered to pay the victim’s relatives
75,000 markkas in damages. Furthermore, he was
ordered to cover the funeral and legal expenses.

Case Goes to Court of Appeals

The case will probably continue to be heard in the
Helsinki Court of Appeals. The victim’s relatives will at
least appeal the city court decision, says Salo. Also, the
suspect’s lawyer, Leo R. Hertzberg, believes that he will
take the case to a higher court.

Hertzberg says he is relieved about the decision, or at
least that the suspect was not convicted of manslaughter.
“During the trial, I have become more convinced that
the way to fight the spread of HIV is by insuring that
infected persons seek treatment. Everyone should also be
reminded of his own responsibility—that is, to practice
safe sex.”

The Espoo man is free pending the decision of the Court
of Appeals. After that, he can appeal for postponement
of his sentence if the Supreme Court grants the case an
appeal.

The entire trial was held behind closed doors, and all
documents are being kept secret. However, the court
released a summary of the reasons for the decision
because of the fundamental meaning of the issue.
Ombudsman Jacob Soderman recommended last week,
in connection with one of his decisions, that the lower
courts prepare short summaries of their decisions, even
when cases have been heard secretly.

WEST EUROPE 37

Physicians Should Intervene With Carriers

Salo hopes that the Helsinki City Court decision will lead
to greater responsibility among HIV carriers. However,
he thinks there should be other methods, in addition to
criminal legislation, to deal with those who deliberately
transmit the disease.

“Asa lawyer, I find that regulations concerning this issue
is really very primitive. Physicians should have thought
of some ways to discipline deliberate transmitters.”

Salo thinks that the first step in the right direction is
better testing of the risk groups so that they, at least, will
not unknowingly transmit the disease. “So many refuse
the tests because they have reason to fear positive
results.”

Salo thinks that many are too trusting of HIV carriers.

“Unfortunately, those infected with the virus are not
always aware of being infected, and this is true whether
in Finland or elsewhere; otherwise, the epidemic would
be well under control. Everywhere in the world there are
people who have decided not to care about anything
because their lives are gone. They hand on the misfor-
tune.”

HIV Carrier Cannot Be Isolated

Salo does not, however, believe in enforced isolation
modeled in Sweden. In Sweden, a person suspected of
deliberately transmitting HIV can be cut off from the
rest of society by a court decision.

In Finland, an HIV carrier cannot be forced into isola-
tion or treatment because the HIV infection has not been
classified as a disease holding an imminent threat to the
public by an infectious-disease law.

Infectious diseases have been divided into three catego-
ries by law: those that hold an imminent threat to the
public, those to be reported, and other diseases. HIV
belongs to the diseases to be reported.

Enforced isolation and treatment can be applied only to
diseases holding an imminent threat to the public—for
example, tuberculosis, cholera, syphilis, and diphtheria.

“The purpose of enforced isolation is to treat the disease.
However, there is no cure for HIV, and, thus, enforced
isolation is not legal,” notes Olli Haikala, the chief
medical officer in the Ministry for Social Affairs and
Health.

According to Haikala, it is difficult to intervene with the
deliberate transmitting of diseases by means of the
public health service. “We in the public health service
are not the police. We could lose the trust of people, and
they would no longer want to come to us for treatment.”

“I cannot accept deliberate transmission of diseases, but
intervention should happen through criminal legisla-
tion,” notes Haikala.



JPRS-TEP-91-025
9 December 1991

same period of time, another 35 percent of the popula-
tion will develop symptoms associated with HIV infec-
tion, but not fulfil the criterion for a diagnosis of AIDS.

With these statistics, a group of. people from all walks of
life participated in an invigorating discussion on AIDS
at the India International Centre here this morning. It
was an inter-sectoral collaboration workshop organised
by the Directorate of Health Services and the Delhi
Administration as part of its National AIDS Control
Programme (NACP). After the customary slide shows
and brief addresses from the dais the discussion was
thrown open to the audience which comprised represen-
tatives of voluntary health organisations, blood banks,
social workers, mediapersons, Army personnel, doctors
and Medical Superintendents of hospitals.

Waiting Disastrous

Prof. A. N. Malviya, Director of AIDS Centre at the
All-India Institute of Medical Sciences, who had done
pioneering work in the field, projected some very
moving and impressive slides and titled his presenta-
tion —“AIDS—the story of sex, blood and death.”
Throughout the presentation he tried to drive home the
point that “it would be disastrous to wait till AIDS
became a major disease like tuberculosis or chickenpox.”
“This is the right time, without further delay to control
the spread of the disease,” he stressed.

Prof. Malviya warned that since the HIV Infection,
which had already set its roots in India, was at present at
low prevalence among the high risk groups, people
should not adopt a laid-back attitude. The Deputy Direc-
tor-General of NACP, Dr. Shiv Lal, however, said that
37 Zonal Practising Centres exclusively meant for blood
screening had been set up in 27 cities. Another 52 cities
had been identified for setting up more such centres with
specific directives to discard the blood after the first
ELISA positive test.

Full-Blown Cases

According to Dr. Shiv Lal, there are 85 reported full-
blown AIDS cases in the country while Maharashtra,
Tamil Nadu and Manipur led with 1,000 each reported
cases of HIV infection. Maharashtra also has the highest
number of full-blown AIDS cases—36, and is also the
only State to develop several counselling centres and
follow up the cases of infected blood donors in a big way.

Dr. Shiv Lal said in Delhi 459 cases of HIV infection
have been reported so far and 50 percent of them have
transmitted the disease through infected blood after
transfusion. Emphasising that HIV infection was
spreading fast attacking the most vulnerable age group of
20 to 40 years, highlighted the role of health education.
He informed that the Government was seeking interna-
tional support for AIDS programme and considering
taking a loan from the World Bank to fight the scourge.

NEAR EAST & SOUTH ASIA 23

The others who spoke on the occasion included the Chief
Secretary of the Delhi Administration, Mr. R. K. Tak-
kar, the Director of Health Services, Dr. V. P. Varshney,
Mr. M. Stampke and Ms. Carol Larivee of WHO. All of
them stressed the need for immediate action and coor-
dination.

Hackneyed

Though the discussion left behind stimulated minds, a
section of the audience also felt that the discussion was a
hackneyed one, failing to throw light on new and strong
corrective, preventive and effective measures and the
success of the programmes introduced so far and the
kind of help ought to be rendered to the already affected
persons. “We were told about the same things which are
oft-repeated at every seminar/workshop on AIDS,” they
complained.

Reacting to this, Mrs. Shailaja Chandra, Secretary of
Health, Delhi Administration, who was the brain behind
the workshop, said that the attempt was even to educate
the educated about what AIDS is, how it spreads and the
do’s and dont’s. She was of the opinion that a large
section even of the literate population was ignorant
about the disease and its implications.

“And it is through such intellectual exchanges we gain
more information and can also share them among our
colleagues, friends, relatives, family members and
acquaintances at place of work and stay,” she added.
And it was with this promise that the participants
dispersed.

IRAN

Health Minister Cited on 186 AIDS Cases in
Country

LD0112122691 Tehran Voice of the Islamic Republic of
Iran First Program Network in Persian 1030 GMT

1 Dec 91

{Excerpts] To mark world AIDS day, ceremonies were
held at Tehran University today. During this event, the
health minister, Dr. Malekzadeh, raised some notable
points. [Passage omitted]

Pointing to the fact that in humans, AIDS is contracted
via sexual contact with an infected person, the reception
of infected blood products, and the transfer of infection
from mother to child, Dr. Malekzadeh said: Due to the
reign of Islamic values and the observance of hygiene,
our country is one of the cleanest areas of the world. If
the people’s awareness is raised, this deadly disease can
be controlled easily in our country.

He added: Currently 180 patients have been registered as
infected with the AIDS virus.

In conclusion, the health minister recommended that
agents selling airline tickets for travel abroad provide
brochures on AIDS for intending passengers.



SPRS-TEP-91-025
9 December 1991

The centre’s estimate of the effect of the epidemic on the
health care system was made making various assump-
tions, among the most important of which were that:

I. Expenditure on health care would grow by 2.5 percent
per annum.

IL. Only about 50 percent of people with AIDS would use
the health service.

Ill. The present balance between private and public
health care would be maintained, but the relative cost of
private care would increase more rapidly.

IV. Those AIDS patients who presented to the health
service in need of hospital care would receive such care.

By the year 2005 the total cost of the epidemic to the
health service could be as high as R[rand)18 billion (in
1991 rands). This would be about 75 percent of all
expenditure on health care. Even on a substantially lower
calculation of hospital costs the epidemic would con-
sume about 34 percent of all funds available for health
care.

Such figures were alarming and pointed to the need for
the health services to develop strategies to cope with the
epidemic so as to provide adequate care also to those
people who were not AIDS patients.

Impact-on-the-Economy

The economic cost of the epidemic was particularly
difficult to quantify, said De Beer, there being a number
of components:

1) Lost Productivity

Although by 2005 the number of working years lost ran
into millions, the cost to the economy was quite small, by
the centre’s calculations between 1 percent and 1.5
percent of GNP [gross national product]. The relatively
low loss of earnings was explained by two factors:

— The high unemployment rate, which meant that many
of those dying would not be formally earning an
income.

— The present massive inequalities in South Africa,
which meant that the death of thousands of wage
earners signified relatively little in terms of lost
income.

2) The Health Care Costs

It was possible that the epidemic would result in
increasing allocations of the GNP to health care.
Although such transfer payments to health care would
not be lost to the economy, they would result in less
productive use. The long-term economic effects of such
growth in health care expenditure was unpredictable.

SUB-SAHARAN AFRICA 1

3) Ill-Defined Costs

The epidemic might extract a range of other costs from
the economy, difficult to quantify.

Mr. de Beer said that the AIDS epidemic demanded
answers to such questions as:

— How to provide humane and high quality support for
those who were already infected and for those infected
in the future.

— How to change sexual behaviour and attitudes.

— Whether there were any particular health service
interventions which could slow the spread of the
disease.

— How the health service could improve the quality of
health care for the majority of South Africans while
meeting this new challenge. Issued on behalf of:

The Centre for Health Policy,

Department of Community Health,

University of the Witwatersrand Medical School
7 York Road, Parktown, Johannesburg

Health Official Says AIDS ‘Gaining Momentum’

MB3011181491 Umtata Capital Radio in English
1500 GMT 30 Nov 91

[Text] Health officials say HIV infection and AIDS are
now firmly established in the Johannesburg community.

Dr. Clive Evian of the Johannesburg City Health AIDS
Prevention Program says Johannesburg residents who
have tested positive for the AIDS virus could easily fill
Ellis Park stadium. He says the epidemic is gaining
momentum at a rapid and alarming rate. But Evian says
the good news is that the private and public sectors are
developing AIDS programs, and a number of nongov-
ernmental organizations have been established to create
AIDS awareness.

However, despite these encouraging signs, schools have
not yet instituted meaningful AIDS programs. Evian
says there has been disappointing response from the
education departments who have a major role to play in
fighting the deadly disease.

Official Says 120,000-180,000 Infected With
AIDS in Country

MB0112080491 Johannesburg South African
Broadcasting Corporation Network in English
0600 GMT I Dec 91

[Text] A spokesman for Johannesburg’s City Health
AIDS Prevention Program, Dr. Clive Evian, has said
that about a quarter of all South Africans infected with
the AIDS virus were from Johannesburg. Speaking at a
symposium to mark World AIDS Day, he said it was



10 SUB-SAHARAN AFRICA

to the Minister of Health about the promotional cam-
paign for the use of condoms as a shield against AIDS.
The Bishops are arguing that promotion of condom use
will aggravate immorality among the youth who are the
major targets of the campaign.

The debate was sparked off by Bishop Misaeri Kawuma
of Namirembe when he told the Minister of Health, Dr.
James Makumbi, who was guest of honour at the
opening of the conference, that the Radio Uganda AIDS
campaign programmes which advocate condom use are
bound to be misunderstood by the youth. Bishop
Kawuma warned that the youth are likely to think that
the programme is giving them a merry go ahead with
sexual immorality.

He also said that while on a tour in western Uganda
recently, some listeners also complained to him about
the same programmes. He said, that the programmes are
alien to African traditions which in the past kept the
standard of morals intact, amidst murmurs of approval
from other Bishops and clergy who are attending the
seminar.

“The ministry should emphasise the betterment of
morals but not to go out and tell young people to use
condoms,” cried Kawuma who added that listeners are
also offended by the programmes.

Responding to the complaint Dr. James Makumbi
explained that the Ministry’s promotion of condom use
in the AIDS control programme is not aimed at immo-
rality, but it is out of desperation because the ministry is
looking for any method which can help reduce the risk of
spreading the disease. “This congregation is expected to
come up with some more feasible strategy to combat the
disease while safeguarding the morals,” the minister
challenged.

He said that the church is a good instrument to mobilise
the people against the spread of AIDS, saying it can exert
influence on the people with a view of changing their
sexual behaviour and can play a major counselling role
for the affected families.

Earlier, the Archbishop of the Church of Uganda, the Rt.
Rev, Yona Okoth said there is the need for change in
traditions “including our christian traditions so that we
save life.”

Rt. Rev. Yona Okoth paid tribute to Father John
Lathrop from the Diocese of Los Angeles in USA, the
United States Agency for International Development
(USAID) for sponsoring the conference.

AIDS Control Program Releases Statistics
92WE0051A Kampala THE NEW VISION in English
6 Sep 91 p 10

[Article by James Kigozi: “AIDS Control Programme
Releases AIDS Statistics”]

[Text] A total of 21,719 AIDS cases for both adults and
children was reported to the AIDS Control Programme

SPRS-TEP-91-025
9 December 1991

(ACP) in 1990. Of these, 19,663 were adults aged 12
years and above and 2,056 were children aged 11 years
and below, according to the situational summary report
on AIDS in Uganda published in the AIDS Surveillance
Report, Fourth Quarter of 1990 by the ACP.

The report says that information on AIDS cases by
district of residence indicate that every district has had
at least a clinical case of AIDS with Kampala leading
with 5,764 cases followed by Masaka with 3,546 cases.

However, independent sources within the ACP said that
the statistics for AIDS cases in all areas are much higher
than these, adding that a big number of cases are still in
the incubation stages while several hundreds are never
teported to hospitals.

Out of the 19,663 adult cases presented in the report,
13,004 (66.13 percent) meet the Uganda Modified clin-
ical case definition and 4,969 (25.27 percent) belong to
the symptomatic HIV infected group, normally con-
firmed by laboratory test; 1,350 cases were reported
prior to the establishment of a systematic AIDS surveil-
lance system, the report says.

Out of the 19,663 adult cases, 14,643 (74.47 percent) had
serum drawn and were all positive for HIV-1 antibodies
by the ELISA machine. Of these, 49.79 percent were
male and 50.21 percent were female. The average age of
all adult cases was 29.71 years, while that for males was
32.01 and females 27.35 years, the report says.

On average, males are older than females. The report
adds that 33.47 percent of the cases were in-patient and
37.26 percent were out-patient while the remaining
29.27 percent did not have their status recorded.

The same report further reveals that a total of 2,056
paediatric cases aged between one and 11 years were
reported. Of these, 887 (43.14 percent met the provi-
sional World Health Organisation’s (WHO) clinical def-
inition for paediatric AIDS in Africa and 1,157 (56.27
percent) were symptomatic and HIV seropositive. The
Test were reported prior to the establishment of system-
atic AIDS surveillance.

Museveni on Threat to National Goals From
AIDS

AB2311095591 Kampala Radio Uganda Network
in English 1700 GMT 20 Nov 91

[Text] President Yoweri Museveni has warned that the
growing devastation of a range of national aspirations by
AIDS is very real unless something is done quickly. He
told an AIDS congress attended by physicians from East
and Central Africa in Kampala today, that apocalyptic
visions of the virtual destruction of much of Africa may
be unwarranted but the growing devastation of a range of
national aspirations is very real unless something is done
quickly. The challenge to you, as doctors, he told the