JPRS-TEP-90-021
27 December 1990

Public Health Minister Wants Global System
Against AIDS

HK0612123090 Beijing GUANGMING RIBAQ
in Chinese 9 Nov 90 p 1

[Report by Fan You (5400 0642): “Public Health Min-
ister Chen Minzhang Calls

[Text] The Sino-U.S. Symposium on Measures Against
AIDS opened this afternoon in Beijing. Chen Minzhang,
China’s public health minister appealed at the meeting:
Adopt region- and nation-transcending joint measures,
and establish a global prevention system and network to
effectively check the spread of AIDS.

According to an estimate by the World Health Organi-
zation [WHO], at present, some 8 million people in the
world have been exposed to the HIV virus; 700,000
people have AIDS; and AIDS prevention has become a
problem which concerns the whole world.

In the early 1980's, the HIV virus was transmitted to our
country. Our country’s health departments started mon-
itoring AIDS in 1985. Up to the end of this September,
the country had tested more than 300,000 blood samples
from the targeted population, and discovered 446 cases
with a positive response, among which 68 were from
people abroad, 378 were mainland residents; five of
them were diagnosed AIDS patients, and among these
five people three contracted the virus from abroad, two
from the mainland.

In the area of research on AIDS prevention, our coun-
try’s health workers have engaged in a series of tasks over
the past few years. At present, we have established a
reliable laboratory for serological research; we have
isolated an HIV virus from a foreign tourist who was an
AIDS patient traveling in China, and used it to test the
presence of an antigen; there are five units which have
established P3-level laboratories, to develop research on
the etiology of AIDS and on molecular biology, we have
also explored Chinese medicine and qigong for treat-
ment of AIDS.

Under the conditions that neither medicine for effective
treatment of AIDS nor special preventive means are
available, our country has extensively developed propa-
ganda and education on AIDS prevention, to help the
masses to understand its danger, grasp preventive knowl-
edge, and do the work in self-protection well.

Active Steps Taken on AIDS Prevention

91WE0094B Beijing CHINA DAILY in English
9 Nov 90 p1

{Article by Huang Zhiling]

[Text] With the growth of international contacts, AIDS
has been transmitted into China and will probably
spread, an international symposium was told yesterday
in Beijing.

CHINA 15

This situation has caused increasing concern in both
medical circles and the Chinese Government, said health
Officials at the opening session of the Sino-American
Symposium on Management of HIV Disease, which
started yesterday afternoon and ends today.

According to Chen Minzhang, Chinese Minister of
Public Health, HIV blood serum tests were done on
300,000 people who were regarded as high risk in this
country from 1985 to the end of September this year.

Of these, 446 mainland Chinese were found to be HIV
carriers. Five of them were AIDS patients, three of
whom were foreigners and one each from Beijing and
Southwest China’s Yunnan Province.

Of the 446 HIV carriers, 68 were foreigners and 378 were
mainland Chinese.

In China, the HIV virus is mainly contracted through
blood or sexual contact. No case of mother-child infec-
tion has yet been found, said He Jiesheng, President of
China’s National Committee of AIDS Prevention and
Control.

He revealed that in the last few years the number of
drug-users has increased rapidly in some parts of China,
especially in the border regions in the southwest. Apart
from the traditional way of taking drugs orally, drug
users have recently been found to take drugs by intrave-
nous injection.

He said that these drug users represent the high risk
population for contracting the HIV virus.

He also revealed that venereal diseases could increase
the risk of contracting the HIV virus. So venereal disease
is also an indication of the spread of the HIV virus.

According to Dai Zhicheng, Vice-President of National
Committee of AIDS Prevention and Control, the gov-
ernment has listed AIDS as a major infectious disease.

Up to now, almost all Chinese provinces have set up
AIDS monitoring stations. Three laboratories to diag-
nose the HIV virus have been set up by the Ministry of
Public Health, Dai said.

The laboratories have already made it clear that HIV was
first transmitted into China in the early 1980s and is
spreading quickly in some regions.

According to Dai, there has been close cooperation
between China and the World Health Organization
(WHO) in the prevention of AIDS.

In 1988, WHO allocated over $300,000 to China for
AIDS prevention purposes. It has also sent experts to
give lectures in China on the subject and has invited
many Chinese experts to attend international confer-
ences on AIDS and to take part in technical training and
to conduct investigations abroad.



36 WEST EUROPE

efforts among drug-users, especially programs involving
hygiene and the use of sterile or disinfected syringes,
diminishes the rate of HIV-virus contamination. Hence
the need, according to him, to further extend syringe-
exchange programs, even though this often raises polit-
ical problems: It is the only way, in his view, to stop the
chain of contamination. “Reluctant politicians must,”
he concludes, “realize that AIDS will kill more people,
more massively, than drug abuse.”

There were many statements of that kind, based on
figures, observations, and attentive studies, made in
Montreux over the last few days. And it became apparent
that, though specialists often agree on the measures to
take, it is the political obstacles that are often the
stubbornest. Hence the importance, one is tempted to
conclude, of these specialists not only evaluating, but
then communicating their convictions to the population
and to political elites.

UNITED KINGDOM

Chief Medical Officer Addresses London AIDS
Parley

91WE0127 London THE DAILY TELEGRAPH

in English 20 Nov 90 p 8

[Article by David Fletcher, Health Services Correspon-
dent]

[Excerpt] A senior National Health Service executive
resigned from her £50,000-a-year post yesterday in pro-
test at spending cuts in the service. Mrs Mary Wyllie, 51,
chief executive of West Essex Health Authority, said the
authority was no longer able to provide an adequate level
of service to the patients in its area.

SJPRS-TEP-90-021
27 December 1990

Her decision follows a cut of £1,600,000 in the author-
ity’s £52 million budget in order to balance the books by
the end of the financial year in April.

She said: “It means we shall do very little non-urgent
work between now and April, yet we have the longest
waiting list in the country—4,988 people.”

Many of them have been waiting for more than a year
and 700 of the less urgent cases have been waiting for
more than two years.

“The situation is getting worse. We are able to do less
each year because of the shortage of money. I could not
see a way forward,” she added.

Mrs Wyllie, who has had a career in the NHS for 27 years
and has been chief executive for 18 months, said she was
unable to find a financial solution.

She said: “We have been living on loans and over-
spending for the last few years. This year we have been
told to balance the books by the end of the year with no
recourse to creative accounting.

“We have reached the stage where the financial position
and the cuts we are having to make leave the district
unable to provide what we would consider an adequate
health service for the population.”

She said the district—centred in Harlow—had been
underfunded for years because financial allocations had
failed to recognise the gradual aging of the population
which was causing the cost of their health care to rise
year by year.

She denied her resignation was prompted by the Gov-
ernment’s health reforms, which, she said, would even-
tually benefit the health service.

But she said the increased work of preparing for the
reforms, coupled with the financial problems, amounted
to intolerable pressure. [passage omitted]



32 WEST EUROPE

for the struggle against AIDS. A few “personnel mem-
bers” were literally astonished, while other were upset, as
if facing a direct attack on civil rights. On the other hand,
the only ones remaining calm were the signers of the
decree-law: the head of the government, the ministers of
defense, budget, treasury, foreign trade and economic
planning, and of interior. But the arguments have
already started.

Article 15 of the decree-law leaves no doubt. “For
personnel of the armed forces and the police, and per-
sonnel of the national firemen’s force, checks for the
absence of drug dependence, a check for the absence.of a
seropositive reaction to HIV infection, and a test of
fitness for performing the services involving risks to the
safety, security, and health of third persons, are arranged
by the appropriate administrations and carried out by
the organizations named in the respective regulations.”

Furthermore, the second and last paragraph of article 15
directs that, “with the exception of the obligations to
communicate or report provided for by law or regula-
tion, the grounds for the measures taken are reported
exclusively to the persons to whom said measures
apply.” Thus, while respecting privacy, positive test
results will involve “measures.”

The conflict with the principle of nondiscrimination
against those having seropositive results, reflected in the
AIDS legislation launched only four months ago, has
appeared obvious to many. “It is contradictory,” said
Elio Guzzanti, vice president of the ministerial commis-
sion for combating disease, “that the AIDS law which
came out in June forbids employers to carry out tests on
persons to be hired and on those already hired, while
now there is a decree-law which instead provides for just
that.”

The contradiction was also pointed out by the jurist,
Stefano Rodota, senator of the Independent Left. He
added harsh criticisms of the procedures for carrying out
the mandatory tests, of the choice of the formula of
decree-law, and spoke openly about “subterfuge.” “It is
absolutely unacceptable that such a sensitive subject as
that of personal freedom should be dealt with by a
decree-law,” said Rodota. “So, if the latter applies to the
substance of the matter, and for the greater part, the
problems of the police forces, we are faced with out and
out subterfuge.” “Furthermore,” Rodota concluded,
“according to the article, the tests would not appear to be
mandatory for all, but instead, are, and I cite: ‘arranged
by the appropriate administrations.’ That means leaving
a margin of discretion which, when applied to such
sensitive standards, can lend itself to abuses and discrim-
ination.”

Comments, however, from Health Minister Francesco
De Lorenzo were positive. “If someone wants to go into
the police and in the armed forces he should know that
this decree exists,” De Lorenzo said. “Anyone wanting
to do that work should know one must take the AIDS
test. The measure does not distort the law on AIDS,

JPRS-TEP-90-021
27 December 1990

which excludes all mandatory verification of the disease,
because it refers to persons in general, avoids discrimi-
nation and the casting out of persons, and provides for
secrecy. If the work of the Interior Ministry requires
some special criteria, I am not opposed.”

The trade unions’ criticisms were also harsh. Carlo
Fiordaliso, general secretary of the UIL [Italian Federa-
tion of Trade Unions] health workers’ union, said, “The
workers’ organizations will not fail to report to the
appropriate quarters total trade union disagreement with
this decree, which was issued without the slightest con-
sultation with the trade union. With this measure, the
individual is badly damaged by open discrimination.”

Franco Bentivogli, confederal secretary of CISL, [Italian
Confederation of Trade Unions] considered it “‘a rather
grave decision, conflicting with the deliberations of the
World Health Organization which rule out the possi-
bility of either private or public employers’ imposing
such an examination.” Furthermore, according to Ben-
tivogli, if this decision is put into effect there cannot but
be serious consequences “in the form of further discrim-
ination, in addition to the discrimination AIDS patients
must already undergo.”

SPAIN

\
20 Percent of AIDS Prisoners Terminal

91WE0052A Madrid DIARIO 16 in Spanish
26 Oct 90 p17

[Text] Some 20 percent of the 279 inmates in Spanish
prisons suffering from AIDS are now terminal, according
to information from the General Directorate of Penal
Institutions sent to Juan Jose Unceta Anton, member of
Parliament representing the Popular group.

The increase in the number of drug-addicted inmates
meant that by the end of October, 58 more cases had
been found than in 1989, when 221 cases were counted.

According to information from Penal Institutions, 75
percent of all 245 conditional releases granted based on
Article 60 of the Penal Code (to which aging prisoners or
those suffering from incurable diseases\ have recourse)
were due to the fact that the prisoners in question were in
the terminal stage of AIDS or AIDS-related complexes.

SWEDEN

HIV-Infected Man Appeals Isolation Sentence

91WE0064G Stockholm DAGENS NYHETER
in Swedish 16 Oct 90 p D4

[Report by Press Wire Service, Inc. (TT)] txt

[Text] The 46-year-old HIV-infected man who is being
held in compulsory isolation under the law on infectious
disease control is now appealing to the government for
clemency.



IJPRS-TEP-90-021
27 December 1990

TOGO

Official Briefs Mrs. Mitterrand on AIDS Figures

AB1212161490 Lome Domestic Service in French
1900 GMT 10 Dec 90

[Excerpt] This morning, Mrs. Danielle Mitterrand, wife
of the French president and president of the French
Liberties Foundation, held a meeting at the WHO center
in Lome. She was accompanied by the Togolese first
lady, Mrs. Badagnaki Eyadema, and was welcomed upon
her arrival at the center by the WHO officials there.

Later, Dr. Dayuka Awissi briefed the president of French
Liberties about the National Committee Against AIDS.
According to Dr. Awissi, this program is one of the six
major parts of our country’s health program. To coordi-
nate the anti-AIDS fight, the National Committee
Against AIDS was set up in 1987. This committee
includes representatives of all political, religious, and
traditional structures in our country. The committee has
carried out several activities in the area of information,
education, and communication. According to Dr.
Awissi, it has produced posters, folders, car stickers,
T-shirts, and caps to support its information, education,
and communication activities. It has also utilized the
media for its activities.

The chairman of the National Committee Against AIDS
stated that it is compulsory in Togo to declare AIDS
cases. All doctors must declare all AIDS cases they have
diagnosed. Thus in 1987, two cases were declared; in
1988, 15 were reported; in 1989, 39 were declared; and
this year from January to September, 63 cases have been
reported by our doctors. The National Committee
Against AIDS chairman said that among Togolese AIDS
patients, there are more men than women. [passage
omitted]

UGANDA

Museveni Says 1.3 Million Infected With AIDS

EA0212185890 Kampala Domestic Service in English
1000 GMT 1 Dec 90

[Speech by President Yoweri Museveni at Kololo Air-
strip, Kampala, to mark World AIDS Day—recorded]

[Excerpts] Representatives of the World Health Organi-
zation, diplomats, fellow Ugandans: We in the National
Resistance Movement have fought many wars and most
of them we have fought successfully. I must, however,
admit that the AIDS war is the most insidious we have
had to fight, although I hope we shall ultimately win it. It
was decided very early after the establishment of our
administration that this monster, AIDS, be given a face
so that our people can recognize the monster immedi-
ately to enable them to run away from the scourge. We
therefore have pursued a policy of openness and candor
as far as AIDS is concerned. This, in our view, is the best

SUB-SAHARAN AFRICA 9

approach to the problem. So I will be as open and candid
as possible on this World AIDS Day, whose theme is:
Women and AIDS.

Today is World AIDS Day because AIDS is a worldwide
problem, but the statistics for our region, sub-Saharan
Africa, and particularly for our country, Uganda, are
depressing. Sub-Saharan Africa accounts for five million
of the estimated eight million cases of HIV infection
worldwide. Of the eight million people with AIDS in the
world, five million are in black Africa, what they call
sub- Saharan Africa, and 1.3 million are in Uganda. So of
the 40 or so black African countries, who all together
have got 5 million, we have got 1.3 million people with
AIDS infection.

In Uganda alone, as I have already said, more than |
million are carrying the virus and over 15,000 adults
have been reported to the hospitals as having AIDS.
Children are not spared either, and in Uganda 100
percent of all reported cases are children [as received]
between the ages of two and five.

The reported cases are merely the tip of the iceberg.
What is submerged and is unreported is even more
frightening. As I have said, 20,000 are reported, but
actually 1 million are infected—1.3 million. Now from
what I hear, there is indeed a war syndrome surrounding
the AIDS scourge. As in other wars, AIDS kills the most
productive segment of the population between [5 and 49
years. We can therefore never hope to develop and
prosper with a population of children and the aged.
AIDS has amongst other problems created the enormous
problem of orphans, orphans both of whose parents
invariably die within a short time of each other. In the
decade of the 1990s, 10 million children will be
orphaned in Africa.

Under normal circumstances our extended family struc-
tures were capable of absorbing these orphans, but not
any more, because few families have been left unscathed
in the AIDS-ridden areas. So the traditional system of
extended family, which used to care for orphans, can no
longer cope with this scale of orphans. In the past if
somebody died, then the brother would take over the
children and then the mother or father would be around.
But the scale is now too much for the traditional system
of caring for orphans, for they are too many and the
adults who are dying are also too many.

Furthermore, with growing urbanization, the extended
family has tended to succumb to the nuclear family due
to the nature of urban family economies which are
incapable of catering for the extended family. So the
extended family is itself under attack. It is no longer
there. It is succumbing to the Western nuclear family—
husband and wife and two children and a dog and a cat
[laughter]—because this is the system they have in the
West. In the West they are also losing. Even the nuclear
families are no longer there for the Western countries.
But for us our situation is not good at all.



JPRS-TEP-90-021
27 December 1990

The first AIDS virus carrier was reported in Seoul in
1986. Since then the number of the carriers has been on
the rise.

Of those infected with the deadly disease, four died and
three others moved to other cities.

A total of 108 people infected with the virus are now
under medical care of health authorities throughout the
country.

TAIWAN

AIDS ‘Increasingly Menacing’; Legislature Passes
Statute

OW0112032890 Taipei CNA in English 0257 GMT

1 Dec 90

[Text] The statute for the control of the Acquired
Immune Deficiency Syndrome (AIDS) passed its third
reading at the Legislative Yuan Friday.

The statute will take effect after it has been promulgated
by President Li Teng-hui.

The statute stipulates that those who knowingly pass
along the AIDS virus and infect others could be sen-
tenced to up to seven years in jail.

Foreigners staying here for more than three months,
under the statute, shall be forced to leave the country if
they refuse to take blood tests or if their blood tests
positive.

The National Health Administration hailed the Legisla-
tive Yuan’s action in passing the statute as the disease
has grown increasingly menacing to the general popu-
lace.

More than 150 AIDS virus carriers have been identified
in Taiwan since the first case was reported in October
1984.

For fiscal 1991, beginning July 1, 1990, public health
authorities have appropriated 60 million new Taiwan
dollars (some 2.2 million US dollars) for tests and
education.

THAILAND

Survey Shows 4,000 Prostitutes Carry AIDS Virus

BK1611025390 Bangkok THE NATION in English
16 Nov 90 p A2

[Text] A Public Health Ministry survey showed that
4,000 prostitutes are carrying the AIDS virus and con-
tinue to have sex with customers. Each prostitute, esti-
mated to have four customer men per night, is expected
to infect one out of ten customers. If the trend continues,
about 1,600 men are likely to be infected with the AIDS
virus each night, said Deputy Public Health Minister

EAST ASIA 19

Suthat Ngoenmun. He added that his ministry will
launch a campaign to discourage customers from visiting
prostitutes. .

200 Test Positive for AIDS Virus in Northern
Province

BK1611025590 Bangkok THE NATION in English
16 Nov 90 p AS

[Article by Khamphon Khotsema]

[Text] More than 200 people in Mae Hong Son have
been tested positive for AIDS, a situation considered
serious, the provincial public health chief official said on
Wednesday.

Dr Somphat Khotchasi told THE NATION that 208
people both hilltribes and low-land residents of the
northern province had been found to be infected with the
Acquired Immune Deficiency Syndrome.

Among the AIDS carriers, 68 of them were prostitutes,
64 of them men who used to frequent brothels and 52
intravenous drug users, Somphat said.

One of them was an eight-month-old boy who contracted
the virus from his mother during her pregnancy and died
from full-blown AIDS, Somphat said.

The doctor said the infected prostitutes are likely to
spread the virus to more men in the neighbouring
provinces of Chiang Mai, Chiang Rai, Lampang and
Lamphun as well as to tourists. Men then passed on the
virus to their families.

Somphat said Mae Hong Son public health officials have
found that only 29 of 68 HIV-positive prostitutes
remained in the province now.

He said most of the prostitutes in the five northern
provinces were likely to be transients, shuttling among
the provinces. They are likely to spend about 2-3 months
in each province before moving on, he added.

He said most of the women, now working in the sex
business in Mae Hong Son, are not natives to the
province. Some of them are illegal Shan immigrants
from Burma and many of them came from the other four
provinces, Somphat said.

He said while the prostitutes are likely to spread AIDS to
local residents in the five northern provinces, tourists
from other parts of the country can also spread the virus
to the women.

To prove that sex business servicing tourists also influ-
enced the spread of the disease in Mae Hong Son, the
doctor said 32 of the 68 infected prostitutes were
detected by the health officials while they were working
in Pai district. The district is a wellknown tourist resort
both for domestic and foreign visitors who enjoy trek-
king in the forest.



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SJPRS-TEP-90-021
27 December 1990 4 AIDS

SRI LANKA
XINHUA Told 28 AIDS Cases Detected /Beijing XINHUA, 1 Dec 90] . 25

SOVIET UNION

Two AIDS Cases in Armenia_ Yerevan International Service, 25 Nov 90]

International AIDS Seminar Ends in Alma-Ata /Olga Petrushel; Moscow TASS, 30 Nov 90]

Ulan Ude Couple Have AIDS /Sergey Trofimov; Moscow TASS, 3 Dec 90) ..
WEST EUROPE

AUSTRIA

Number of Deaths From AIDS Declining /Vienna WIENER ZEITUNG, 29 Nov 90]
FINLAND

AIDS Support Centers in Several Cities Close ...... 27
No Guarantees For Funding /HELSINGIN SANOMAT, 7 Oct 90] . 27
Ministry Official Comments /Minna Pantzar; HELSINGIN SANOM. 27
Cuba, Sweden Apply Strict HIV Anticontagion Rules
[Susanna Reinboth; Helsinki HELSINGIN SANOMAT, 16 Sep 90] .... . 28
ITALY
1991 AIDS Funding Program Approved [Milan ITALIA OGGI, 26 Sep 90] ....... . 31
AIDS Test Required for Police, Firemen, Soldiers
[Arnaldo D'Amico; Rome LA REPUBBLICA, 24 Oct 90] ...... . 3h
SPAIN
20 Percent of AIDS Prisoners Terminal {Madrid DIARIO 16, 26 Oct 90] ...... 32
SWEDEN
HIV-Infected Man Appeals Isolation Sentence /Stockholm DAGENS NYHETER, 16 Oct 90] +... 32

Wave of Goteborg HIV Cases Traced to Intravenous Drug Use
[Peter Sandberg; Stockholm DAGENS NYHETER, 14 Oct 90]
Europe’s First ‘Integrated’ Drug-HIV Hospital Ward

[Kerstin Hellbom; DAGENS NYHETER, 28 Sep 90] 33
Stockholm Hospital AIDS-Study Group Claims Advan
[Stockholm DAGENS NYHETER, 23 Oct 90] ....... 33
Infected With AIDS Through Blood Transfusion [Stockholm ‘NS NYHETER, 23 Sep 90] 34
Uppsala University to Establish AIDS Research Center
[Stockholm DAGENS NYHETER, 23 Sep 90] . . 34
Study: Youth Sex Practices Little Affected by AIDS Warnings
[Carin Stahlberg; Stockholm DAGENS NYHETER, 23 Sep 90] .... . 34
SWITZERLAND
Montreux AIDS Conference Findings Reported
[Michel Danthe; Geneva JOURNAL DE GENEVE, 2 Nov 90] .... . 35
UNITED KINGDOM
Chief Medical Officer Addresses London AIDS Parley
[David Fletcher; London THE DAILY TELEGRAPH, 20 Nov 90] .... 36



30 WEST EUROPE

the threat of obligatory isolation may lead to people’s
being unwilling to let themselves be tested for HIV.

“Is it better that 100 persons infected with HIV are
unknowingly spreading the disease than it is that one
person known to be HIV-positive is freely circulating
and spreading the disease?” Mansson asked. [passage
omitted]

Courts Ban Discrimination

The lessening of HIV-infected persons’ opportunities for
working and attending school has given rise to many
lawsuits in different parts of the world. In the United
States, for example, many public schools that refused to
accept HIV-positive children as pupils have been sued.

The first case involving the dismissal of an HIV-positive
worker tried in Finland ended in a victory for the worker
in the lowest level courts. Helsinki Municipal Court and
later the Helsinki Court of Appeals ordered a restaurant
to pay damages to an employee discharged because he
was infected with AIDS. The case is currently being
examined by the Supreme Court.

The restaurant justified its dismissal of the employee on
the grounds that it was protecting customers and other
employees. The court, however, noted that there is not a
single case on record in the world in which AIDS was
transmitted through food or as an airborne infection.
Thus, the court emphasized, the HIV-positive employee
did not constitute any danger worth noting to the other
employees and to customers.

Explaining the grounds for dismissal because of illness,
junior researcher Tarja Kroger of the University of
Helsinki thought that the dismissal of an HIV-positive
employee may be allowed if the employee poses a real
danger to either other employees, employers, or cus-
tomers.

According to Kroger, the employer must first try to
resolve the problem by placing the HIV-positive
employee in another position or by providing him with
means of protection. If this does not work, dismissal may
be legal.

“For example, a surgeon infected with HIV may pose so
great a risk to a patient that his dismissal may be
approved. However, a restaurant employer's fear of
losing customers does not constitute sufficient grounds
for dismissal; the danger must be real,” Kroger empha-
sized.

In addition to direct discrimination, AIDS has given rise
to indirect discrimination directed against the sex of the
subject. For example, an English airline company
refused to hire men for its passenger service crews
because, according to the company, homosexuality
among stewards—and thus also AIDS—is so common.

The airline justified its policy on the basis of the safety of
its passengers: In its opinion, homosexual men endanger
Passengers in an accident situation. In January 1987,

SJPRS-TEP-90-021
27 December 1990

English officials responsible for seeing to it that equality
is observed ordered the company to cease applying its
personnel policy, which discriminated against men.

Sweden’s Harsh and Homey Solution

Located on the outskirts of Stockholm, the hospital in
Danderyd is the last place in the world in whose back-
yard one might expect to find a Swedish rural idyll.
Behind the hospital’s colossal main building, however,
lies concealed a small, yellow wooden building that
seems to be standing there primarily because the bull-
dozer stopped at that point—or did so out of mercy.

Danderyd’s hospital building number 21 is like an ordi-
nary old woman’s cottage, with its well-tended garden
and homey curtains on the windows. A gray cat on the
steps was meowing for someone to let him in. Instead of
the sterile air of a hospital, the inviting smell of home
cooking floated in the air of the entrance hall.

The cat is one of the building’s three permanent resi-
dents. The others are two young women in compulsory
isolation on the basis of the law governing contagious
diseases. They had been picked up on Malmskillnadsga-
tan, in Stockholm’s red-light district, because they are
infected with HIV.

The purpose of the homey atmosphere is to make the
inconveniences of enforced isolation easier to bear. They
have made an effort to avoid the institutional atmo-
sphere of a hospital and a prison, and the house is indeed
like an ordinary home. The only difference is that one
cannot get out without the keys.

The inmates may move about freely inside the house, but
they are only allowed out in the company of two custo-
dians.

“This sometimes seems a bit troublesome to the girls,
and they feel that they are being watched; but that’s just
what they are—being watched,” the head of the unit,
Barbro Beck, remarked.

One of Beck’s charges has been in compulsory isolation
for over three years, since April 1987, and the other for
more than six months.

In Sweden they have been allowed for about four years to
isolate a person infected with HIV if he refuses to comply
with the provision of the law that he not continue to
spread the disease. The provincial court decides on
isolation. It can place a patient in isolation for a max-
imum of three months the first time, and after that the
term may be extended six months for each violation.

The Swedes are pretty much in agreement on the need
for allowing compulsory isolation, although foreign
human rights experts raise their eyebrows at the Swedes’
uncompromising stand. In the opinion of its critics,
Sweden’s ostensibly noble attempt to care for its [AIDS
victims] in compulsory isolation in a homey setting may
soon give way to stiffer measures.



16 CHINA

The symposium is sponsored by the Chinese Medical
Association and the People to People International Cit-
izen Ambassador Programme of the United States.

Scientists Develop New Type of Artificial Blood

0W2711181390 Beijing XINHUA in English
1532 GMT 27 Nov 90

[Text] Chinese scientists have developed a new type of
artificial blood, the “CHINESE SCIENCE NEWS”
reported today.

The new fluoro-carbon artificial blood was developed by
scientists at the Shanghai Institute of Organic Chemistry,
under the Chinese Academy of Sciences.

The scientists have made progress in the synthesis and
emulsification of the blood, analysis of its effects and its
toxicology.

The blood has proved successful in experiments with
animals, and will soon be put into clinical use.

According to the scientists, the blood will be free of
serum contamination such as the AIDS virus.

The scientists have begun to conduct experiments for the
clinical use of the blood and expect to produce it within
the next few years.

Health Officials on Measures To Control AIDS
Spread

0W0312114290 Beijing Television Service in Mandarin
1243 GMT 29 Nov 90 \

[Editorial Report] Beijing Television Service in Man-
darin at 1243 GMT on 29 November carries a 20-minute
program “AIDS—Its Trend To Spread Wide and Pre-
vention.” The program opens with a shot showing a
female reporter entering the gate of the Ministry of
Public Health office, while the narration states: “AIDS
was introduced into our country in the early 1980's. In
recent years, the disease has become widespread to a
relatively serious extent, and has become a severe epi-
demic in certain localities. With regard to this, we
interviewed Public Health Minister Chen Minzhang.”
Shots are then shown of his interview with the female
reporter.

When asked about the spread of AIDS in China, Chen
Minzhang said: “Since 1985, when the first AIDS case
was discovered in our country, and up to the present, we
have received reports on 446 cases of the disease. Of
these, five patients are showing symptoms. Two of the
patients are citizens of our country, while the other three
are from abroad. In the past, AIDS patients mainly came
from abroad, and very few were local people, that is, our
own people. But the situation has changed since last
year. Among the 446 cases, only 68 are from the outside,
while the remaining 378 cases are local people. This
deserves our great attention. Moreover, 368 of the 378

SJPRS-TEP-90-021
27 December 1990

cases have been found in certain remote areas in Yun-
nan. Though the geographic scope is limited, the influ-
ence of the disease is considerable. To prevent its spread,
we have taken a series of measures. In the cases found in
Yunnan, the principal channel of infection is the intra-
venous injection of narcotics. As a matter of fact, the
transmission of the disease in our country is through
sexual contact, blood transfusions, and intravenous
injection of narcotics. This information should be used
in educating people on how to prevent the disease. They
should be made aware that AIDS may be transmitted
through these channels.”

Then, with video illustrations, the narration explains
how the AIDS virus is transmitteed from one person to
another, stating what are and what are not possible
channels of its spread.

The next sequence of shots show the same reporter's
interview with Dai Zhicheng, director of the Department
of Health and Epidemic Prevention under the Ministry
of Public Health.

In response to the reporter’s question about China’s
AIDS research work and measures taken to monitor the
disease, Dai Zhicheng said: “All provinces, municipali-
ties, and autonomous regions in our country have started
AIDS monitoring work. The Ministry of Public Health
has set up three laboratories to test AIDS cases and give
final diagnoses. These three laboratories are the Virolog-
ical Laboratory of the Chinese Academy of Preventive
Medicine, the Shanghai Municipal Health and Epidemic
Prevention Station, and the laboratory in the Military
Medical Science Academy. Thus, an intial AIDS moni-
toring system has been established in our country. In the
first place, we have a reliable serological method for
AIDS diagnosis. Secondly, we have separated the virus
from clinical AIDS cases. The virus can be used as an
antigen for diagnosing the disease. In addition, we have
made progress in using herbal medicines to treat AIDS.”

Asked about the control measures the government has
introduced for AIDS carriers, Dai Zhicheng said: “They
should avoid abnormal sexual activities. In normal
sexual intercourse, it is necessary to use condoms. They
also should be prohibited from giving and receiving
blood. This will prevent the transmission of the disease
through blood and sexual contacts. This is the first
measure. The second measure is that close medical
observation will be kept on positive AIDS carriers. These
carriers often become patients after a period in which the
disease has been latent. It is imperative to observe them
closely so as to discover symptoms as early as possible
and isolate them according to the Law on Contagious
Diseases. This will prevent the spread of the disease in
our society.”

With regard to comprehensive efforts made to control
the disease, Dai Zhicheng said: “Like other veneral
diseases, AIDS is closely related to social activities. In
Western countries, AIDS is a disease that is very hard to
control. In our country, because of the superiority of our



22 LATIN AMERICA

COLOMBIA

Health Minister Says AIDS Cases Total 1,942

PA1012215090 Bogota Radio Cadena Nacional
in Spanish 1200 GMT 2 Dec 90

[Text] Health Minister Camilo Gonzalez Posso has
announced that the government will penalize hospitals
refusing to give adequate attention to AIDS victims,
with fines of up to the equivalent of 200 times the
minimum salary.

The measure was adopted after the Health Ministry
revealed that it has detected 1,942 AIDS cases.

The minister said that the most affected areas are
Bogota, Antioquia, Valle, Rizaralda, Santander, and
Caldas.

Minister Gonzalez Posso, saying that the situation is
worrisome, stated that 483 persons have died in
Colombia as a result of AIDS. He announced that severe
measures will be adopted to prevent and deal with this
terrible disease.

Gonzalez Posso said that his ministry has detected 1,942
AIDS cases, 928 of which are definitely infected victims
and 1,014 of which are carriers of the virus.

JAMAICA

Health Ministry Estimates Over 3,000 AIDS
Infections

FL2611154090 Bridgetown CANA in English
1537 GMT 25 Nov 90

[Text] Kingston—There were 180 reported cases of
Acquired Immune Deficiency Syndrome (AIDS) in
Jamaica up to the end of October, the national news
agency, Jampress, reported. So far, 110 persons here
have died of the incurable disease.

Jampress quoted Gene Grohall, a United Peace Corp
volunteer, as saying that based on Ministry of Health
estimates, at least 3,000 Jamaicans may be affected with
AIDS although not showing any visible symptoms. This,
he said, was the nature of the disease which was known
to remain dormant for up to five years before showing
any signs.

Pointing to the international implications of the disease,
the health educator noted that in the United States,
145,000 persons were sick and dying from AIDS, and an
estimated two million were infected without any mani-
fested symptoms, Jampress reported.

SJPRS-TEP-90-021
27 December 1990

PERU

Health Minister Reports 323 Confirmed AIDS
Cases

PY0712040090 Lima Television Peruana in Spanish
1800 GMT 5 Dec 90

[Summary] Health Minister Carlos Vidal Layseca
announced today that 323 AIDS cases have been con-
firmed in our country. He added that about 30,000
people throughout the country could have this disease.

ST. CHRISTOPHER & NEVIS

Government Unveils Anti-AIDS Action Plan

FL0312144590 Bridgetown CANA in English
1944 GMT 2 Dec 90

[Text] Basseterre, St. Kitts—St. Kitts-Nevis has put
together an action plan for combatting the dreaded
disease AIDS with the help of the World Health Organi-
zation (WHO), the Pan American Health Organization
(PAHO), and the Caribbean Epidemiology Centre
(Carec).

Health Minister Constance Mitchum, speaking in a
national broadcast to mark the observance of World
AIDS Day on Saturday, said the emphasis of the pro-
gramme was on increasing public awareness about the
disease. Knowledge was the only effective means cur-
rently available to combat the disease, said Mitchum.
The plan of action includes talks with schoolchildren,
lectures to various community groups and organizations,
counselling workshops, and the use of popular theatre.

“Everyone should therefore participate in obtaining
proper knowledge on the subject and pass it on to those
who do not know,” Mitcham said.

No figures have been forthcoming from the authorities
concerning the extent of AIDS in this twin-island Carib-
bean state, including the number of deaths. Mitchum
however urged citizens to be supportive and sympathetic
towards AIDS victims.

Government, she added, was doing its part by providing
free medical care. As part of efforts to combat the spread
of the disease, the government has also initiated a
condom distribution programme. Mitchum said the
country, with the help of the National Bank Group of
Companies, had acquired an AIDS testing machine for
use at the main Joseph N. France Hospital.

Health Officials Report 30 Diagnosed AIDS
Cases

FLO0312145090 Bridgetown CANA in English
1351 GMT 3 Dec 90

[Text] Basseterre, St. Kitts—S1. Kitts-Nevis health
authorities have reported 30 diagnosed AIDS cases to



18 EAST ASIA

HONG KONG

Center Planned for AIDS Victims

91WE0102 Hong Kong SOUTH CHINA MORNING
POST in English 21 Sep 90 p7

[Article by Helen Signy]

[Text] Hongkong’s first support centre for victims of
Acquired Immune Deficiency Syndrome (AIDS) is to be
established in the territory by World AIDS Day on
December 1.

Comfort Care Concern, set up about two years ago to
provide support for the terminally ill, is now reaching
out to AIDS victims due to a lack of support for patients
in Hongkong.

The chairman, Mrs Jane Tedbury, said the centre would
provide counselling and help for all AIDS patients in
Hongkong, which was lacking such services due to the
rare occurrence of the disease in the territory.

“Hongkong does not even appear in any of the statistics
anywhere for AIDS, but estimates are that there are
1,000 people, and the number of 2,000 has also been
bandied around,” she said.

“I think it’s going to explode, but we are in a very
advantageous position to be there when it does explode,”
she added.

Mrs Tedbury, who has researched AIDS help groups
overseas, said the organisers needed a permanent venue
in which to set up a support centre.

The organisation is also appealing for funds to establish
an office and a functioning day centre for meetings and
counsellor training.

She said the centre, which would cater for all AIDS
victims, their relatives and friends, would provide a
meeting place, support group, hot line, counselling, edu-
cation and support during the later stages of the illness.

The centre will train its own counsellors, in conjunction
with the Government AIDS Counselling and Health
Education Unit, in specific skills needed to treat the
delicate issue of AIDS, she said.

“They have a desperate need to be able to talk to
somebody and not feel it’s going to be a judgment in any
way.

“The greatest skill in dealing with someone with AIDS is
to just listen, hold their hand and accept whatever their
lifestyle is, as it’s not your business,” she said.

JPRS-TEP-90-021
27 December 1990

Over 5,000 Residents May Carry AIDS Virus

HK0212035490 Hong Kong SUNDAY STANDARD in
English 2 Dec 90 p 1

[Article by Stuart Becker]

{Excerpt] A leading Government expert says 5,000 Hong
Kong people may have the virus that causes AIDS, more
than 33 times the official estimated of 149.

Dr Patrick Li, of the AIDS Counselling and Health
Education Service at the Queen Elizabeth Hospital, said
this was a conservative estimate of how many people
might test positive for the Human Immuno-deficiency
Virus (HIV) which causes AIDS.

This was a more realistic figure than the official one,
according to which there are 149 “officially” diagnosed
HIV carriers and 43 with the full-blown AIDS disease, he
said.

Another AIDS expert, Dr Vincent Lam, predicted that
the number of HIV carriers would increase five-fold to
25,000 by 1995. This was also conservative.

“Assuming that AIDS in Hong Kong follows a similar
course to that of countries where it has been prevalent
since 1981, we can expect to see a substantial increase in
HIV-infected people, both male and female, adults and
children, over the next three to five years, with most of
these going on to develop full-blown AIDS in that time
span.

“This will mean that these carriers, their families and
friends, literally tens of thousands of individuals, will
have to come to terms with AIDS.”

If Hong Kong does not wake up to the problem, AIDS
will take the territory by surprise, according to a group of
volunteers, the Comfort Care Concern project.

The disease is spreading much faster among heterosexual
women than previously thought, according to Lam, vice
president of Comfort Care Concern.

The group used World AIDS Day yesterday to launch a
helpline, enabling Chinese and English speakers to make
confidential calls about AIDS. [passage omitted]

SOUTH KOREA

Number of Seoul AIDS Sufferers Reaches 31

SK0412020890 Seoul THE KOREA HERALD
in English 4 Dec 90 p 3

{Text] The number of Seoul citizens infected with the
AIDS virus totaled 31 as of the end of October this year,
compared to last year’s 15, according to the Seoul City
government yesterday.



—

SJPRS-TEP-90-021
27 December 1990

“Lace-curtained cottages have a tendency to gradually
become barbed-wire fences and barracks,” a Finnish
critic gloomily predicted.

The custodians at the hospital in Danderyd do not
unreservedly approve of enforced isolation, either.
Barbro Beck criticized the isolation law for being a law
[that discriminates against the patient’s] sex and social
class. She pointed out that, up to now, those who are in
compulsory isolation have been, with one exception,
young women who use heroin and sell themselves to get
drugs.

Beck is amazed at people’s simple-minded conviction
that prostitutes ought to take into consideration their
clients’ safety.

“Many men pay them more if a condom is not used,”
Beck pointed out.

According to Beck, the law is particularly aimed at “the
society’s regular clients,” those young people who have
for a long time been in and out of various institutions.
For example, one of Beck’s charges has been in the
custody of the society since she was a child.

To have someone placed in compulsory isolation, no
conclusive proof is necessary that the person to be
isolated is actually still infecting others with the disease.
“To have someone isolated, it is sufficient to have seen
the HIV-infected individual often enough on Malmskill-
nadsgatan,” Beck said.

Four HIV-positive persons are at present in isolation in
Sweden. Two of them are located in the hospital in
Danderyd, one is in Beckomberg near Stockholm, and
one—the only man in the group—is in prison for violent
behavior.

Compulsory isolation costs Swedish society only staff
expenses. For example, at the hospital in Danderyd, 17
custodians are employed to keep watch over the two
women in compulsory isolation.

It is anticipated that the need for compulsagy isolation
will grow at a steady rate with the rise in the number of
people infected with HIV. Sweden already leads the HIV
statistics for the Nordic countries with about 2,500
carriers of the disease, whereas, in Finland, for example,
about 300 cases of persons who have contracted HIV
have so far been confirmed.

ITALY

1991 AIDS Funding Program Approved

90M10026 Milan ITALIA OGGI in Italian
26 Sep 90 p 42

{Excerpt] Italy will launch its fourth AIDS research
project in 1991. The announcement was made by the
Higher Institute of Health after having published notifi-

cation of a competitive examination for Italian

WEST EUROPE 31

researchers. The same day the World Health Organiza-
tion revealed the first alarming results of research on the
diffusion of the disease among children, indicating that
by the year 2000, the number of seropositive children
could be 10 million as opposed to the current 700,000.
Funding for the 1991 research project will amount to a
total of 31 billion lire, 7 billion lire more than for the
current year. Funding for the first project in 1988 was 6
billion lire, 16 billion lire for 1989, and 24 billion lire for
this year. Research will be divided into seven sub-
projects: the psychological and psychiatric aspects of the
disease (1.5 billion lire); assistance (2.5 billion lire);
clinical medicine and therapy (5.2 billion lire), diagnos-
tics (3.2 billion); etiopathogenesis, that is, the basic study
of the AIDS virus and immunology, (14 billion), and
animal tests (1.8 billion lire). Research is coordinated by
Professor Giovanbattista Rossi, director of the virolog-
ical laboratory at the Higher Institute of Health.

All the proposals must be submitted by 1 October and
will be evaluated by a commission of 10 experts,
including two foreigners: Anthony Fauci, director of the
National Institute of Infectious Diseases in the United
States and Claude Griscelly, a world famous immunolo-
gist from the Paul Necher Institute of Paris. Of the 510
projects submitted last year, 262 received funding.

{passage omitted]

AIDS Test Required for Police, Firemen, Soldiers

91WE0061A Rome LA REPUBBLICA in Italian
24 Oct 90 p 24

[Article by Arnaldo D’Amico: “Mandatory AIDS Test
for Soldiers and Police. An Attack on Civil Rights”)

[Text] Carabinieri, policemen, firemen, members of the
armed forces, and the criminal police are the first classes
of workers in Italy who are obliged to submit to the AIDS.
test. The minister of interior explained the blood test will
be administered to all new recruits, regardless of branch
of service to which they will be sent, while personnel
already in service will be given the test only if there are
well-founded reasons.

The regulation, which also requires tests to detect the use
of narcotics, dates from 4 October, when a decree-law for
“increase in the staff of the personnel of the police
force,” was published in the GAZZETTA UFFICIALE.
Thus, the decree-law must be submitted to both Cham-
bers for approval. Meanwhile, in any event, as the final
sentences of the text recall, “it is now mandatory for
everyone to respect the law and see to it that it is
respected.”

Thus, inserted into a decree-law on the police force, the
mandatory test to identify the HIV virus in the blood
became mandatory for certain categories of workers
some days ago. The action escaped notice of all those
who, for various reasons, follow problems connected
with the illness, and also of the ministerial commission



JPRS-TEP-90-021
27 December 1990

nation’s educational system has not yet seen the urgency
of communicating to the youngest the sometimes mortal
risks of human sexuality.

ZIMBABWE

Health Workers Asked To Set Example

91WEOI09A Harare THE HERALD in English
16 Oct 90 p 1

[Excerpt] Between 350,000 and 400,000 Zimbabweans
are believed to be infected with HIV, the AIDS virus,
and all of them will be dead by the year 2000, the
ister of health, Dr Timothy Stamps, warned yes-
terday.

Speaking at the graduation of environmental health
technicians at Murewa Public Service Training Centre,
Dr Stamps said the scrouge of AIDS had to be faced, but
since there was no vaccine or effective treatment, pre-
vention was paramount.

He appealed to the health technicians to lead by example
in their fight against the disease. “I expect you all, not
only by your preaching, but also by your personal prac-
tice and lifestyles to be shining examples of the essential
need to stick to one partner, mutually, faithfully, for
life.”

Practice

Dr Stamps said there was need for a cultural revolution
in attitudes and practice with regard to sexual activity.
He feared that those who already had the virus would
transmit it to others through “promiscuous selfish
behaviour.”

“This is the fastest growing threat to our children, and to
our hard-won independence and peaceful development
in the country God has blessed us with,” he said.

He urged the graduates to persevere on whatever project
they established, and he called for the involvement of
local communities in environmental health schemes.

The minister was impressed by the health technicians’
achievements in providing safe water supplies and a
good sanitation programme. By the end of last year more
than 70 percent of the people had access to safe drinking
water while more than 20 percent had Blair toilets.
[passage omitted]

Ministry Requires Statistical Information on

91WE0109C Harare THE HERALD in English
30 Oct 90 p I

[Text] Medical practitioners will be required as from the
beginning of December to submit all statistical informa-
tion on AIDS, the minister of health, Dr Timothy
Stamps, said yesterday.

SUB-SAHARAN AFRICA 13

Addressing more than 20 doctors of the College of
Primary Care Physicians of Zimbabwe in Harare, Dr
Stamps said the “confidentiality” relationships that
bound doctors to their patients worried a lot of practi-
tioners when it came to AIDS.

“I intend, therefore, to make AIDS notifiable in terms of
the Health Act, in which case the patients name, date of
birth, sex, martial status, permanent address, district
and hospital of treatment will be required to be notified
to the administrators of health and to local authorities.”

He said the provision would eliminate the doctor’s
“dialectical liability” in the event of a patient saying a
doctor had no right to tell anybody else about the
patient’s condition.

Alarming

Giving an update of the number of AIDS cases in
Zimbabwe so far, Dr Stamps said a total of 5,086 cases
had been reported at the beginning of the 3rd quarter of
the year. The figures included those which had been
reported since 1987 when the AIDS awareness campaign
was launched.

However, the figure was alarming considering it was
1,952 more again that recorded for the 2d quarter and
3,454 more than the figures reported at the end of the Ist
quarter, said Dr Stamps.

Since 1985, the Blood Transfusion Service had reported
that a total of 388,286 blood donors tested positive for
the HIV virus. Projections indicated that these people
would die of AIDS within the next 5 or 10 years.

A disturbing phenomena which had surfaced as a result
of AIDS tests carried out on donated blood was the
alarming high proportion of schoolchildren testing HIV
positive. Many of these were between the age groups of
14 and 21.

Confidentiality

He said some doctors were concerned they could not give
proper notifications of AIDS cases they handled because
of the confidentiality required and the difficulty
involved in making a correct diagnosis.

Dr Stamps criticised some staff members at mortality
units housing AIDS patients who he said dressed with
double gloves like spacemen to prevent being infected by
the AIDS virus.

“We have to change such attitudes. There is no such
factor as a risk-free career or life. The aim is to minimise
the risk and not to be so apprehensive as to give further
burden to patients or give them additional fears.”

Importation of essential drugs by doctors and pharma-
cists under the open general import licence which was
due to go into effect on Monday as part of the trade
liberalisation programme has been ‘deferred, Dr Stamps,
announced later yesterday.



JPRS-TEP-90-021
27 December 1990

looking into the possibility that TB speeds up the
progress of HIV infection to fully blown AIDS.

SA doctors fear a second outbreak of TB may soon
follow the first as the disease is highly infectious and
spreads rapidly—particularly in poorer communities.

Deaths

Apart from the risk of passing on AIDS, each TB sufferer
can also infect half the people he or she comes into
contact with, according to a WHO report.

The report adds that, after a steady decline in TB cases in
much of Africa, the disease is on the rampage again and
health workers predict an “avalanche” of cases soon.

TB experts are talking about a “holocaust” and health
services are worried about how they will cope with the
flood of cases in the next few years.

Hennie Oosthuizen, the SA National Tuberculosis Asso-
ciation’s public relations officer for the Western Cape,
said there had already been a substantial increase of TB
in the area—traditionally the worst-hit in the country.

“We have some 5 deaths a day and 54 new cases reported
each day,” said Mr Oosthuizen.

Dr Theo Collins, the South African National Tubercu-
losis Association’s community education director, said:

“Between 12-million and 15-million people in this
country have dormant TB infections and may never
suffer from the disease. But, if they become infected with
the HIV virus, they stand a 99 percent chance of devel-
oping TB and then may pass it on.

“The major drugs used against TB are not effective in an
HIV patient because his or her immune system is unable
to do its part.”

The drugs inhibit the spread of the bacteria while the
immune system is supposed to do the rest in eradicating
it entirely.

Risk

Dr D. Dickson, director of the East London Blood
Transfusion Service, said vaccination against TB in
HIV-infected people will not work either.

He said the TB vaccine depended on the immune system
being intact for it to work. And, because it is a live virus
vaccine, there is a risk of the HIV patient becoming infected
instead of developing an immunity to tuberculosis.

Dr Collins said Santa was running a programme where
children with dormant TB infections were given drug
treatments until the bacteria is killed off.

Doctors consider him a good candidate for the expensive
treatment because his mum is punctual with her appoint-
ments.

SUB-SAHARAN AFRICA 5

“Given on a monthly basis, the serum keeps infection at
bay and Sipho is one of our healthier babies as a result,”
said Dr Friedland.

“But there is no cure. AIDS babies are like children who
are always sick.

“They have chronic symptoms of diarrhoea and enlarged
glands and their growth is stunted,” he said.

“They die when a bad attack of pneumonia strikes.

“Taking precautions is the only way to prevent AIDS, as
the virus is sexually transmitted,” he said.

“AIDS spreads because it has a long incubation period of
up to 10 years during which you yourself may not be sick,
but you can pass the virus on.”

AIDS Epidemic Spreading to Women, Children

91WE0123C Johannesburg SUNDAY TIMES
in English 11 Nov 90 p 12

[Article by Felicity Levine]

[Text] At least one AIDS-infected baby is being born in
South Africa every day—and most mothers are too
afraid to tell the fathers the truth.

At Soweto’s Baragwanath Hospital alone 300 AIDS
mothers have given birth this year. The figure last year
was 100.

AIDS expert Professor Ruben Sher said the only way for
South Africa to avert disaster was for victims to face the
truth and take proper precautions.

Angry

He estimated that | in every 150 women in PWV
townships could be infected, but so far there were no
infected white babies on record.

He said: “AIDS is spreading at an alarming rate because
people are promiscuous. Every time they move they take
the virus with them.

“We are in the acute stages now and people most stop
denying it.”

Official statistics give the number of children with AIDS
as only 69—but experts dismiss this figure as “the tip of
the iceberg.”

While unwilling to confirm the figures, specialists at the
hospital agreed that paediatric AIDS was on the increase.

Paediatrician Dr Ian Friedland, who heads the Barag-
wanath AIDS unit, said:

“We do not officially screen for AIDS and have no
means of keeping track of all the women who give birth
here.



28 WEST EUROPE

testing as well as the services of a psychologist, doctor,
social worker, and attorney. A sum of about 400,000
markkas was needed to continue operations for the
remainder of the year.

Pantzar: How is it possible that the support center was
allowed to stop functioning, interim office manager of
the Health and Social Services Ministry Arto V. Klem-
ola?

Klemola: The money to function has been provided by
the Bank Teller Machine Association [BTMA]. I do not
know why the BTMA did not give more funds to the
AIDS support center. We cannot give money directly.
The BTMA probably was not able to anticipate the
increase in AIDS cases. In my opinion, it should better
plan its use of funds in the future so that this does not
happen again. The work of the support centers should
not be allowed to stop.

Pantzar: What does the Health and Social Services
Ministry intend to do to maintain the support centers?

Klemola: We have presented the Cabinet with an esti-
mate of the needed additional funds. It is our recommen-
dation that the support center be granted approximately
as much money as it needs. The final decision on the
actual sum rests with the Cabinet and Parliament, how-
ever.

Pantzar: What will happen to the support center?

Klemola: If the Cabinet acts on the matter, I would think
the centers could begin working within two weeks. Funds
for their operation, however, would not be available
until December at the earliest.

Pantzar: Does the AIDS support center intend to resume
operations if the request for funds remains on the
Cabinet agenda, operations manager Outi Lithen?

Lithen: Yes. We would struggle on somehow then. The
most important thing is knowing that the money is
coming.

Pantzar: How much money have you requested for next
year?

Lithen: Five million markkas. That would be enough.
We are usually granted less money than we request,
however.

Pantzar: Does the support center intend to expand
operations?

Lithen: That depends on the financial situation. We have
had a request from Lahti about establishing a support
center there. The city has already found facilities for
operations, and operating funds have been applied for.
Every center must also have two continuously paid
workers because there is just too much work for one.

SJPRS-TEP-90-021
27 December 1990

Pantzar: The BTMA did not think the AIDS situation
was this serious. When the number of AIDS cases
increased this year, our funds no longer sufficed to serve
everybody.

Cuba, Sweden Apply Strict HIV Anticontagion
Rules

91WE0014A Helsinki HELSINGIN SANOMAT
in Finnish 16 Sep 90 p C4

[Article by Susanna Reinboth: “AIDS Destroys
Rights”—first paragraph is HELSINGIN SANOMAT
introduction}

[Excerpts] The world is protecting itself from the HIV
virus with laws, but there are few laws that protect
carriers of the disease from discrimination.

AIDS, the immune deficiency disease, is rocking the
Western conception of individual rights. Over the past
few years, a whole slew of special laws have been passed
in different parts of the world that allow carriers of the
HIV virus, which causes AIDS, to be isolated from the
rest of the society.

In a climate of general panic, Finland represents a
moderate approach—so far. It is, however, feared that
the way Finland is reacting will change once our AIDS
statistics reach the depressing level of those of other
Western countries.

“The situation is somewhat the same as with the ques-
tion of foreigners: As long as there were hardly any
foreigners, Finns appeared to be unbiased,” Public
Health Service director Veijo Raunio drew a compar-
ison.

Human rights expert Katarina Tomashevskiy of the UN
health organization, WHO, estimates that AIDS laws
were enacted in 51 different countries during the worst
years of the panic, from 1985 to 1987. In the United
States alone, 360 laws or regulations involving AIDS
went into effect.

Most of these laws impose obligations and prohibitions
on carriers of the disease. Among them there are also
laws the purpose of which is to prevent discrimination
against those infected with the virus—that is, those who
are HIV-positive, and AIDS patients. It has, however,
proved difficult to prevent discrimination because
public opinion has been constantly stiffening as the
epidemic spreads.

Because of people’s fear and suspicion, it has been hard
for those who are HIV-positive to keep their jobs and
homes, continue to attend school, or obtain treatment
for their disease. Those groups of citizens representing
the most uncompromising opinions even demand the
complete exclusion of individuals infected with HIV
from the society. Moral views associated with the disease
also add to discrimination against AIDS patients. There
is otherwise a tendency for society to discriminate



JPRS-TEP-90-021
27 December 1990

Spread of AIDS Follows African Pattern

91WD0202 Bombay THE TIMES OF INDIA
in English 29 Oct 90 p7

[Text] New Dethi (PTI)—A leading immunologist has
warned that the spread of AIDS infection in India is
showing striking parallels to the pattern in some African
countries devastated by AIDS.

“We're now most concerned about India because it
seems it has the greatest potential here to get out of
control,” Dr John Dwyer, professor of medicine at the
university of New South Wales in Australia said.

In an interview to PTI yesterday, Dr Dwyer who chairs
the AIDS society for Asia and Pacific, said a major
assault will be required to combat the spread of HIV, the
AIDS virus, which has already infected 250,000 in India.

Earlier this year the World Health Organisation
informed the Indian Council of Medical Research that
over 60,000 AIDS patients in India will require hospi-
talisation over the next five years.

Dr Dwyer said that the AIDS society for Asia and Pacific
would ask the Australian and Japanese governments to
fund the surveillance programme in India which is
expected to cost over $3 million over the next year.

But it is not feasible to have mass testing programmes in
a country of this size Dr Dwyer said.

WHO experts had informed the ICMR that at the
current rate of spread of the disease in India, by 1995
every third pregnant housewife in Bombay is likely to be
found infected with the AIDS virus.

ISRAEL

Statistics on AIDS Carriers, Victims Given

TA0212094590 Jerusalem THE JERUSALEM POST
in English 2 Dec 90 p 2

[Report by science and health reporter Judy Siegel]

[Excerpt] [passage omitted] World AIDS Day, held
around the world yesterday, is being marked today in
Israel. :

NORTH EAST & SOUTH ASIA 25

The Health Ministry says that 537 AIDS carriers have
been reported here since 1986; 129 Israelis have devel-
oped the full-blown disease in the past decade, and 79 of
them have died. Unless a cure is found, the carriers will
eventually develop full-blown AIDS themselves.
Twenty-five others have been diagnosed with only some
of the symptoms, and two of these have died.

Although the number of reported carriers has declined
substantially since 1986, experts believe that this is due
to decreased public awareness which. resulted in a drop
in the number of people who go for the voluntary, free
blood tests available at seven public hospitals.

The Israeli AIDS victims include seven women, four of
whom have died, and four infants who were infected at
birth or from breast- feeding. According to ministry
statistics, 29.4 percent of the carriers are homosexuals
and bisexuals; 20.9 percent drug abusers; 20.9 percent
hemophiliacs (the possibility of the AIDS virus being
present in the cloting factor they receive has now been
eliminated); and 4.7 percent heterosexuals. [passage
omitted]

SRI LANKA

XINHUA Told 28 AIDS Cases Detected

0W0112114990 Beijing XINHUA in English
1126 GMT 1 Dec 90

[Text] Colombo—Sri Lankan health authorities have so
far detected 28 AIDS cases in the island country, the last
one only a few days ago, bringing the figure for this year
to seven.

Sri Lanka Red Cross Society (SLRCS) national coordi-
nator K.D.C. Perera made the disclosure to XINHUA
this morning. He said that of the 28 AIDS cases tested
positives so far, seven are Sri Lankans and the others are
foreigners.

He said there are nearly 600 HIV-infected persons in Sri
Lanka moving freely in the community. They will
increase by leaps and bounds in the next two to three
years. A Buddhist country as Sri Lanka did not take the
problems seriously in the past few years, he noted.

Stressing that the AIDS infection multiplies in loga-
rithmic proportions, Perera said that the SLRCS’
planned program on AIDS aims mainly to educate a
socially accepted and communications-wise dynamic
segment of the population, so that they will be able to
influence a vast majority of the people towards safe sex
behavior, which is the ultimate solution for AIDS.



2 SUB-SAHARAN AFRICA

Medical Association on Child Marriage, Abortion

ABO712190890 Dakar PANA in English 1841 GMT
7 Dec 90

[Text] Accra—The week-long eighth congress of the Con-
federation of African Medical Associations and Societies
(CAMAS) ended in Accra Friday with a call on African
governments to seriously consider enacting legislation
against child marriage and to review all laws on abortion.
Ina four point resolution clearly aimed at curbing teenage
pregnancy and its attendant problems in Africa, the par-
ticipants held that adolescents on the continent are sexu-
ally active but have no access to contraception or do not
use them. The conference attended by some 14 African
medical associations was under the theme Health of the
Mother and Child in Africa.

The resolution noted that adolescent sexual behaviour
exposed teenagers to sexually transmitted diseases that
may compromise their future reproduction or result in
premature deaths. The doctors there urged African gov-
ernments to make provision for health services specifi-
cally for adolescent reproductive health needs.

In a separate resolution, the meeting recommended that
respective medical associations should work with their
governments to improve the educational and socio-
economic status of women. Members should improve
family planning services as well as referal systems which
have a bearing on the quality of maternal care.

The resolution said in order to make an impact on the
rural communities, emphasis should be placed on the
training and retraining of traditional birth attendants.
Medical associations should also incorporate compo-
nents of primary health care such as adequate food
supply, immunization and control of locally endemic
diseases in the safe motherhood strategy at all levels of
medical training.

KENYA

Ownership and Availability of Anti-AIDS Drug

£A3011123890 Nairobi KTN Television in English
1800 GMT 28 Nov 90

[Text] The minister for health, Mwai Kibaki, said today
that Kemron was developed by KEMRI [Kenya Medical
Research Institute], jointly collaborating with Amarillo
Cell Culture Company of Texas, and Hayashibara Bio-
chemical Laboratories of Japan. He said the drug’s
ownership has clear delineated roles played by the three
collaborators.

The minister was giving a ministerial statement in par-
liament on the ownership and availability of the drug.
He assured the members that Kemron would be avail-
able at a small cost. He said plans were under way for its
availability to provincial hospitals and other approved
institutions through KEMRI. Kibaki said that due to the

JPRS-TEP-90-021
27 December 1990

drug’s sensitivity it remained a restricted medicine. He
said it was still undergoing hospital-based clinical trials.

Health Minister on Resources Shortage, AIDS

EA0112125990 Nairobi KNA in English 1420 GMT
30 Nov 90

[Excerpts] The government predicts three years of
resources shortages brought about by the Gulf crisis and
increased fuel prices, which have continued to drain most
of the foreign exchange earnings. The forecast was made
today by the minister for health, Mr. Mwai Kibaki, when
he opened a one-day workshop on “Women, Children and
AIDS”, at the Kenyatta International Conference Centre.
The workshop, organised by the Kenya Medical Womens’
Association and sponsored by the National AIDS Control
Programme, also doubled as part of the activities orga-
nised to mark the World AIDS Day tomorrow.

The minister said that while the government will do
everything possible to carry out essential health pro-
grammes, he cautioned that some programmes might be
forced to delay until the resources stabilized. On AIDS,
the Acquired Immune Deficiency Syndrome disease, the
minister noted that there were 11,000 reported cases in
Kenyan hospitals and that 200,000 persons were esti-
mated to be HIV positive. [passage omitted]

The minister said that the government through his
ministry had succeeded in creating awareness of the
killer disease and called on Kenyans to check their social
habits which might lead them to contracting the disease.
[passage omitted]

Increase in AIDS Sufferers

ABO0212151990 Dakar PANA in English 1334 GMT
2 Dec 90

[Text] Nairobi—The number of AIDS sufferers in Kenya
has risen from 9,000 to 11,000 over a three month
period, the country’s health minister, Mwai Kibaki, said
Saturday. He said that the country now had over 20,000
HIV virus carriers and that people should take caution
since there was no way of telling who had the virus.

In a meeting to mark the World AIDS Day attended by
hundreds of Nairobi residents, Kibaki said that the
disease had permeated society and would continue to do
so unless everyone took part in the campaign against
AIDS. He said the World Health Organization (WHO)
projected that between 1.5 million and three million
women would die of AIDS in the 1990s and that women
AIDS sufferers would pass it on to their children, hence
the need for special focus on women.

The minister called on the society to show compassion
for AIDS orphans since they had no one to depend on.
These children belong to us, we must help them, provide
them in the true African tradition, he said.



IJPRS-TEP-90-021
27 December 1990

CAMEROON

205 AIDS Patients Undergo Treatment

AB04 12132090 Paris AFP in French 1458 GMT
I Dec 90

[Text] Yaounde—A support march for AIDS patients was
organized here today to mark the Third World Day on
AIDS, according to an official source in the capital. Two
hundred and five AIDS patients, 95 of whom are women,
are currrently undergoing treatment in Cameroon. The
rate of AIDS prevalence in the country is one percent, but
it has reached nine percent among prostitutes.

DJIBOUTI

Official Says 336 People Infected With AIDS

EA3011150190 Djibouti Domestic Service in Somali
1700 GMT 29 Nov 90

[Excerpts] According to Dr. Said Salah, 336 people have
been infected with AIDS. [passage omitted}

{Begin Dr. Salah recording] In Djibouti, the first AIDS
case was detected in 1987. So far, (212) [number indis-
tinct] people have died and 52 have been admitted to
hospitals as full-blown cases. [end recording]

GHANA

Radio on Rate of AIDS Propagation Since 1986

AB0412131290 Accra Domestic Service in English
1300 GMT 1 Dec 90

[Commentary by Asamoah Odei]

[Excerpts] World AIDS Day is designed to expand and
strengthen the worldwide efforts to stop AIDS. It means
talking about Human Immune Deficiency Virus, HIV,
infection, caring for people with HIV infection and AIDS,
and learning about AIDS to sustain and reinforce the
global effort to stop its spread. Since the killer disease was
first reported in the United States of America in 1981,
almost all countries worldwide have been affected by the
AIDS disease. Out of the 160 countries reporting to the
World Health Organization, 152 have reported at least one
case of AIDS with the cumulative total of 298,914 cases
being reported as of 2 November 1990. [passage omitted]

Ghana, like all other countries, has not been spared by
the AIDS pandemic. Available data indicate that many
more people are being affected by the killer disease. In
1986, 26 cases of AIDS were reported in this country,
while 35 and 266 cases were reported for 1987 and 1988
respectively. In 1989 alone [numbers indistinct] cases
were reported and preliminary analysis of data for 1990
indicate that the number of cases reported in 1990 will
exceed that of 1989.

SUB-SAHARAN AFRICA 1

In Ghana, although the transmission of the AIDS virus is
mainly through heterosexual contact, there is a female
preponderance of AIDS cases. In 1986, the male to female
ratio was as high as one is to eight. The ratio in 1989 was
one is to four, although men and women infected with the
AIDS virus face physical pain, psychosocial trauma, and
sometimes discrimination, AIDS presents additional prob-
lems for women. [passage omitted]

At present evidence suggests that between 25 and 35
percent of infants born to HIV-infected mothers will be
infected and most of these children will die before their
fifth birthday. Looking after such children is particularly
stressful for women, who are themselves infected with
the AIDS virus.

World AIDS Day today should be seen as a day to open
fully all channels of communication to strengthen the
exchange of information and experience, and to forge a
spirit of social tolerance. The challenge facing us is how to
reduce some of the adverse effects of AIDS on women. It is
imperative that women’s access to information about
AIDS be improved by mobilizing all women’s groups to
talk about AIDS. Men should also be encouraged to
support women in their efforts to protect themselves from
AIDS. In the long-term, an improvement in women’s
social, economic, and political status would alleviate many
of the AIDS-related problems which they face.

Government To House Indigenous AIDS
Treatment Shrine

AB0412122890 Accra Domestic Service in English
1 Dec 90

[Text] The government is to build a hostel at (Ngoase)
for AIDS patients at the Drobo Memorial Clinic. The
Brong Ahafo regional secretary, Mr. Owusu Acheam-
pong, announced this at Ngoase at a durbar to highlight
activities marking this year’s Apuor Festival at the
Kwaku Ofiri Shrine. During the celebration, the people
speak out freely without fear of victimization, against
any misdeeds by leaders during the year. This is meant to
make the leaders behave better in the coming year. Nana
Drobo announced that his clinic is entering into cooper-
ation with the Department of Pharmacy of the Univer-
sity of Science and Technology for research and devel-
opment of herbal medicine for the cure of breast cancer
and diabetes. He disclosed that since 1988, he has
successfully treated 45 people with the HIV virus who
had been tested positive by the Korle Bu and Okomfo
Anokye Teaching Hospitals. Eighty-five others with the
virus are now undergoing treatment at the center. Nana
Drobo said as a result of research and experience, the
treatment period for AIDS patients is now three months
instead of six months initially.



14 SUB-SAHARAN AFRICA

Options

“The implementation of the new regulations is being
deferred pending the conclusion of consultations that are
now taking place,” Dr Stamps said at a Press conference
in Harare. However, the drugs will still be obtainable
through the old system.

The consultations were being held to tighten up abuses in
the importation of drugs. Such abuses included the
importation of unregistered drugs, some of which were
much more expensive than locally available options.

Dr Stamps also said the imposition of contraceptives on
women for any reason was a contravention of humani-
tarian principles and warned that it was a possible
criminal offence.

He said that even HIV-positive or mentally ill women
should not be forced to take contraceptive pills.

17,500 AIDS Cases Expected by Year’s End

91WE0109B Harare THE HERALD in English
31 Oct 90 pI

[Text] Zimbabwe will have 17,500 cases of full blown
AIDS by the end of the year, the minister of health, Dr
Timothy Stamps, yesterday told the Mashonaland
Chamber of Commerce.

He said in the last 4 months, 11,461 tests had been
conducted in the country and 43 percent of these tested

JPRS-TEP-90-021
27 December 1990

negative, 19.4 full-blown and 30 percent had shown HIV
positive, including AIDS-related diseases like tubercu-
losis.

“One interesting observation is that the country’s north-
eastern and eastern border areas stand out as most
severely affected areas,” said Dr Stamps, at the cham-
ber’s general meeting.

He said a “great challenge” lay ahead in view of such
economic changes like the structural adjustment pro-
grammes to ensure that there was a minimisation of
effects of the transmission of the global scourge.

Dr Stamps said it was important that the government,
the private sector and all concerned be involved in
meeting this challenge.

Government Begins One Week Campaign Against
AIDS

MB2611071090 Johannesburg Domestic Service
in English 0500 GMT 26 Nov 90

[Text] The Zimbabwean Government has begun a one
week national campaign against AIDS.

Speaking on Zimbabwean television President Robert
Mugabe said the disease was seriously threatening Zim-
babwe’s future. Mr. Mugabe said 25 percent of the AIDS
cases in Zimbabwe involved children younger than five
and that most of the remaining cases concern people
aged between 20 and 40.

The Zimbabwean National AIDS Council has estimated
that half a million Zimbabweans are carrying the AIDS
virus.



4 SUB-SAHARAN AFRICA

at Camp Dial Diop, which houses the headquarters of the
Armed Forces. The equipment was provided by the World
Health Organization.

It will serve to disseminate preventive messages aimed at
combating the scourge, of which there are already 361
official cases, throughout the corps (gendarmes and
soldiers). No cases have been reported within the ranks.
Dr. Ibra Ndoye and physicican-commanders Lamine
Cisse Sarr and Souleymane Mboup, national coordi-
nator, president, and head of the sero-epidemiological
committee of the CNPS (National Social Welfare Fund)
respectively, attended the ceremony, as did a number of
army and gendarmerie superior officers.

As far as the Minister of Health and Social Development
and General Mansour Seck are concerned, preventive
habits are instilled very early in military recruits and
have existed for a very long time. The prevalence rate of
sexually transmitted diseases [STD] among soldiers in
Senegal is practically nil. There is confidence that not a
single preventable case is tolerated in the military. That
is true for STDs and many other illnesses.

General Seck pointed out that the health services of the
Armed Forces were totally available to effectively step
up and diversify informational and educational activi-
ties to prevent AIDS.

SIERRA LEONE

PANA Cites AIDS Statistics

AB0412194090 Dakar PANA in English 1357 GMT
4 Dec 90

[Article by Eve Langba]

[Text] Freetown—Sierra Leoneans have now accepted
the reality that the killer disease AIDS is steadily on the
increase in their West African nation.

As the country’s first lady, Mrs Hannah Momoh, was
launching the celebrations marking the 3rd World AIDS
Day Saturday, a total of 16 Sierra Leoneans had offi-
cially died of the disease, which was first heard of in
Sierra Leone in 1987.

At the time, the first case of a Sierra Leonean AIDS
patient was announced in a telex received in Freetown
from the country’s embassies in Bonn and Moscow. A
few days later, another telex was received from Interpol
that the victim was airborne and would arrive by Aero-
flot from Moscow.

As if the country faced an imminent invasion, the Sierra
Leone police and military were immediately put on
standby and the news was in all the local media.

This was how the problem of the killer disease AIDS
blasted its way into Sierra Leone, catching everybody,
including the government on the wrong foot. But the
panic quickly disappeared, as the government had to

JPRS-TEP-90-021
27 December 1990

take urgent measures to cope with sporadic cases of the
disease from various areas around the country.

According to statistics from the national AIDS com-
mittee, to date a total of 4,100 blood serum samples from
Prostitutes, homosexuals and heterosexuals have been
tested at the special AIDS laboratory at the Connaught
Hospital in Freetown. Out of these lot, 200 prove to be
positive while 35 others have already developed into
full-blown AIDS cases.

The national AIDS control programme, which started
operations in 1987, has already mapped out four priority
areas for the prevention and control of the AIDS disease
in Sierra Leone. These priorities are: establishing a
laboratory for HIV testing, an epidemiological survey,
health education and the development of a medium term
plan (MTP) for combatting the disease.

This programme has obtained support from the United
States Agency for International Development (USAID)
which is currently sponsoring AIDS control activities in
western and eastern Sierra Leone.

SOUTH AFRICA

Cabinet Approves Interdepartmental Committee
To Combat AIDS

MB2910133690 Johannesburg Domestic Service
in English 1100 GMT 29 Oct 90

[Text] A national interdepartmental committee for the
combating of AIDS has been approved by the Cabinet.

The minister of national health and population develop-
ment, Dr. Rina Venter, said in a statement in Pretoria
this step confirmed the government’s commitment to
make optimal use of the government sector in the fight
against the virus. The committee will include the
director generals of several government departments
who will be appointed by Dr. Venter.

The function of the committee will be to promote
programs to combat AIDS at all levels within the gov-
ernment and private sectors, to identify the role of
various departments and to coordinate and evaluate
Projects.

AIDS-Linked TB Epidemic Predicted

91WE0123D Johannesburg SUNDAY TIMES
in English 11 Nov 90 p 12

[Article by Terry van der Walt]

{Text] A wave of tuberculosis cases may soon swamp
South Africa after the discovery of a deadly link between
the bacterial infection and AIDS.

Already hospitals are dealing with increasing numbers of
AIDS patients who succumb to TB as their immune
systems collapse. The World Health Organisation is also



20 EAST ASIA

Somphat said the public health officials were trying to
slow down the spread of the deadly disease by giving free
condoms to prostitutes so that they would encourage
their customers to use them.

VIETNAM

No HIV Seropositive in Four Major Cities

BK0712161190 Hanoi VNA in English 1447 GMT
7 Dec 90

{Text] None of the 46,124 blood samples taken of
high-risk groups in four major cities in Vietnam has
proved to be HIV seropositive.

The confirmation was made at the National Workshop
on Vietnamese Women and AIDS held in Hanoi on
December | in response to World AIDS Day.

The workshop, jointly sponsored by the Vietnam
Women’s Union [VWU] and the World Health Organi-
zation (WHO) and UNDP [United Nations Develop-
ment Program], was attended by Nguyen Thi Dinh,
president of the VWU; M. Gonzalez, WHO. representa-
tive; and David Smith, UNDP resident representative.

The participants stressed the imperative need to coordi-
nate actions by concerned organisations and ministries

SJPRS-TEP-90-021
27 December 1990

for the implementation of a medium-term plan on AIDS
prevention and control. The 1991-93 plan, directed by
the National AIDS Committee headed by Health Min-
ister Pham Song, will focus on sentinel sero-surveillance
on high risk groups, on training of health workers, and on
the dissemination of information, education and com-
munication on AIDS.

Both M. Gonzalez and David Smith pledged to coordi-
i ii ig Vietnam carry out the
medium-term plan. In the initial execution of the plan,
WHO will provide Vietnam with 2 million U.S. dollars.

On November 27, a meeting was held in Hanoi jointly by
the Central Committee of the Ho Chi Minh Communist
Youth Union and the National AIDS Committee in
response to World AIDS Day.

The youth union’s plan of action in the prevention and
control of AIDS and drug abuse will focus on youths in
major cities like Hanoi, Ho Chi Minh City and
Haiphong.

Sharing the global concern at the rapid spread of AIDS,
the secretariat of the union worked out regulations on
AIDS prevention and control. It points out that little is
known about AIDS by the population, particularly the
youth, the prime target of this deadly disease.



| SPRS-TEP-90-021
27 DECEMBER 1990
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IPRS-TEP-90-021
27 December 1990

Johannesburg Leads Nation in AIDS Cases

91WE0123B Johannesburg THE STAR in English
16 Nov 90 p1

[Article by Shirley Woodgate]

[Text] The Johannesburg/Soweto area is the AIDS cap-
ital of South Africa.

Some 10,000 of the 100,000 people now infected with
the virus have been diagnosed, a report released yes-
terday by the Johannesburg City Health Department has
found.

But the killer disease’s epicentre appears to be moving to
Natal and Kwa-Zulu, according to senior deputy medical
officer Dr Nicky Padayachee.

Coinciding with the release of the report, Dr Padayachee
issued an urgent appeal for greater efforts by Govern-
ment departments to combat what he termed “the worst
epidemic to hit the world since the turn of the century.”

The report confirms findings that AIDS, which was
previously seen as largely a homosexual disease, has
shifted heavily into the heterosexual arena.

Up to the end of last year, two-thirds of the country’s
reported AIDS cases were transmitted by homosexuals,
mainly white.

However, a significant shift has occurred since the start
of 1990 when more than half the reported cases have
been transmitted by heterosexuals, mainly black.

The report states that in 20 years’ time, between 20 and
40 percent of the total black adult population may be
infected, depending on the availability of an effective
vaccine, new drugs and the scope of preventive health
education programmes.

Figures show that men account for nearly 80 percent of
all reported cases in the country.

Among whites, infected males outnumber women by 36
to 1, among coloureds by 3 to | and among blacks the
proportion is equal, the survey found.

Doubled

The average number of actual AIDS cases throughout the
country has doubled every year since 1982, when the
first two cases were reported.

Transvaal has the most cases, followed by Natal, the
Cape and the Free State, with the bulk of the cases
occurring in the biggest cities in each province: Johan-
nesburg, Durban, Cape Town and Bloemfontein.

“The SABC should seriously rethink its refusal to screen
condom advertisements, and more education at schools
level is essential in view of recent statistics from the
Cape showing 70 percent of high school pupils are
sexually active,” Dr Padayachee said.

SUB-SAHARAN AFRICA 7

The World Health Organisation has predicted that an
estimated 10 million infants and children in sub-Saharan
Africa will develop and die from AIDS by the year 2000.

Worldwide, an estimated 8 million people are infected,
of whom 5 million are in Africa, the International AIDS
Centre has said.

Government Cuts Funding for Fight Against
AIDS

MB2511120190 Johannesburg SUNDAY TIMES
in English 25 Nov 90 p 3

[Report by Felicity Levine: “R1.8m Is Slashed Off AIDS
Budget”)

[Text] The government is “shifting” funds allocated for
the fight against AIDS to other sectors.

Democratic Party health spokesman Mike Ellis yes-
terday disclosed that R{rand]1.8-million had been cut
from this year’s R5.4-million AIDS budget.

The money will be used for immunisation instead.

“I was told by senior officials at the Department of
National Health that they had run out of money for
immunisation,” said Mr. Ellis.

“They, too, are deeply concerned about taking funds
from the small amount allocated for AIDS.”

The R5.4-milllion AIDS budget covers:
—A national education programme,

—A surveillance project to estimate the numbers
infected;

—Research carried out by the National Institute of
Virology.

Johannesburg Health Department AIDS expert Dr.
Nicky Padayachee slammed the cut as “irresponsible”.

“Mozambique, one of the poorest countries in the world,
spends twice what we do on AIDS,” he said.

Government Says Fight Against AIDS ‘Absolute
Priority’

MB2711134890 Johannesburg SAPA in English

1234 GMT 27 Nov 90

[Text] Pretoria—The AIDS crisis in South Africa is
regarded as an “absolute priority” by the Department of
National Health and Population Development.

Reacting to earlier reports stating that R [rand] 1.8
million was cut from the AIDS budget, the department
said in a statement faxed to SAPA on Tuesday [27
November] no cutback of the budget is intended for this
year.



6 SUB-SAHARAN AFRICA

“Our conservative estimate is that at least 100 HIV-
positive women gave birth last year, and 300 this year.

“The figure could even be greater.”

Mothers are spreading the virus because they are afraid
to tell their husbands and lovers they are infected.

The plight of these women is pitiful as they watch their
babies die, knowing they are dying themselves.

This week young mothers who are out-patients at Barag-
wanath spoke of the agony of bearing their AIDS-burden
alone.

“When I am at home and my child is not ill, I forget we
are both dying. But, when she gets sick and I bring her to
the clinic, the nightmare starts again,” sobbed a 20-
year-old Alexandra mother.

“T breast feed even though it spreads the virus to my
child. If I stop, my husband will ask me why and I cannot
tell him we have AIDS.”

A beautiful 22-year-old Thokoza mum was shattered this
week when she was told she and her four-month-old baby
were HIV positive.

Gazing down at her doomed child, she said: “I have not
even told my husband...I just tell him the child is sick.

“He would be angry with me. My mother, who has a hot
temper, would beat me.”

The baby is undersized, has chronically swollen glands
and a cough.

She was admitted to Baragwanath a week ago with
pneumonia. Now she is well enough to be discharged
until the next bout of infection strikes.

Dr Friedland said 11 children and their mothers were
under his supervision.

“The number varies because many never come back
once they are diagnosed positive,” he said.

“Denial is a key reaction and getting them to tell their
husbands or take precautions is extremely difficult.”

Despite high-profile education campaigns, township
men are still reluctant to take precautions.

Few people have changed their lifestyles and many men
readily admit to having more than one partner.

A recently-diagnosed HIV-positive single mother from
Soweto considers herself lucky because she does not have
to tell her boyfriend they and their baby have AIDS.

“He was killed in a gun-fight in Soweto last month, so I
don’t have the problem of telling him,” she said.

The 18-year-old woman decided it was preferable not to
have sex rather than take precautions.

JPRS-TEP-90-021
27 December 1990

“I cannot ask a man to wear a condom. He will be
suspicious,” she said.

The single mother has just recovered from an attack of
tuberculosis. Baby Sipho receives monthly shots of intra-
venous anti-bodies at Baragwanath to boost his immune
system.

Soweto Launches Campaign to Fight AIDS

91WE0123A Johannesburg THE CITIZEN in English
15 Nov 90 p 15

[Text] A new campaign to combat AIDS in Soweto
would involve the whole community, particularly
women, said the Medical Officer of Health for Soweto,
Dr Ngokoana Khomo.

She said this year had been declared the Year of the
Woman and AIDS by the World Health Organisation
and that the SA Department of Health had initiated the
Soweto campaign via a letter from the Minister of
National Health, Dr Rina Venter.

Dr Khomo announced that church groups, youth organ-
isations, teachers, nurses and traditional healers (sango-
mas) would be involved in the campaign.

Awareness

She said health education, in the forms of awareness,
dissemination of knowledge and motivating changes in
people’s lifestyles, was of prime importance.

Dr Khomo said women were responsible for the physical
and moral upbringing of their children and by involving
them in the AIDS campaign, and she hoped to cut off the
spread of the disease through paediatric infection.

At the same conference, Dr Paul Vorster of the Depart-
ment of National Health, said that World AIDS Day
would be on 1 December and extensive planning was
already in hand for South Africa’s participation.

Fatal

He said the disease was fatal because it was incurable
and no vaccine was available.

The latest statistics show 229 South Africans have died
of AIDS from 499 cases reported since the disease first
appeared in 1982. .

The figures showed that since the first two cases were
reported in 1982, the number had increased by 259
homo/bi-sexual, 176 heterosexual, 14 haemophiliac, 17
blood transfusions, 32 paediatric and | intravenous drug
abuse case.

There had been a marked increase in heterosexual cases
since 1989 while homosexual incidences had dropped
dramatically from its 1989 peak.



SPRS-TEP-90-021
27 December 1990

AUSTRIA

Number of Deaths From AIDS Declining

AU2911095190 Vienna WIENER ZEITUNG
in German 29 Nov 90 p 7

[Text] While the number of new AIDS cases continues to
increase strongly all over the world—about 300,000
cases are registered at the WHO—Austria shows a dif-
ferent trend.

In particular since last year the number of new cases and
deaths has declined, the Health Ministry reported on the
occasion of World AIDS Day on 1 December.

On the other hand, parallel to the international develop-
ment, the proportion of women infected with HIV is
increasing.

Last year 139 new cases were treated in Austria, 54
people died. This year, however, “only” 108 new AIDS
patients were registered by 5 November 1990—this is
the relatively “positive” trend. “Only” 26 deaths were
reported. In total, there have been 486 cases of AIDS in
Austria so far; 248 people died (by 5 November).

It is assumed that about 6,000 to 8,000 people are
infected with HIV in Austria. The proportion of the
individual groups of persons is clearly shifting toward
heterosexual contagion or infection through the use of
nonsterile syringes and needles.

Says Dr. Helga Halbich of the Health Ministry: “The
majority of HIV infections in women can be traced back
to drug addiction or to heterosexual contacts with drug
addicts.”

FINLAND

AIDS Support Centers in Several Cities Close

No Guarantees For Funding

91WE0027A Helsinki HELSINGIN SANOMAT
in Finnish 7 Oct 90 p 8

[Unattributed article: “Lack of Money Will Force the
Closing of the AIDS Support Centers on Monday”}

[Text] Support centers for AIDS patients will have to
stop functioning on Monday because they have not
received guarantees of funding for the remainder of the
year. This break in operations will affect support centers
in Turku, Tampere, Kuopio, and Oulu, in addition to the
one in Helsinki.

The support centers gave notice of their financial diffi-
culties already last spring. At the beginning of September
they announced that, unless guarantees of funding for
the rest of the year are received by the end of September,
their operations will cease.

WEST EUROPE ra

The total amount of funding for this year is about 2.2
million markkas, but the amount needed to provide full
service is between 4 and 5 million markkas, according to
Outi Lithen, operations manager of the AIDS support
center. There have been negotiations for additional
funding with the city of Helsinki and the Health and
Social Services Ministry.

“The Health and Social Services Ministry has recom-
mended that money be set aside in the supplementary
budget. If funding is granted, we can resume operations,
possibly in late October. Our operations would also
continue if someone would donate approximately
400,000 markkas. With that kind of money, we could
struggle on until the end of the year.”

No money can be expected from the city of Helsinki
because, a week ago, city manager Raimo Ilaskivi trans-
ferred the matter back to the board of health and
recommended that the board deal with the matter as one
of its own problems.

The primary source of funds for the AIDS support
centers has been the Bank Teller Machine Association
[BTMA]. In addition to this, the communities in which
the centers are located have provided support. The
BTMA is not able to give additional funds in the middle
of the year, however.

Services offered by the AIDS support center include, in
addition to HIV antibody testing and open telephone
lines, the opportunity to consult a doctor, psychologist,
psychiatrist, social worker, or attorney.

All services are free of charge to the patient. In addition,
a person facing a crisis can find a support person for
himself, and various therapy groups also offer psycho-
logical support.

The closing of the centers on Monday means that all of
the functions of the centers will cease. Persons phoning
the center will be told about compensatory services
offered by society.

The open phone lines of the AIDS support centers
handled about 12,000 calls last year, and the number is
ever increasing.

Ministry Official Comments

91WE0027B Helsinki HELSINGIN SANOMAT
in Finnish 9 Oct 90 p 5

[Interview with ministry official Arto V. Klemola and
AIDS support center operations manager Outi Lithen by
correspondent Minna Pantzar; place and date not given:
“AIDS Support Center Ran Out of Funds?”]

{Text} At the present time, the AIDS support centers
cannot offer their services because they closed their
doors on Monday due to the lack of funds. The centers
have proved their need because they handle about
12,000 phone calls a year on their open phone lines.
Their range of services also included HIV antibody



26 SOVIET UNION

Two AIDS Cases in Armenia

NC2711142690 Yerevan International Service
in Armenian 1630 GMT 25 Nov 90

[Text] Proceeding from the decision to implement the
USSR law on the prevention of AIDS, the Armenian
Republic’s Council of Ministers has passed a decision on
measures for the social protection of AIDS victims.

The decision stipulates that a state pension is to be
granted to those victims aged 16 or below. The pension
will be set at the lowest wage level. Privileges will also be
accorded to one of the parents looking after such young
victims.

An ARMENPRES correspondent asked Mayrapetyan,
Armenia’s deputy health minister, if AIDS poses a real
danger in Armenia.

Mayrapetyan replied: I can assure you that no such
danger exists. So far only two carriers have been found in
Armenia. One of them was a foreign student and the
other was a citizen of ours who had served in Africa.
Neither of them exhibits the clinical symptoms of the
disease. We have carried out 600,000 blood tests over
the last three years and no trace of the disease was found.
Therefore, in practice this tragic disease does not exist in
our republic. Nevertheless, the government's decision is
an important undertaking and aims at preventing the
disease and—God forbid—at ensuring the social protec-
tion of the afflicted in the event of an occurrence.

International AIDS Seminar Ends in Alma-Ata

LD3011131790 Moscow TASS in English 1259 GMT
30 Nov 90

[Article by correspondent Olga Petrushel]

[Text] Alma-Ata—An international seminar on the
activity of nursing staff in the prevention and combat-
ting of HIV-AIDS has ended in the capital of Kaza-
khstan.

Specialists from the World Health Organisation (WHO)
and the WHO European Regional Bureau held the

IPRS-TEP-90-021
27 December 1990

seminar in Moscow, for nearby regions, and in Alma-
Ata, for Central Asian republics, Kazakhstan and Tran-
scaucasia.

“We have arrived at a pessimistic conclusion: Children
in the Soviet Union become infected with the AIDS
virus more often than adults,” Elizabeth Stussi, staff
member of the WHO European Regional Bureau, told
TASS.

“This happens because the country’s hospitals are poorly
provided with the necessary instruments. There is a lack
of the most elementary thing—disposable syringes—and
medical personnel are not aware of the danger of the
disease that has been recorded already in 150 countries.

“Forty-eight AIDS patients and about 600 people
infected with the AIDS virus, including 270 children,
have been registered in the Soviet Union.

“Medical forecasts are that if people strictly follow the
Tules of fighting the disease, there will be about 700,000
HIV-infected people in the Soviet Union by the year
2000. Otherwise, the number will grow far more sharply.

“In one year’s time we shall visit the Soviet Union again
to analyse work done, and it will become clear then
whether medical specialists in the Soviet Union have
been able to protect people from the ‘20th century
plague”, Stussi said. »

Ulan Ude Couple Have AIDS

LD0312123490 Moscow TASS in English 1218 GMT
3 Dec 90

[By TASS correspondent Sergey Trofimov]

{Text] Buryatiya, a Soviet republic incorporated into
Russia, in Eastern Siberia, is the latest region to be hit by
the AIDS virus.

A married couple in the republican capital Ulan Ude
have been diagnosed as having the acquired Immune
Deficiency Syndrome (AIDS). The two contracted it
abroad through promiscuity.

“A faulty diagnosis is out of the question,” Valeriy
Varnaukov, head of the national anti-AIDS centre, told
TASS.

“It has been confirmed by repeated blood tests that were
screened both in Ulan Ude and Moscow,” he said.



JPRS-TEP-90-021
27 December 1990

MALI

100 AIDS Cases During First Week in 1990

AB0512102890 Bamako Domestic Service in French
1500 GMT I Dec 90

[Excerpts] The international community is celebrating
the third World AIDS Day today under the theme:
Women and AIDS. Following is an excerpt of the state-
ment of Dr. Abdoulaye Diallo, minister of public health
and social affairs.

[Diallo recording] Why AIDS and women? According to
WHO reports, during the first 10 years of the disease
about 500 cases of AIDS occurred in women and chil-
dren. According to the same source, in the 1990's the
disease will claim at least 3 billion additional victims
within the same group. [passage omitted]

In Mali, out of 100 patients counted in the first week of
1990, 34 are women, 56 percent of whom are between
the ages of 20 and 39. It seems important to me to
emphasize here that the impact on women is not only a
matter of figures. This disease affects them because of
their various social, economic, and family roles. [passage
omitted] [end recording]

MAURITIUS

AIDS Reportedly Under Control; Prevention
Stressed

91WEO0099A Port Louis LE MAURICIEN in French
10 Nov 90 p 4

[Article by Jean-Marc Poche: “AIDS: Situation Is Under
Control But The Country Is Still Vulnerable”; first
paragraph is LE MAURICIEN introduction; italicized
words published in English]

[Text] Although the AIDS situation is under control in
Mauritius, the country remains highly vulnerable, said
the vice-prime minister and minster of health Dr. Prem
Nababsing during a press conference yesterday.

Dr. Nababsing explained that Mauritius was a tourist
country and, as a consequence, was very open to for-
eigners. Contacts with visiters are increasing because
Mauritians are traveling more and more. Such a situa-
tion requires that responsible Mauritian authorities be
constantly vigilant.

Dr. Prem Nababsing introduced the press to a WHO
delegation, headed by Dr. Astrid Richardson, currently
in Mauritius to evaluate the AIDS awareness campaign.

The minister explained that Mauritius had received
WHO aid as part of a global aid program initiated by the
organization in 1987. Because for now the disease
cannot be cured by any medication, prevention must be
stressed. A short-term program was carried out between
August 1987 and December 1988. A medium-term pro-
gram was begun in 1989. The WHO delegation now in

SUB-SAHARAN AFRICA 3

Mauritius is charged with assessing the plan and making
appropriate suggestions to improve it.

WHO’s representative Sir J. Fareed, for his part, under-
scored the political will of the government, which totally
supports the AIDS awareness campaign. The virus, he
said, is rapidly spreading in the world and today affects
some 280,000 people, 95 percent of them young and of
middle age. The situation is becoming more complicated
with transmission “from mother to child”.

Dr. Astrid Richardson was extremely pleased with the
work done in Mauritius and the way the program is being
executed. If the effort continues, Mauritius will be able
to be used as a model “for the low prevalence of AIDS.”

As Dr. Chan Kam, head of the Mauritian prevention
campaign, emphasized, 10 cases of seropositive individ-
uals have been officially reported in Mauritius, five of
them fatal.

NIGERIA

Health Minister Reports 500,000 AIDS Patients

AB2711181790 Paris AFP in French 2049 GMT
23 Nov 90

[Text] Lagos—Nigerian Health Minister Professor
Olikoye Ramsome Kuti said at a news conference here
today that some 500,000 people have been infected by
the AIDS virus in Nigeria, adding that 20 percent of
prostitutes in Lagos are HIV positive, according to a
survey conducted by specialists. The minister said that
his ministry made a point of publishing these figures in
order to create awareness among the population on the
spread of the disease in Nigeria.

The Nigerian minister explained that the factors contrib-
uting to the spread of the virus include: the existence of
“professional blood donors” who donate their blood in
exchange for sums of money; prostitution; and the dif-
fusion of infected blood. According to eyewitness
accounts received by AFP, blood donors roam about
government hospitals selling their blood to needy
patients for 100 to 200 naira ($20) a liter.

SENEGAL

No AIDS Cases Reported in Armed Forces
91WE0066A Dakar LE SOLEIL in French 4 Oct 90 p 5

[Article by F. Diaw: “Audio-Visual Materials for the
Soldiers”)

[Text] The Minister of Public Health and Social Develop-
ment Mr. Assane Diop and the Air Force Division General
and Chief of Staff of the Armed Forces Mansour Seck,
attended a ceremony marking the arrival of an important
shipment of audiovisual materials from the National Anti-
AIDS Committee to the Armed Forces Medical-Social
Service. It took place late Tuesday morning 25 September



JPRS-TEP-90-021
27 December 1990

socialist system, we can take comprehensive measures to
control it. For example, an antipornography drive is
being developed throughout the entire society. I believe
that this is an effective measure for eliminating AIDS
and other veneral diseases. It is imperative to firmly ban
such unhealthy or criminal acts as prostitution, visiting
prostitutes, and using drugs. Also, it is necessary to enact
legislation to ban them. This is the radical way to
eliminate the soil for growing AIDS. Finally, I wish to
take this opportunity to call on the public in society and
all public health and medical workers to properly and
scientifically deal with AIDS patients and positive AIDS
carriers. They should not discriminate against and for-
sake these people, but should exercise revolutionary
humanism. As seriously harmful as this disease is, AIDS
can be prevented from a scientific viewpoint.”

The program ends with a shot of the reporter at the
entrance of the Ministry of Public Health office. She calls
for strengthening propaganda and education in an effort
to prevent the spread of AIDS.

Beijing Holds Forum Marking AIDS Awareness
ay

HK0612122390 Beijing RENMIN RIBAO in Chinese
30 Nov 90 p 3

[Report by Ai Xiao (5337 4562): “Beijing Medical
Circles Hold Forum on ‘AIDS Awareness Day””’}

[Text] A forum on AIDS prevention in China was held
today in the Great Hall of the People. It was attended by
medical specialists and presided over by Dr. Qian Xin-
zhong, member of the Central Advisory Committee and
chairman of a world sexual disease and AIDS fund. The
specialists reached a common conclusion: Under the
conditions that effective treatment and vaccines are not
yet available, propaganda and education aimed at pop-
ularizing knowledge of disease prevention and elimi-
nating panic, should be put on a priority position.

The Ist of December is “AIDS Awareness Day.” This
year, the topic for AIDS Awareness Day is “Women and
AIDS.” According to a World Health Organization
[WHO] report, since man recognized and diagnosed the
first AIDS case in 1981, up to 31 October this year, more
than 298,000 people in 157 countries or districts have

CHINA 17

suffered from AIDS. Up to now, at least 8 million people
in the world have been exposed to the HIV virus, and
one-third of them are women; what is more unfortunate
is that it has been clinically proved that about 50 percent
of their babies will contract the virus. Most of these
innocent babies will die before the age of five. In its
worldwide planning against AIDS, WHO has made it
clear that it will seek cooperation with women’s organi-
zations, help prevent AIDS with them, and resolutely
support their demand for protecting themselves.

Chen Muhua said in her speech: The problem of
“Women and AIDS” involves various quarters of
society, and should arouse concern from the public. The
All-China Women’s Federation is cooperating with
public security organs, civil administration departments,
and health departments to integrate AIDS prevention
with cracking down on drug smuggling, drug addiction,
and prostitution.

The specialists pointed out: Other than the transmission
channels, such as intravenous drug injection and blood
transfusion, the problem of transmission through sexual
contact cannot be ignored. In Yunnan Province, two
men have been tested positive to the HIV virus; their
wives have also tested positive to the virus; and this
indicates that sexual contact as a transmission channel
has become a realty in our country.

Chen Minzhang said: In the past five years, our country
has tested 325,375 blood samples, and found 446 people
positive to the virus, among them five were diagnosed
AIDS patients. However, we should say that the domain
for monitoring is very small and is far from satisfying the
monitoring requirement. It is hoped that this work will
be supported by various quarters of society. At the same
time, whatever is linked to AIDS, such as antidrug,
campaigns, sexual disease prevention, Hepatitis B pre-
vention and treatment, etc., should be combined for
overall consideration, so as to develop topical research
and carry out comprehensive rectification.

Dr. Keirn {Ji En 1015 1869}, WHO representative in
China, also made a speech. A letter from Ji Pengfei was
also read at the forum. Well-known scholars and experts
such as Fei Xiaotong, Zhu Jiming, and Wang Aixia
attended the forum.



34 WEST EUROPE

patients. The hope is that the substances will strengthen
the immune system. So far tests on a few patients have
had promising results.

“We are happy about our progress. We have probably
succeeded in producing just the ‘right’ antibodies to
stimulate patients’ failing immune defenses,” said Pro-
fessor Britta Wahren of the National Bacteriological
Laboratory.

She heads the research group that tested the substances
on seven patients at Soder Hospital in Stockholm.
According to SVENSKA DAGBLADET an American
pharmaceutical company has purchased the so-called
monoclonal antibodies from Sweden for possible mass
production.

Infected With AIDS Through Blood Transfusion

91WE0064C Stockholm DAGENS NYHETER
in Swedish 23 Sep 90 p 5

{Report by Press Wire Service, Inc. (TT)]

{Text] Goteborg (TT}—A man from western Norway will
receive 1 million Norwegian kroner in damages after
being infected with HIV as a result of a blood transfu-
sion. Following a traffic accident the man was given
HIV-Positive blood at Haukeland Hospital in Bergen in
1985.

The Bergen Municipal Court felt the hospital’s lack of
supervision is a threat to patients. Thus the large com-
pensation is regarded as justified for preventive reasons,
according to GOTEBORGS-POSTEN.

The court also said the large sum was motivated by the
fact that HIV infection is regarded as a 100-percent
disability.

Uppsala University to Establish AIDS Research
Center

91WE0064B Stockholm DAGENS NYHETER

in Swedish 23 Sep 90 p 5

[Report from News Wire Service, Inc. (TT)]

[Text] Uppsala University will establish a center for
research concerning AIDS and sexually-transmitted dis-
eases in accordance with a decision made by the vice
chancellor. The center will be led by a committee con-
sisting of five or six members.

It will coordinate research carried out by various univer-
sity institutions and hospitals—including those in other
countries—and strengthen education in the area.

Representatives of other relevant sciences will be eligible
to participate in an advisory group associated with the
center.

IJPRS-TEP-90-021
27 December 1990

Study: Youth Sex Practices Little Affected by
AIDS Warnings

91WE0064A Stockholm DAGENS NYHETER
in Swedish 23 Sep 90 p 5

{Article by Carin Stahlberg: “HIV Campaign Not
Reaching Students”—first paragraph is DAGENS
NYHETER introduction]

[Text] Students lead a riskier sex life than young people
the same age who are not attending a university. A study
in Uppsala shows that a third of them had intercourse
with a new partner in the past year without using a
condom.

“The results of our study are disturbing. The campaigns
to prevent the spread of HIV have obviously had little
effect on students,” said midwife Tanja Tyden of the
Student Health Service in Uppsala.

She was the one who proposed a research and informa-
tion project concerning students’ sex practices which was
carried out by the Akademiska Hospital’s women’s clinic
in cooperation with the Student Health Service.

Some 343 students who visited the Student Health Clinic
answered a questionnaire concerning their sex practices.
Another 60 students were interviewed on their attitudes
toward sex. The final results will be presented at the
medical conference in Alvsjo in December but Tanja
Tyden and physicians Cecilia Bjorkelund-Ylander and
Sven-Eric Olsson have already published a partial report
in the latest issue of LAKARTIDNINGEN.

More Than Three Partners

Of 102 male students questioned with an average age of
24, 21 percent said they had had more than three
partners in the past year. In the last 12 months 30
percent of the students had had intercourse with a new
partner without using a condom and over half of them
said they had had intercourse “the first night” without
using a condom.

“The explanation for the young people’s behavior is that
it takes time to change sex practices. It is not accom-
plished overnight or, rather, in three years. After all, the
AIDS campaigns started in earnest in 1987,” said Tanja
Tyden, who is somewhat critical of the AIDS delega-
tion’s campaigns.

“To succeed with a campaign one must find out what the
students know, what attitudes they have and how they
behave. First then can one try to reach them.”

The partial report also shows that the students were
almost 18 years old when they had their first sexual
experience and that they had had an average of eight
partners.

Some 40 percent reported that they had had intercourse
they regretted afterward because they had not been sober



SJPRS-TEP-90-021
27 December 1990

and more than one in five students had had at least one
sexually-transmitted disease.

“The students know a lot about HIV and AIDS but they
do not think it concerns them. They frequently reason as
follows: If I sleep with another student I don’t run much
risk of being infected with HIV. They don’t think stu-
dents who live in student areas in Sweden have HIV or
might get it,” Tanja Tyden explained.

Many Take Chances

“We don’t want them to be terrified of AIDS but they
should be aware that there is a risk of getting HIV if they
do not practice safe sex. But many take chances.”

Tyden, Bjorkelund-Ylander and Olsson compared the
results of their study with an earlier study by Bengt
Brorsson on the general public’s attitudes and behavior
with respect to HIV and AIDS. In Brorsson’s study
around 15 percent of the men had had three or more
sexual partners in the last year and only 10 percent had
had intercourse “the first night.”

The Uppsala group therefore concluded that students
have a riskier sexual lifestyle than others of the same age.

“Uppsala students are probably representative of stu-
dents in the rest of the country. I have no evidence for
this statement but it is hard for me to believe otherwise,”
said Tanja Tyden.

An information campaign on HIV and sexually-
transmitted diseases that is aimed directly at students is
being conducted in Uppsala this fall.

SWITZERLAND

Montreux AIDS Conference Findings Reported

91WEO101A Geneva JOURNAL DE GENEVE
in French 2 Nov 90 p 15

[Article by Michel Danthe: “AIDS Prevention: Evalu-
ating Is Believing” —first two paragraphs are JOURNAL
DE GENEVE introduction]

{Text] 300 congress participants from around the world
examined the latest studies on AIDS prevention this
week in Montreux.

The Montreux Congress on AIDS Prevention ended
Thursday evening. Gathering some 300 participants
from around the world, it allowed specialists to swap
their latest figures, present their problems, and propose
their solutions for AIDS prevention. The main concern
of the congress participants was to evaluate preventive
programs carried out pretty much everywhere in the

WEST EUROPE 35

world. The main questions debated were: Did preventive
efforts attain their goals for a given country, city, or
group—yes, no, and why?

It is still not well known that, in the area of program
evaluation, our country is a pioneer. Though it was not
the first country in Europe to conduct a national preven-
tive campaign—Greece was—it was the only one to
immediately set up a systematic and coherent policy for
evaluating its successive campaigns.

Consequently, Switzerland was very much in view
during the programs, debates, and presentations at the
Montreux Congress. It was represented by the Lausanne
University Institute of Social and Preventive Medicine,
the mainspring of the project. This made it possible to
measure the state of prevention among the country’s
seasonal residents (see our 1 November editions), the
progress of campaigns among drug-users, the role of
doctors as preventive agents, and, more generally, the
impact of campaigns among the general population.

But beyond our boundaries, in this type of congress it is
the experiences and observations of other countries,
other continents that give food for thought.

Seroconversion Rate: Calculations

Touting the slogan “Knowledge is power,” the English
epidemiologist Noel Gill emphasized campaigns to mon-
itor the transmission rate of the virus in a population.
For, as far as he is concerned, it is no longer a matter of
knowing how many people in a population are infected.
In 1990, it is much more useful to know the rate of virus
transmission, the rate of seroconversion in a given
population. It is a way of getting a changing, rather than
fixed, picture of the epidemic, absolutely necessary for
decisionmaking. To do this, the English specialist recom-
mends running anonymous tests on blood samples col-
lected from the general population.

“Knowledge is power”: Many specialists gathered in
Montreux who, like the American William Darrow, have
tracked the progress of the infection among prostitutes—
and among prostitutes of the whole world—provided
proof of that statement during the last few days. Though
in Western countries preventive campaigns seem to have
paid off among “classic” prostitutes, there is a need to
remain quite vigilant concerning those who use drugs. As
for prostitutes in third-world countries (Africa, India) or
countries with booming sexual-tourism industries (Thai-
land), the situation is threatening or already explosive:
seroconversion curves continue to climb. The Thai,
Sittitrai Werasit’s, conclusion: “It’s two hundred
people” a day that are infected in Thailand.

Though one leaves such sessions disheartened, others
give reason for hope: Gerry Stimson, English drug-
addiction specialist, shows that sustained preventive



SJPRS-TEP-90-021
27 December 1990

date, including 19 deaths from the fatal disease which
kills by destroying the body’s immune system.

Chief medical officer Dr. Franklyn Lloyd, speaking on
Saturday during activities marking World AIDS Day,
said sexual intercourse was the mode of transmission in
each case. The 30 cases exclude persons who are asymp-
tomatic and non-nationals who were diagnosed here. Dr.
Lloyd said one teenager was among the victims. The
others were adults.

He said the spread of the disease here showed “a
preponderance of male homosexuals, male heterosex-
uals, and male bisexuals.” Besides sexual intercourse,
AIDS can also be transmitted through intravenous drug
use. Dr. Lloyd said there was no known cases of trans-
mission via this route here so far.

ST. LUCIA

Doctors Ask Media for Sensitivity in AIDS
Reporting

FL2711204090 Bridgetown CANA in English
1705 GMT 27 Nov 90

[Text] Castries—Doctors have called on the media in St.
Lucia to be sensitive in reporting on AIDS cases. Dr.
Michel Ooms and Dr. Stephen King made the recom-
mendation at a one-day workshop which also suggested
the St. Lucia government enact legislation, making it
mandatory that AIDS be treated as a notifiable disease.

The workshop organised by the St. Lucia Media Workers
Association and the Ministry of Health, was told on
Tuesday that of 9,000 persons tested here for the disease,
only 48 were positive. So far, 26 persons have died from
the disease, which kills by destroying the body’s immune
system.

“The number of real cases and deaths could very well be
much more, since our projections are that we are just
dealing with the tip of the iceberg,” Dr. Ooms, co-
ordinator of the Ministry of Health’s AIDS programme,
said. She reported there was increasing evidence that
“the disease is being spread here through perinatal
(associated with birth) means,” adding: “this is a cause
for concern.”

Dr. Ooms urged the media practitioners to be sensitive
in their reporting on the disease, saying sensationalism
could drive AIDS patients underground. Head of the
AIDS laboratory, Dr. King, said the media should ensure
that information about individuals with the disease was
given “only with their consent.”

“Confidentialty in such cases is important to ensure
information about the individuals is only released with
their consent,” he said. This was a reference to a recent
controversy here surrounding the death of a four-
year-old child said to have had AIDS.

LATIN AMERICA 23

King said that it was important for the St. Lucia Gov-
ernment to enact legislation making AIDS a notifiable
disease, since the official records here were confined to
persons who visited hospitals or clinics. “There is a need
to have private doctors report AIDS cases to the hospi-
tal’s lab so that they could be included in the national
statistics,” he remarked.

King said that none of the drugs being used for the
treatment of AIDS could be found here, but indicated
that St. Lucia health officials were looking at the possi-
bility of joining Barbados in acquiring the Kenyan-
developed drug, Kemron.

“. Lucia may have to share the information on it with
Barbados and we may have to look at the possibility of
joining Barbados in its use if it proves effective and is
affordable,” he said.

Head of the Barbados AIDS task force, Professor Mickey
Waldron, said recently that he would be writing regional
governments about the possibility of using the drug in
the treatment of AIDS.

ST. VINCENT & THE GRENADINES

AIDS Cases Statistics Reported

FL 2411165690 Bridgetown CANA in English
1536 GMT 24 Nov 90

{Text] Kingstown, St Vincent—Known AIDS cases in St
Vincent and the Grenadines currently stand at 57,
according to Dr. Paul Forgathy, chairman of the AIDS
committee of the main Kingstown general hospital here.

Dr. Forgathy made the rare disclosure of local AIDS
statistics at a public discussion on the disease, held by
the local AIDS action committee on Thursday evening.
He said the disease was first diagnosed here in 1984, but
two-thirds of the 57 cases had been diagnosed between
1988 and October this year.

Dr. Forgathy said 24 persons who had tested positive,
had gone on to become full blown cases and nineteen of
them had died. He said most of the infected persons here
had been exclusively heterosexual, with only seven males
admitting to homosexuality. Most of the cases, 75 per-
cent to be precise, fell within the 20-39 age group. The
figure also includes two infants born to infected mothers,
and one 61 year old person.

The local AIDS action committee has embarked on an
education programme on the causes of the disease and
ways of dealing with infected persons.



IJPRS-TEP-90-021

27 December 1990 3 AIDS
THAILAND
Survey Shows 4,000 Prostitutes Carry AIDS Virus /Bangkok THE NA TION, 16 Nov 90] 19
200 Test Positive for AIDS Virus in Northern Province
[Khamphon Khotsema; Bangkok THE NATION, 16 Nov 90] «..-++« 19
VIETNAM
No HIV Seropositive in Four Major Cities [Hanoi VNA, 7 Dec 90] . 20
EAST EUROPE
CZECHOSLOVAKIA
AIDS—25 Cases in Slovakia, 161 in Czech Lands [Prague CTK, 27 Nov 90] 21
AIDS, Health Situation of Refugees /Prague PRACE, 27 Nov 90] ... 21

LATIN AMERICA
COLOMBIA
Health Minister Says AIDS Cases Total 1,942 Bogota Radio Cadena Nacional, GMT 2 Dec 90] . 22

JAMAICA

22

Health Ministry Estimates Over 3,000 AIDS Infections [Bridgetown CANA, 25 Nov 90] ss.

PERU

Health Minister Reports 323 Confirmed AIDS Cases /Lima Television Peruana, 5 Dec 90] ..
ST. CHRISTOPHER & NEVIS

Government Unveils Anti-AIDS Action Plan [Bridgetown CANA, 2 Dec 90] ...
Health Officials Report 30 Diagnosed AIDS Cases /Bridgetown CANA, 3 Dec 90].

ST. LUCIA

Doctors Ask Media for Sensitivity in AIDS Reporting /Bridgetown CANA, 27 Nov CT) 23
ST. VINCENT & THE GRENADINES

AIDS Cases Statistics Reported [Bridgetown CANA, 24 Nov 90] .... . 23

NORTH EAST & SOUTH ASIA
ALGERIA

Minister of Health Reports 57 AIDS Cases Algiers EL MOUDJAHID, 17 Oct 90} .......
INDIA

AIDS Continues Spreading Among Manipur Addicts {Calcutta THE STA TESMAN 4 Oct] .
Spread of AIDS Follows African Pattern (Bombay THE TIMES OF INDIA, 29 Oct 90] ...

ISRAEL

Statistics on AIDS Carriers, Victims Given
[Judy Siegel; Jerusalem THE JERUSALEM POST, 2 Dec 90]



10 SUB-SAHARAN AFRICA

I commend the efforts of nongovernmental organiza-
tions such as Africa Foundation, Child Welfare and
Adoption Society, Ambassadors of Hope, World Vision,
Daughters of Church, and all the ones I saw here today.
I salute or I commend their efforts. The resources of
these organizations are clearly inadequate to cope with
the flood of AIDS orphans and orphans of other wars.
These organizations deserve all the support we are
capable of giving them.

What is to be done? The government has embarked on a
multisectoral approach and that end has established a
ministerial AIDS commission under either the chair-
manship of the prime minister or the president. I have
not decided on this. We shall see what to do, but it will
either be under me or under the prime minister. But lam
about to make a decision on that issue. But it will be
multisectoral. It will no longer be in the Ministry of
Health because the Ministry of Health has no drugs. So
what are they for? [laughter] I do not see why we should
waste time with them. In any case, they are not equipped
to deal with orphans.

The commission will have its own secretariat which will
plan, monitor, and coordinate all AIDS-related pro-
grams throughout the country. It will also facilitate the
mobilization of funds for these programs from within
and from outside Uganda. I call upon all opinion leaders
at all levels of governance to give high priority to the
control of AIDS. [passage omitted]

Women are the real builders of families because they are
the real procreators of children and have a greater
influence over them, particularly in their early lives, than
men. In most cases mothers retain this greater influence
over their children well into adult life. So women play a
major role in the molding of people, and they are the
foundation upon which families and nations are built.
They will now have to play a leading role in the survival
of the community of our society. | am now appealing to
Ugandan women to seriously rethink the bringing up of
their children. Have a look at the nation, at the family
again. What is the role of the family? Is the modern
ugandan family still performing its real functions? If not,
what is to be done? [passage omitted]

ZAIRE

Preventive Measures Said Slowing AIDS Spread

91WE0048A Paris LE MONDE in French
24 Oct 90 p 19

[Article by LE MONDE special correspondent Jean-
Yves Nau]

[Text] Matonge, the old Kinshasa pleasure quarter, was
burying one of its own that night under the open sky.
Prior to the funeral held in broad daylight there had been
a gathering of people for the ‘mortuary party”, a grip-
ping expression of collective mourning. By the red light
of candles, the women shook branches, sang, and wept to

JPRS-TEP-90-021
27 December 1990

the cadence of an invisible orchestra. In the darkness one
could sense the presence of the crowd, male and silent, in
the distance. Matonge was strangely empty that night.
There was no excitement at the Good Samaritan, no
excitement at the Sans-Chemise past midnight. And
much later, at Petit Jean’s and Kitoni Mayard’s, only a
handful of couples were there to drink the local beer. The
only ambiance to be found was in the foreign alcohol and
Zairian music of the air-conditioned nightclubs uptown.
Not far from the river, a few cars were slowly gliding
along 30 June Boulevard and Justice Avenue looking for
“Londoners,” “free-living” women thus called because
of their taste for miniskirts and Western garb.

Love and Death

Are people still having fun in the Zairian capital? It is
doubtful. Matonge is sad and “Kin joy” and “Kin
ambiance” have lately changed. AIDS is no longer a
menace here: It has become a scourge. People are
learning to live one day at a time with the creeping
infection, harder to bear than any known disease since it
involves nothing less than sex, and a malady that links
love and death more closely than any other. Kinshasa is
waking up to the magnitude of its drama. And after
having cloaked it for some time, the city is no longer
afraid to exhibit it openly, even while specialists moni-
toring the epidemic on the dark continent are beginning
to nurture a few timid hopes for the bewitching and
somber city. In contrast to most of the large urban
agglomerations of central Africa, the Zairian capital
seems to have managed to contain the spread of the
infection afflicting it. Epidemiologists assure us that,
although 7 to 8 percent of the capital’s adults are infected
with the AIDS virus, this proportion, although undeni-
ably dramatic, has not risen for several years now. Not
much of a victory announcement, to be sure, but the
apparent leveling off does allow some timid hope. How
do we understand what is happening here when it is
known that the percentage of seropositive adults in
Abidjan, Lusaka, Kigali, or Kampala is climbing
steadily? Westerners in Kinshasa assume, without being
able to prove it, that Zairians have changed their sexual
behavior after seeing one or more fatal cases among their
acquaintances. Many confidences made by women attest
to the new attitudes of their partners. Might it, on the
contrary, be a natural phenomenon? With the epidemic
having reached a sort of plateau, perhaps the virus
cannot, for various mysterious reasons, continue its
spread.

“Prudence”

Until the trend is explained and, most important, con-
firmed, all we can do is underscore the number of
preventive initiatives undertaken here over the last sev-
eral years. They have made the Zairian capital the hub of
innovative experimentation as well as a model that many
African cities smitten by the epidemic could imitate. The
first experiment concerned, naturally, condoms, of
whose existence Kinshasa has recently learned and that

ee



12 SUB-SAHARAN AFRICA

unlike most of their public health colleagues, to go out
into the “real night life” of the big city of Kinshasa and
not limit themselves to “Londoners” and women
working in the more or less discreet bordels here called
“bars” and “hotels.” The most difficult feat in the study
was undoubtedly reaching the “Mingandos,” women
thus named for a tribe that lost all its men long ago and
who, often elderly, prostitute themselves under the most
sordid conditions.

The long investigation also required taking an interest in
practices that until now have not been well known. One
of these consists of having the woman “dry her vagina”
using a number of organic or mineral compounds, either
to give more pleasure to her partner or to “disinfect”
herself.

With AIDS forcing the issue, it was necessary to take an
interest in a thousand and one aspects of “Kinshasa”
sexuality and to attempt to modify some of the most
dangerous behaviors. It is an often thankless and diffi-
cult job, as was the one performed with the aid of the
Zairian Commercial Bank among 178 “unmatched”
couples, The term signifies that one of the two spouses is
seropositive. Here too, the only weapon is the condom,
now systematically used by 75 percent of the couples.
The latest statistic bearing witness to the impact of AIDS
on sexuality: the sharp decline over the last five years in
cases of “criminal adultery” judged by the Kinshasa
court, a drop which, according to Zairian specialists, can
only be explained by the growing trend toward
monogamy and sexual abstinence.

It is undoubtedly too early to establish a cause-and-effect
link between these new behaviors and the relative lev-
eling off of the epidemic in the ian capital. None-
theless, Kinshasa today does seem like a showcase city,
the model of what could be done in black Africa if
political leaders could be induced to make an accurate
measurement of the scourge afflicting them. People in
the Mama Yemo Hospital in Kinshasa (2,000 beds for
2,600 patients) are dying more and more of AIDS; of the
200 patients in the internal medicine wing managed by
Dr. Kapita, an average of 50 are AIDS patients, most
often at the terminal stage. The doctors here do what
they can, with the meager resources they possess and
without any antiviral medications. For the multinational
pharmaceutical company Wellcome, which makes the
only effective product, AZT, has apparently not yet hit
on a formula for humanitarian collaboration with the
African countries that are the world’s hardest-hit victims
of this new and terrible disease.

The “Zairian Model”

Does Zaire know just how useful it can be by investing,
as it has over the last two years, in an original program of
AIDS information and prevention? If the truth be told, it
is not so much the Zairian authorities as a small group of
foreign doctors and moneylenders, essentially from Bel-
gium, the EC, and the United States, that is behind
Kinshasa’s “AIDS project.” Since historical colonial ties

JPRS-TEP-90-021
27 December 1990

and geopolitical interests are not always incompatible
with health imperatives, this initiative and its funding
have made it possible to implement concrete preventive
programs. Those programs are not, at least we hope not,
totally unrelated to the striking slowdown, even stagna-
tion, of the epidemic in the country’s capital.

The game, of course, is not over. It would probably be
best to reinforce the programs undertaken as quickly as
possible. Although the use of condoms has increased
sharply, it is still far from the rule in most of the country,
and detection of virus-infected and therefore infectious
blood donors is not, as one might hope, systematically
carried out.

The country’s coldfooted highest ranking officials are
still afraid to broach the subject publicly. This silence is
especially regrettable and unfortunate as it is easy to
imagine the huge impact that a political discussion of the
topic could have in such a country. But aside from a few
more or less sensational campaigns, no government
official has yet dared to publicly mention the reality of
the epidemic and the anti-AIDS weapons that must be
marshalled, both individually and collectively.

Meager Balance

Nonetheless Zaire, more than most other black African
countries faced with this unprecedented epidemic, is
beginning to point the way. It is doing so thanks to the
remarkable work of Professor Peter Piot and his col-
leagues at the Anvers Institute of Tropical Medicine,
relayed in country by courageous Zairian physicians.
Their work is particularly interesting in that it does not
conceive of AIDS as a disease apart, but sees its preven-
tion through condoms as an integral part of the battle
against all sexually transmitted diseases, so common on
the African continent.

Can such a “Zairian model” be exported? At bottom,
that is what is at stake in the Kinshasa experiment. If, as
we hope, the group that designed and developed this
project manages to demonstrate its effectiveness in the
short term, the health and political authorities of African
countries may finally agree to amplify their action to
combat dissemination of the virus in those groups—
prostitutes, truck drivers, and people with multiple
sexual partners—which are most at risk, but also most
likely to be infected and therefore infectious.

Can France, like most industrialized countries, vaunt
itself as an example in this area? It is not likely. Except
for a few televised campaigns urging the use of condoms,
the balance of concrete initiatives directed at children
and adolescents is still, whatever anyone says, meager.
Looking at available epidemiological data—France is
said to have fewer than 200,000 seropositive individuals
(LE MONDE, 22 September)—the argument could
undoubtedly be made that the epidemic is not as serious
as it is in black Africa. It is nonetheless highly regrettable
that, faced with the dramatic reality of AIDS, the



SJPRS-TEP-90-021
27 December 1990 2 AIDS

AIDS Epidemic Spreading to Women, Children

[Felicity Levine; Johannesburg SUNDAY TIMES, 11 Nov 90]
Soweto Launches Campaign to Fight AIDS (Johannesburg THI
Johannesburg Leads Nation in AIDS Cases

[Shirley Woodgate; Johannesburg THE STAR, 16 Nov 90] ....
Government Cuts Funding for Fight Against AIDS

[Felicity Levine; Johannesburg SUNDAY TIMES, 25 Nov 90}. ......
Government Says Fight Against AIDS ‘Absolute Priority’ /Johannesburg SAPA, 27 Nov 90]
HIV-Positive Eastern Province Blood Donors Increase /Johannesburg SAPA, 3 Dec 90] ..
Department Reports Increase in Pediatric AIDS Cases

[Marguerite Moody; Johannesburg THE STAR, 12 Dec 90) ....

SWAZILAND

au

~)

oe won

Health Minister Says AIDS Spreads at 2 Percent Rate
[Mbabane THE TIMES OF SWAZILAND, 29 Nov 90]

TOGO

Official Briefs Mrs. Mitterrand on AIDS Figures /Lome Domestic Service, 10 Dec 90] .....
UGANDA

Museveni Says 1.3 Million Infected With AIDS /Kampala Domestic Service, 1 Dec 90]
ZAIRE

Preventive Measures Said Slowing AIDS Spread /Jean-Yves Nau; Paris LE MONDE, 24 Oct 90] . 10

ZIMBABWE
Health Workers Asked To Set Example /Harare THE HERALD, 16 Oct 90] .... 13
Ministry Requires Statistical Information on AIDS {Harare THE HERALD, 30 Oct 13
17,500 AIDS Cases Expected by Year’s End /Harare THE HERALD, 31 Oct 90) ... 14
Government Begins One Week Campaign Against AIDS
[Johannesburg Domestic Service, 26 Nov 90] .... 14
CHINA
Public Health Minister Wants Global System Against AIDS
[Fan You; Beijing GUANGMING RIBAO, 9 Nov 90] 15
Active Steps Taken on AIDS Prevention /Huang Zhiling: CHINA DAILY, 9 Nov 90] 15
Scientists Develop New Type of Artificial Blood (Beijing XINHUA, 27 Nov 90) . 16
Health Officials on Measures To Control AIDS Spread [Beijing Television Service, . 16
Beijing Holds Forum Marking AIDS Awareness Day [Ai Xiao; Beijing RENMIN RIBAO, 30 Nov 17

EAST ASIA
HONG KONG

Center Planned for AIDS Victims Helen Signy; SOUTH CHINA MORNING POST, 21 Sep 90] . 18
Over 5,000 Residents May Carry AIDS Virus

[Stuart Becker; Hong Kong SUNDAY STANDARD, 2 Dec 90) .... 18
SOUTH KOREA
Number of Seoul AIDS Sufferers Reaches 31 /Seoul THE KOREA HERALD, 4 Dec 90] cesessesse. 18

TAIWAN

AIDS ‘Increasingly Menacing’; Legislature Passes Statute /Taipei CNA, 1 Dec 90]



JPRS-TEP-90-021
27 December 1990

The man was sentenced in August to nine months in jail
but wants the sentence changed to a penalty that does not
deprive him of his liberty.

The 46-year-old man is being held at Kronoberg Jail in
Stockholm because it proved difficult to deal with him in
other ways. The man’s repeated threats against the staff
of Beckomberga Hospital were the reason for the district
court sentence in August.

Attempts to place the man in a correctional facility failed
because of his risk of being mistreated by fellow inmates.
He is accused of having spread HIV infection via hypo-
dermic needles.

One of the reasons he gave for his appeal for clemency
was that the death of his mother has left him deeply
depressed.

The man has assaulted young boys on several occasions
while under the influence of drugs.

Wave of Goteborg HIV Cases Traced to
Intravenous Drug Use

91WE0064F Stockholm DAGENS NYHETER
in Swedish 14 Oct 90 p 13

[Article by Peter Sandberg: “HIV Virus Spreading in
Goteborg”—first paragraph is DAGENS NYHETER
introduction} :

[Text] The communicable disease control physician in
Goteborg fears the HIV virus has spread among Gote-
borg’s intravenous drug users.

In the past no HIV-positive samples have been found in
the tests made at treatment facilities and drug outpatient
clinics in Goteborg.

“What has changed the situation is that a 35-year-old
man who is an intravenous drug user has been diagnosed
with AIDS. Earlier he was just infected with HIV, but
now the disease has also broken out. This means he has
had the infection for a number of years. He has reported
that he shared syringes and hypodermic needles with
others,” said Per Haglind, communicable disease control
physician in Goteborg.

The spread of HIV in Goteborg has differed radically
from Stockholm and Malmo where groups of intrave-
nous drug users have been greatly affected for several
years.

The reason why this did not occur in Goteborg may be
that not much heroin was used there. Instead amphet-
amines predominated among intravenous drug abusers.

Doctors who work with addicts have also noted that the
warnings against carelessness with syringes and needles
have been heard, that Goteborg’s drug addicts “showed
a sense of responsibility.”

It is now feared that the situation may change. It is very
likely that there are a number of infected people among

WEST EUROPE 33

Goteborg’s intravenous drug users, a group consisting of
around 4,000 people, according to the police.

Europe’s First ‘Integrated’ Drug-HIV Hospital
Ward

9I1WE0064E Stockholn DAGENS NYHETER
in Swedish 28 Sep 90 p 14

[Article by Kerstin Hellbom: “Integrated Care for HIV-
Infected Drug Addicts”]

[Text] An HIV-infected drug abuser in Stockholm can
now get help from the treatment services for infectious
diseases and drug addiction as well as the social service
system in one and the same ward.

This program will start on Monday at Roslagstull Hos-
pital.

That is the opening date of Ward 9 which will be the first
in Europe to provide integrated care for infected drug
addicts. The ward, which used to be a traditional infec-
tious disease ward, has been remodeled at minimal cost
to serve 10 patients.

The need for a separate ward for the infected drug
addicts became obvious a few years ago when they first
began to develop AIDS. Both the staff and the patients
were disturbed and it was practically impossible to
provide care for the drug addicts themselves. Either the
addicts left the hospital as soon as the worst symptoms
were over or they received drugs from their visitors. Care
in the new ward is voluntary but the doors will be locked.

“Not to keep the patients from getting out but to prevent
drugs from coming in,” said project leader Aud Krook.

Infectious disease personnel from Roslagstull, specialists
from the drug addiction treatment service at Huddinge
Hospital and social workers from the City of Stockholm
are associated with the project. It will continue at least
until Roslagstull is transferred to Huddinge sometime in
1992.

Sore infections are still the most common among drug
addicts, but an increase in the number of people with
AIDS and HIV infection is expected within a few years.
Of the 554 registered intravenous drug abusers in
Sweden today, 12 have been diagnosed as having AIDS.
Of the 260 abusers treated at Roslagstull annually,
between 50 and 60 have sharply reduced immune
defenses, in other words approximately 20 percent.

Stockholm Hospital AIDS-Study Group Claims
Advance

91WE0064D Stockholm DAGENS NYHETER
in Swedish 23 Oct 90 p 15

[Unattributed article: “New Swedish HIV Treatment”]

[Text] A Swedish research group has succeeded in pro-
ducing artificial antibodies for treating HIV and AIDS



IPRS-TEP-90-021
27 December 1990

CZECHOSLOVAKIA

AIDS—25 Cases in Slovakia, 161 in Czech Lands

AU2911134290 Prague CTK in English 1328 GMT
27 Nov 90

[Text] Bratislava—So far 25 persons tested positive for
the AIDS (acquired immune deficiency syndrome) virus
in Slovakia, with three of them falling ill, and ten of them
being foreigners, representatives of the Slovak Health
Ministry told newsmen here today.

At the press conference, marking World AIDS Day
(December 1), health ministry representatives said that
the Czech Republic had 161 persons testing positive for
AIDS, 58 of them foreigners, and 21 people actually ill.

Ministry representatives said that of the five persons
infected this year, two were students from Ethiopia and
three were homosexual or bisexual men from Slovakia.
Although the situation as regards the occurrence of AI’ DS
is relatively good in Czechoslovakia, compared with
other countries, the disease is expected to spread.

AIDS, Health Situation of Refugees
AU3011105390 Prague PRACE in Czech 27 Nov 90 p 3

{“‘py”-signed report: “The New Refugee Status Is
Becoming a Necessity; AIDS Among the Immigrants”}

[Text] Krasna Lipa—In the refugee camp in Krasna Lipa
near Rumburk, three Angolans were discovered to be
carriers of the HIV virus causing AIDS. It was to be

EAST EUROPE 2

expected sooner or later. Of course, it is not a reason for
a panic and horror. The fact is that as long as no sexual
intercourse with these people occurs, there is no need to
paint the situation black.

On the other hand, it is true that last week, upon
discharge from the special department of the infectious
diseases ward at the regional hospital in Usti nad Labem,
two Angolans disappeared from the camp and currently
nobody knows of their movements. The idea of placing
barbed wire fences around the camp does not offer any
tangible solution. At this time, the problem lies in the
inadequate refugee status and unsolved legislative prob-
lems. The procedural guidelines valid until now refer
only to students and workers on long-term assignments.
If these people are discovered to be carriers of the virus,
they are immediately expelled from the country. There-
fore, one must first standardize the approach to such
cases among the refugees. As a result, physicians and
hygienists are calling for medically well-equipped camps.
A letter was sent from a hygiene station in Decin to the
office of the Government Commissioner for Refugees.
The physicians ask in the letter for an explanation of who
acceded to housing the refugees in an inn near Jirikov
under conditions which threaten their health and do not
correspond to hygienic regulations. According to Law
36, in case of failing to follow these regulations, a fine
from 1,000 to 100,000 korunas may be imposed.

A week ago, the refugees moved from the unsuitable inn
Zatisi near Jirikov to Krasna Lipa. Today, 227 refugees
of 13 nationalities live in the former state-farm educa-
tional center. There are Bulgarians, Romanians, Soviets,
and also six dozen people with dark complexion. They
are all undergoing medical tests.



Epidemiology
AIDS

JPRS-TEP-90-021 CONTENTS 27 December 1990

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

SUB-SAHARAN AFRICA
CAMEROON
205 AIDS Patients Undergo Treatment /Paris AFP, 1 Dec 90]
DJIBOUTI
Official Says 336 People Infected With AIDS [Djibouti Domestic Service, 29 Nov 90].
GHANA
Radio on Rate of AIDS Propagation Since 1986

[Asamoah Odei; Accra Domestic Service, 1 Dec 90] .. wd
Government To House Indigenous AIDS Treatment Shrine /Accra Domestic Service, 1 Dec 90]

Medical Association on Child Marriage, Abortion /Dakar PANA, 7 Dec 90] .. 2
KENYA
Ownership and Availability of Anti-AIDS Drug [Nairobi KTN Television, 28 Nov 90] . 2
Health Minister on Resources Shortage, AIDS [Nairobi KNA, 30 Nov 90] 2
Increase in AIDS Sufferers {Dakar PANA, 2 Dec 90]... 2
MALI
100 AIDS Cases During First Week in 1990 /Bamako Domestic Service, 1 Dec 90] 3
MAURITIUS
AIDS Reportedly Under Control; Prevention Stressed
[Jean-Marc Poche; Port Louis LE MAURICIEN, 10 Nov 90] 3
NIGERIA
Health Minister Reports 500,000 AIDS Patients /Paris AFP, 23 Nov 90] .... 3
SENEGAL
No AIDS Cases Reported in Armed Forces /F. Diaw; Dakar LE SOLEIL, 4 Oct 90] 3
SIERRA LEONE
PANA Cites AIDS Statistics /Eve Langba; Dakar PANA, 4 Dec 90] 4
SOUTH AFRICA
Cabinet Approves Interdepartmental Committee To Combat AIDS
[Johannesburg Domestic Service, 29 Oct 90} 4
AIDS-Linked TB Epidemic Predicted
[Terry van der Walt; Johannesburg SUNDAY TIMES, 11 Nov 90] 4



JPRS TEP 90021
27 December 1990

agaist minori belonging to risk groups: homosexual
inales, prostitutes, and drug users. In the United States,
most of thos fected with HIV also belong to various

ethnie and racial minorities.

In some countries they have begun to replace the laws
edly enacted in the early and mid-1980’s with laws
more favorable to human rights.

In the course of a decade, governments have come to
realize that the interests of the society and AIDS patients
are not necessarily in conflict with one another.

Council of Europe Opposes Isolation

At the Council of Europe human rights conference held
in June, Katarina Tomashevskiy expressed the opinion
that the best way to stop the spread of AIDS is to make
sure that the human rights of those who are HIV-positive
and AIDS patients are respected.

“Voluntary consent to testing for AIDS depends largely
on whether discrimination against those who are HIV-
positive is prohibited by law,” Tomashevskiy empha-
sized. She alluded to a study conducted in San Francisco
in March 1989, according to which most local males
would have agreed to testing if discrimination against
people who are HIV-positive were prohibited by law.

Compulsory testing for HIV has been introduced in
some countries. In the states of Louisiana and Illinois in
the United States, for example, anyone who intends to
get married is tested. As for Soviet law, it provides for
the obligatory testing of foreigners, drug users, homosex-
uals, and prostitutes.

The obligatory isolation of those who are HIV-positive is
considered to be the most serious infringement of all on
people’s human rights. Only one country, Cuba, has
begun to systematically isolate people who are HIV-
positive. In Cuba, anyone infected with HIV must give
up his job, his home, and his family and move into a
sanatorium located near Havana.

According to a study conducted by Roberta Cohen and
Laurie S. Wiseberg, those who are isolated in the sana-
torium have to take part in medical experiments in
Cuba, to test drugs, among other things. They do not,
however, know whether consenting to these experiments
is obligatory.

The isolation of “difficult” patients is permitted in some
West European countries—in England and in Bavaria in
West Germany, for example—even though a negative
view of this practice is taken in the Council of Europe
recommendation. In Sweden, too, for several years now
it has been possible to isolate an AIDS patient through a
tuling by a provincial court.

Sweden has indeed announced that it does not see how it
can endorse the Council of Europe recommendation on
AIDS patients’ rights because it considers it to be con-
tradictory to Swedish law.

WEST EUROPE 29

In addition to the difference of opinion on forced
isolation, the Council of Europe’s negative stand on
obligatory testing rubs the Swedes the wrong way.
According to Swedish law, obligatory testing is possible,
although Minister of Social Affairs Ingela Thalen stresses
the fact that the tests are, as a rule, voluntary. There are
also provisions in Swedish laws that govern the obliga-
tions of those infected with HIV—for example, the
provision enjoining them from spreading the disease.

“Of Danger to the Public” or “Must Be Reported”?

Swedish AIDS Committee chief secretary Hakan Wrede
of the Ministry of Social Affairs thinks that forced
isolation is of little importance in terms of Sweden’s
AIDS policy.

“Our most important task is to disseminate information
so that people will behave responsibly and thus keep the
disease from spreading. There are, however, people who
knowingly spread the disease without caring about
others. Society must have the right to intervene if
nothing else helps. It is, of course, clear that the loss of
one’s freedom is such a serious matter that it cannot be
applied needlessly,” Wrede emphasized.

Finnish officials view Sweden’s policy of isolation with
silent disapproval. The isolation of those who are HIV-
positive has not even been seriously discussed in Fin-
land.

“AIDS is actually a disease that is relatively difficult to
contract,” Marita Liljestrom, legal adviser to the Min-
istry of Social Affairs and Health, argued. According to
Liljestrom, Finland’s AIDS policy follows the general
European approach, but Sweden’s uncompromising atti-
tude clearly departs from the policy pursued by the other
West European countries.

In both Finland and Sweden, contagious diseases are
divided into three classes: those that are of danger to the
public, those that must be reported, and other contagious
diseases. In both countries, those suffering from conta-
gious diseases that constitute a danger to the public may
be isolated. In Sweden, being infected with HIV is
classified as having a disease that constitutes a danger to
the public, whereas, in Finland, infection with HIV is
only a disease that must be reported.

Expert Ulf Mansson, who is familiar with AIDS prob-
lems, thinks that infection with HIV can be added to the
list of contagious diseases that constitute a danger to the
public without changing the definition of a public danger
disease in the laws. According to the law, a disease that is
contagious and spreads quickly, is dangerous, and the
spread of which can be prevented by measures aimed at
the infected parties is viewed as a danger to the public.
According to the law, yellow fever, cholera, syphilis,
diphtheria, typhus and typhoid, polio, and tuberculosis,
among others, are public danger diseases.

In attorney Mansson’s opinion, compulsory measures
are not suitable for combating AIDS. He pointed out that



24 NORTH EAST & SOUTH ASIA

ALGERIA

Minister of Health Reports 57 AIDS Cases

91WEO0O09IA Algiers EL MOUDJAHID in French
17 Oct 90 p 19

[Text] Health Minister Hamid Sidi Said presided over a
meeting of the national committee against AIDS held at
the National Public Health Institute in Algiers on
Sunday. This committee was set up to study the short-
and medium-term activities of the program and the
difficulties encountered by the committee in imple-
menting its plan to fight HIV infection.

Since it was set up in July 1989, the national committee
has been divided into specialized subcommittees that
have worked with the resources available to implement a
short-term program covering the following: epidemi-
ology; facilities, including the designation of seven rest
centers for AIDS patients in the four largest cities in
Algeria; reinforcement of blood control capabilities; and,
medical information and training programs, in addition
to a public information campaign.

To date, according to statements from Professor
Bouguermouh, chairman of the committee, 57 cases of
AIDS have been recorded by the specialized services.

Once the short-term program has been implemented, the
committee intends to begin, probably in January 1991,
another medium-term work plan that will consolidate
the initial activities and promote public information
campaigns, total control of blood transfusion centers,
and a cooperative program with Maghreb and European
countries to step up the campaign against AIDS. For the
time being, the committee reports that the laboratories
have control over 60 percent of transfused blood. As for
constraints, the committee would draw attention to the
tisk of a shortage of re-agents and nondurable goods,
such as disposable syringes and gloves.

In his statement, Sidi Said congratulated the members of
the committee on the work accomplished but, he added,
Algeria’s geographical location makes it essential for us
to be more vigilant in our efforts to control this dreadful
disease.

Since prevention is the only effective weapon, the min-
ister invited the members of the committee to turn their
attention specifically to the public to try to get them
involved in the effort. He stressed the fact that it is high
time to tear down the taboos surrounding this disease
and to get the public to adopt preventive rules of
conduct.

In the area of strengthening efforts to control blood and
protect personnel involved in treating this disease, the
minister stated that the central services were doing
everything possible to guarantee a supply of re-agents
and nondurable products.

JPRS-TEP-90-021
27 December 1990

INDIA

AIDS Continues Spreading Among Manipur
Addicts

91WD0139 Calcutta THE STATESMAN in English
4 Oct 90 p3

[Text] The acquired immuno-deficiency syndrome
menace in Manipur continues to wreak havoc among a
sizeable section of drug addicts and the total number of
HIV positive cases detected so far is more than 900. Dr
S. Pal, Director of the National Institute of Cholera and
Enteric Diseases (NICED), Calcutta, said on Wednesday
that the Government had sanctioned a project proposed
by the NICED that would allow the institute’s
researchers to conduct'a detailed study on the AIDS
phenomenon.

The NICED, under the project, will undertake an exten-
sive epidemiological survey and concentrate on the
unique features of the disease in the North-East. While
elsewhere in.the country the spread of AIDS can be
attributed mainly to heterosexual behaviour, in Manipur
and its adjoining States, the killer virus has been trans-
mitted mostly through intravenous injections adhered to
by drug addicts.

A workshop on AIDS scheduled to be held in Imphal
between 8 and 10 October had to be postponed because
of the violence in Delhi. It will not be possible under the
prevailing circumstances for Central officials to attend
the workshop. The NICED will, however, present its
findings on the AIDS situation in Manipur at an inter-
national conference on AIDS, scheduled for December
in Bombay.

What cause of concern is the ignorance about the real
extent of the problem in Nagaland and Mizoram. The
NICED authorities have been able to examine only a few
cases from Nagaland but none from Mizoram. The tests
conducted with samples received from Kohima showed
that more than 50 percent of the drug addicts were
affected. The percentage of drug addicts affected in
neighbouring Manipur is estimated to be around 54.
Heroin from Burma reaches not only Manipur but also
Mizoram and Nagaland.

Since Mizoram is also suspected to have been hit by a
similar AIDS outbreak, the NICED authorities will send
a team of investigators to Aizawl soon. The team is
expected to leave for the north-eastern State later in
October. The Mizoram Government’s Directorate of
Health Services had recently sent an epidemiologist to
the NICED laboratory in Calcutta to be trained in
chemical detection of the AIDS antibody.

The epidemiological study which the NICED would
conduct in Imphal as well as Kohima and Aizawl
includes a survey of the social and economic causes that
had contributed to the spread of the killer disease.



8 SUB-SAHARAN AFRICA

The department said continuous education programmes
were needed to increase awareness that individuals have
a responsibility to stop the spread of the virus.

HIV-Positive Eastern Province Blood Donors
Increase

MBO0312204290 Johannesburg SAPA in English
2015 GMT 3 Dec 90

[Text] Cape Town—The number of blood donors diag-
nosed as HIV-positive at the Eastern Province Blood
Transfusion Service has trebled this year.

Ten people who have attempted to donate blood to the
service have tested HIV-positive this year, according toa
spokeswoman.

In 1989 three blood samples were found to be HIV-
positive when tested, she said.

There have been 34 HIV-positive donors identified at
the unit since testing was first started in September 1985.

The deputy medical director of the unit, Dr Jane Pearce
and a nursing sister, have been counselling the blood
donors and their families. The donors were informed for
the first time they had tested HIV-positive by the service.

The infected donors have varied from 18 to 35 years old,
with an average age of 24 years.

Blood that is tested and shows up negative to the HIV
antibodies can still be infected. The HIV antibodes
might not have shown up in the blood when it is tested
but the virus could still be present, according to the
spokeswoman.

There is a risk of one in 500,000 of catching AIDS from
tested blood, she said.

There have been no cases of a person being infected with
tested blood in the western Cape.

Department Reports Increase in Pediatric AIDS
Cases

MB1212130390 Johannesburg THE STAR in English
12 Dec 90 p 1

[Report by Marguerite Moody: “Concern at Increase in
Paediatric AIDS Cases”]

[Text] Twenty new cases of AIDS were reported last
month, bringing the total number reported so far to 574,
the Department of National Health and Population
Development said yesterday.

In its latest AIDS update, the department said the
number of paediatric cases had increased from 23 in
June to 74 at the end of November.

“It is clear from the number of paediatric cases that
heterosexual AIDS is on the increase, and this has serious
implications for child health and future generations.”

JPRS-TEP-90-021
27 December 1990

A large part of the department’s AIDS prevention activ-
ities next year will be concentrated on young people.

Planned projects for 1991 include the following:

—Two AIDS educational films for high school children,
dealing with the facts around AIDS, and the preven-
tion of the disease.

—A survey of young people’s attitudes, beliefs and
practices surrounding sex and AIDS. This survey will
guide future education strategies.

—A campain to make parents aware of the importance
and need for open AIDS and sex education.

—The design of an AIDS training package for school-
children. This package will enable any youth worker,
teacher or parent to inform children about AIDS and
to prepapre them to meet the challenge of a safe sexual
lifestyle.

“In this major and important effort the department can
only succeed with maximum support from the general
public, including young people themselves, parents,
teachers and all youth workers,” the statement said.

SWAZILAND

Health Minister Says AIDS Spreads at 2 Percent
Rate

MB2911084190 Mbabane THE TIMES OF
SWAZILAND in English 29 Nov 90 p 3

[Unattributed report: “AIDS Cases Up By Two Percent”)

[Text] Health Minister Dr. Fanny Friedman says AIDS
in the country is rapidly spreading, at a rate of two
percent compared to 0.2 percent in 1987 when the first
case was reported in Swaziland.

So far 28 people have been confirmed to be suffering
from AIDS, Dr. Friedman told the 18th Commonwealth
Regional Health Minister’s Conference for East Central
and Southern Africa held in Gaborone, Botswana
recently.

She said means have been made to curb the disease.

“A number of workshops have been organised in the
country for different groups such as community leaders,
traditional healers and journalists,” she said.

Dr. Friedman also reported to the seminar that the
screening of blood for transfusions and confirmation of
the HIV tests are now done here.

She said a survey on sexually transmitted diseases and
their close link with AIDS is being conducted by a
consultant from the European Economic Community.

“The results will be available before the end of the year.”



SJPRS-TEP-90-021
27 December 1990

have become an essential prophylatic device. Dissemi-
nation of condoms in Kinshasa is the most striking
example of what specialists call, for lack of a better term,
“social marketing.” Distribution in dispensaries or
health centers, nearly always ineffective, had to be aban-
doned in favor of the usual marketing channels. The
profits earned were then reinvested to boost distribution
of the product. Zaire has thus become one of the target
areas of Population Services International, a nonprofit
American association, which for the last three years has
attempted to step up distribution of the condoms sup-
plied free of charge by the United States via USAID [US
Agency for International Development]. Manufactured
by Ansell Corporation, the “American condoms” are
repackaged in Kinshasa under the French-language
brandname Prudence, with an African logo showing a
panther against a full moon and an explicit slogan: “The
condom of the self-confident man.” Prudence has so
thoroughly invaded Kinshasa that the brandname has
become synonymous with condoms. Prudence is every-
where, on signs, calenders, tee-shirts, beer-glass bot-
toms.... This, of course, shocks the prudish customers of
the Intercontinental Hotel. Prudence sells for 30 cen-
times a package of three and is easy to get in nightclubs,
companies, or military installations. Sales have skyrock-
eted. “We will jump from 20,000 condoms distributed in
1987 to 9 million, and our goal for next year is 16
million,” explains Mr. Carlos Ferreros (Population Ser-
vices International). Purchases of Prudence condoms are
made by men nine times out of ten. Seventy percent of
users admit to employing them between one and three
times a week, and 22 percent over four times a week. Mr.
Ferreros is pleased with the attitude of Catholic author-
ities, officially hostile to the use, of male condoms—an
increasingly difficult attitude to uphold—but who have
not in practice opposed his association’s work. He has
announced that distribution will soon be expanded to
the remainder of the country, despite numerous trans-
portation problems. The association has a long job ahead
of it, especially in the rural areas of Zaire, where several
studies have shown that the vast majority of women have
never seen condoms and do not even know they exist.

Twelve “Hunters”

Kinshasa has also been the site of another highly exem-
plary preventive initiative for the last two years. Led by
Dr. Marie Laga (Anvers Tropical Medicine Institute), it
is part of the national “AIDS” project funded by the
Americans and Belgians and headed in Kinshasa by Dr.
Nzilambi Nzila, an epidemiologist. Zairian’s capital has
thus become, together with Kenya’s, one of the rare
metropolises of black Africa where thinking about AIDS
and prostitution has finally broken out of specialist
circles. “In the beginning, this was in 1988, we were
looking at the possible relationships between sexually
transmitted diseases and infection with the AIDS virus,”
explains Dr. Laga. “We wanted to provide an answer to
the question, which has remained highly controversial.
Today we think we have proved that the presence of
sexually transmitted diseases promotes infection by the

SUB-SAHARAN AFRICA oF

virus. As soon as that is shown, prevention of AIDS
depends on preventing gonorrhea, trichomoniasis, or
infections with chlamydia. In practice, then, we have
begun large-scale preventive work.”

In 1985 Dr. Nzila had already established, based on a
study of 300 prostitutes, that 27 percent of them were
seropositive. Belgian and Zairian doctors then began a
long quest to gather one of the largest “cohorts” of
prostitutes ever assembled in Africa.

The Belgian and Zairian doctors, making the most of the
vestiges of colonial health facilities, hired 12 “hunt-
ers”—six men and six women—and succeeded in per-
suading the women that participation could only benefit
them. They gathered over 1,200 prostitutes in Kinshasa.
This long-range undertaking made it possible for the first
time to sketch a rough map of the very complex world of
prostitution in this city of nearly 4 million inhabitants.

The investigation was especially difficult in that it was
carried out without any police participation. Although
officially illegal in Zaire, prostitution is fully tolerated
there and exists, we are assured, without any form of
pimping. The only argument used by the doctors was
persuasion, sometimes combined, it is true, with some
form of remuneration. In a house purchased in the heart
of downtown Matonge, bearing no particular name and
especially no distinguishing characteristic, each doctor
performs scores of gynecological examinations daily,
continually reiterates the advice, and hands out Pru-
dence condoms (over 25,000 a month). Their use is
explained, with the help of a wooden penis, to those who
do not know how or do not dare ask. In the beginning,
over 20 percent of the prostitutes knew nothing about
the use of condoms and some of them thought they were
supposed to swallow them.

The Belgian and Zairian doctors have just made public
their findings. In 1988, only 2 percent of the prostitutes
claimed to use condoms; today, all or nearly all of them
say they do...from time to time. One reason, of course, is
refusal (six time out of ten) by the customer who, having
paid, feels he has the right to sexual relations without a
condom. There is also (one out of three times) what the
doctors term “negligence”, with the woman saying she
forgot all about it.

Sordid Prostitution

Finally, there are the much more complex relations with
a regular partner. Here, the “mutual trust” of the rela-
tionship prohibits any use of condoms—accused either
of lessening sexual pleasure or preventing conception,
whereas a child is nearly always desired. This is espe-
cially problematical as the “regular partner” frequently
has several partners himself and is often infected.

Over the last two years, 30 of the women in the group
have died of AIDS. In 1988, 38 percent of them were
seropositive. Today 40 percent are. A relatively slight
rise when compared to that observed among Kigali or
Nairobi prostitutes. But to achieve this, the doctors had,