Southeast Asian nations are being applauded for making the political commitment to fight the spread of AIDS. But health workers say greater a commitment is now needed from family and society to end the stigma associated with AIDS.
After years of hoping the problem of AIDS would go away, governments of the Greater Mekong region are now making the political commitment to fight the pandemic. Thailand, Laos, Burma, Cambodia, Vietnam and China's southern Yunnan province have shifted from ignoring the problem to acknowledging it. They now look to regional and international cooperation to halt the virus' widening grasp.
There are now at least seven million people in Asia who are HIV positive, out of a worldwide population of more than 40 million. China has a million HIV victims and India has almost four million.
Dr. Lee Nah Hseuh is a manager with the United Nation's Aids program. For her, the cooperation in the region is one of the few positive signs to emerge more than a decade after AIDS arrived in Southeast Asia. "In the past [governments] saw it exclusively as a medical issue, or a health sector issue," he says. "Now we see a shift. I would attribute it to the efforts at many different levels both from the U.N., the government itself, as well as globally."
Governments in the region hope to avoid the devastation seen in Africa, where in some countries, 40 percent of the population is infected with HIV, the virus that causes AIDS. Dr. Lee Nah says there is no time to waste. "Asia, if they start to reform now with the political commitment, with the differing sectors joining in, we could avert the disaster that we are witnessing now in Africa."
Thailand was one for the first Southeast Asian nations to face up to AIDS. Aggressive campaigns in the early 1990's to promote condom use paid off in cutting transmission rates.
One AIDS expert in Thailand, Dr. Anupong Chitwarakorn, says there are now around one million Thais infected with the virus. Thailand's AIDS death toll is approaching 400,000. But Dr. Anupong says there are disturbing new trends as the virus spreads. "In the year 2000 we found that the newborn [babies] who were infected from the mother - well the proportion increased to 13 percent of all infections," he says. "And when we look at the number of adults we found that half of the new adult infections in the year 2000 were housewives."
At the Mercy Center Aids hospice in Bangkok's Klong Toey slum community, the focus is on bringing relief and hope to the sick, and giving the epidemic's youngest victims happiness during their brief lives. There are eight HIV positive children and four mothers among the hospice's population of 45.
Usanee Janngeon, a manager at the hospice, says while official figures suggest some success in the fight against AIDS, there is little evidence of progress in the day-to-day battle. "Personally I don't feel it's any better," she says. "The reason I am saying that is what we are seeing everyday, what we're hearing everyday, and the intake of patients."
The child patients, some abandoned by their mothers, receive medical care, love and attention, as well as schooling. And it is the arrival of more children at the hospice that mark a sad trend. "There are also children who have already been infected - probably a vast majority of them who have no mom or no dad to look after them," says Ms. Usanee. "Those are the children that are coming forward now."
Up to 200,000 Thais aged between 15 and 24 are HIV positive, and the number is rising. Dr. Anupong says that highlights the need for renewed education campaigns. Thailand is following global trends - U.N. data show that more than half of those newly infected with HIV are aged between 15 and 24. "We found that our youth still have casual sex and the condom usage rate was still not over 60 percent when compared to 90 percent when they visit the sex workers," says Dr. Anupong.
The Thai government already spends one million dollars a year on AIDS programs, and hopes to boost that to $10 million within five years. One target will be teenagers as young as 13.
"We're trying to involve the society as much as possible," says Dr. Anupong. "And trying to implement our activities through the grassroots so they will know it is their responsibility to protect themselves."
But personal responsibility may only be part of the solution. The Mercy Center's Ms. Usanee says based on experience even the anti-retroviral drugs, the best method so far to fight the virus, will fail without adequate family support. "Antiviral drugs by [themselves] will not help them [the patients] unless they get the love and the care and the understanding by their family," she says. "That is the most important - followed by food, followed by medicine."
Ms. Usanee tells of two young patients at the hospice, both receiving the cocktail of drugs, but only one supported by his family. But the other man, with a wife and two children, found he had been abandoned. After finding they had left their home, he gave up the fight for recovery, refusing food and medicine. "If my family cannot even accept me then why should I live?" says the male patient. Then after that conversation a day later he died.
Ms. Usanee says more will die under the same circumstances until society ends the stigma associated with AIDS and there is greater compassion for those fighting for their lives.