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WHO AIDS chief says injecting drugs are a big danger in spread across Asia

Associated Press - October 10, 2006


HANOI, Vietnam More work must focus on injecting drug users and men who have sex with men to prevent the spread of HIV in the Asia-Pacific region, a top World Health Organization official said.

Dr. Kevin De Cock, director of the WHO's Geneva-based HIV/AIDS department, told The Associated Press on Monday that the human immunodeficiency virus that causes AIDS could spread quickly, even in countries currently with very low HIV rates like the Philippines, if there's a jump in injecting drug use.

"I think that's the danger," he said. "I would predict that if some of these countries suddenly turn, that a very rapid spread in injecting drug users would be the likeliest scenario."

Some countries in the region have already experienced HIV spikes from dirty needle use. HIV infections in pockets of India's northeast, along with some areas in Vietnam, for example, are being driven up by injecting drug users.

De Cock, on a two-day fact-finding mission to Vietnam that ends Tuesday, said more work must also be done to reach men who have sex with men. Research is lacking for this vulnerable group in the region, even as some developed countries see infection rates among this group continue to climb.

"I think it's a very worrying situation, actually, and it needs much more attention," he said, adding that men who swap sex for drugs could serve as a bridge for the infection to spread.

"In places like London and Amsterdam, those are among the most supportive environments in the world, and yet we're still seeing a lot of transmission," he said. "And you sort of wonder, what is lacking here?"

An estimated 8.3 million people were living with the virus last year in the Asia Pacific region, where infections have largely remained concentrated within high-risk groups such as sex workers and injecting drug users.

India alone is home to an estimated 5.7 million cases ù more infections than any other country, according to UNAIDS figures. In China, there were some 650,000 people infected last year, nearly half of them injecting drug users, UNAIDS estimated.

"Anything that happens in those countries, be it policies or epidemiological changes, they are potentially important for the region," he said of India and China, both with populations over 1 billion.

Of all the countries in Asia-Pacific, De Cock said Papua New Guinea appears to be the only one with a generalized epidemic similar to some African countries. It shares an island north of Australia with Indonesia's easternmost Papua province, and the country of 5.7 million is plagued by political instability, poverty and rampant sexual violence against women.

The adult per capita infection rate is 1.8 percent, according to UNAIDS. Last month at a WHO regional meeting in New Zealand, the country's health minister said isolated pockets could have HIV rates as high as 30 percent.

"Papua New Guinea probably is somewhat in a class of its own in this region," De Cock said, adding that more data is needed to better understand the epidemic there.

De Cock was scheduled to leave Vietnam on Tuesday after he and a high-level delegation met with government officials. Experts fear Vietnam, which has an estimated 260,000 people living with the virus, is at a critical point. So far, most cases have been concentrated in vulnerable groups such as sex workers and injecting drug users, but officials worry the epidemic could soon become more generalized.

HANOI, Vietnam More work must focus on injecting drug users and men who have sex with men to prevent the spread of HIV in the Asia-Pacific region, a top World Health Organization official said.

Dr. Kevin De Cock, director of the WHO's Geneva-based HIV/AIDS department, told The Associated Press on Monday that the human immunodeficiency virus that causes AIDS could spread quickly, even in countries currently with very low HIV rates like the Philippines, if there's a jump in injecting drug use.

"I think that's the danger," he said. "I would predict that if some of these countries suddenly turn, that a very rapid spread in injecting drug users would be the likeliest scenario."

Some countries in the region have already experienced HIV spikes from dirty needle use. HIV infections in pockets of India's northeast, along with some areas in Vietnam, for example, are being driven up by injecting drug users.

De Cock, on a two-day fact-finding mission to Vietnam that ends Tuesday, said more work must also be done to reach men who have sex with men. Research is lacking for this vulnerable group in the region, even as some developed countries see infection rates among this group continue to climb.

"I think it's a very worrying situation, actually, and it needs much more attention," he said, adding that men who swap sex for drugs could serve as a bridge for the infection to spread.

"In places like London and Amsterdam, those are among the most supportive environments in the world, and yet we're still seeing a lot of transmission," he said. "And you sort of wonder, what is lacking here?"

An estimated 8.3 million people were living with the virus last year in the Asia Pacific region, where infections have largely remained concentrated within high-risk groups such as sex workers and injecting drug users.

India alone is home to an estimated 5.7 million cases ù more infections than any other country, according to UNAIDS figures. In China, there were some 650,000 people infected last year, nearly half of them injecting drug users, UNAIDS estimated.

"Anything that happens in those countries, be it policies or epidemiological changes, they are potentially important for the region," he said of India and China, both with populations over 1 billion.

Of all the countries in Asia-Pacific, De Cock said Papua New Guinea appears to be the only one with a generalized epidemic similar to some African countries. It shares an island north of Australia with Indonesia's easternmost Papua province, and the country of 5.7 million is plagued by political instability, poverty and rampant sexual violence against women.

The adult per capita infection rate is 1.8 percent, according to UNAIDS. Last month at a WHO regional meeting in New Zealand, the country's health minister said isolated pockets could have HIV rates as high as 30 percent.

"Papua New Guinea probably is somewhat in a class of its own in this region," De Cock said, adding that more data is needed to better understand the epidemic there.

De Cock was scheduled to leave Vietnam on Tuesday after he and a high-level delegation met with government officials. Experts fear Vietnam, which has an estimated 260,000 people living with the virus, is at a critical point. So far, most cases have been concentrated in vulnerable groups such as sex workers and injecting drug users, but officials worry the epidemic could soon become more generalized.


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