Michael Richardson: Asia must face up to Aids crisis

COMMENT

BANGKOK - At least in numerical terms, Aids is becoming a far greater threat to human existence than conventional armed conflict.

More than 20 million people have died of Aids since the first diagnosis of the disease in 1981. In the next decade, the pandemic is expected to kill more people than all the combatants who died in World War I, World War II, the Korean War and the Vietnam War combined.

While Aids has caused severe suffering and economic damage in Africa, the XV International Aids Conference in Bangkok last week swung the spotlight on to Asia.

The United Nations Programme on HIV/Aids warned that the epidemic in the region - home to 60 per cent of the world's population - was expanding. "Asia is in a similar sort of position to Africa 15 years ago," said UN Aids chief Peter Piot. "This is not a time to misread signals, with Asia facing life-and-death choices in preventing a full-blown Aids catastrophe."

Of the 38 million people worldwide with acquired immune deficiency syndrome, Aids, or the human immuno-deficiency virus, HIV, that causes the deadly disease, around 7.4 million live in Asia. Some 1.1 million people in the region were infected with HIV in 2003 - more than any year before. An estimated 500,000 people in the region are estimated to have died of Aids last year.

What are the economic implications of the epidemic for Asia, especially for the two rising giants of the region, China and India? Aids can slow economic growth by raising healthcare costs, shrinking the workforce, lowering productivity and deterring investment.

Young people - 15 to 24-year-olds - account for nearly half of all new HIV infections. As a result, the International Labour Organisation projects that the workforce in 38 countries hard-hit by Aids (all but four in Africa) will be between 5 per cent and 35 per cent smaller by 2020 because of the disease.

The UNAids report to the conference noted there had been sharp increases in HIV infections in China, Indonesia and Vietnam. It said that India has 5.1 million infected people, a rise of 500,000 from a year earlier. This is the largest number of people living with HIV outside South Africa.

Of course, Asia is not nearly as badly affected as sub-Saharan Africa, where 25 million people - over half the world total - were estimated to be HIV infected in 2003. HIV prevalence is still under 1 per cent in the majority of countries inAsia. This is small compared to the Aids-ravaged nations of southern Africa where on average around 8 per cent of adults between 15 and 49 have the virus.

But Asia's economic growth prospects could be undermined by a lax attitude to the looming Aids crisis, especially in the three most populous countries in the region - China, India and Indonesia. Asia could follow the devastating downward spiral of sub-Saharan Africa if governments do not implement effective programmes of prevention and treatment.

In a separate report to the conference, UNAids and the Asian Development Bank based in Manila found that HIV/Aids threatens to erode Asia's recent progress in poverty alleviation and economic development.

The ADB-UNAids analysis estimates that a comprehensive effort to prevent and treat the epidemic in Asia will cost about US$1.5 billion ($2.3 billion) a year, rising to around US$5.1 billion annually by 2007. But in 2003, only US$200 million was spent fighting the disease in the region.

Without more aggressive prevention efforts, some 10 million people in Asia will be infected with HIV between now and 2010. Meanwhile, the economic cost to the region - including lost income, extra costs borne by Aids-affected families, and state spending on the disease - will rise to US$17.5 billion a year by 2010, the study estimates.

China, India, Indonesia and Vietnam are among the Asian countries where Aids can be spread quickly and widely because the sex industry is active and condom use is low.

Public knowledge about Aids is also poor. Drug abuse is a growing problem with a high proportion of injectors using contaminated needles and syringes, and there is an increasingly high degree of population mobility.

The United States National Intelligence Council, in a report published in 2002, forecast that China will have 10 to 15 million HIV/Aids cases by 2010, while India is likely to have 20 to 25 million - the most of any country in the world. Fifteen million HIV-positive people in China would represent roughly 2 per cent of the adult population. Twenty-five million infected Indians would reflect a 4 per cent adult prevalence rate.

A World Bank study a year ago gave a bleak assessment of the potential economic costs of the epidemic to any country that allows it to get out of control. The study noted that in Africa existing estimates range between a modest decline of 0.3 per cent and a more significant 1.5 per cent fall in GDP growth annually.

* Michael Richardson, a former Asia editor of the International Herald Tribune, is a visiting senior research fellow at the Institute of Southeast Asian Studies in Singapore.