@inbook{45751ea658db4e7ab51a3d839f35b1f5,
title = "Asia: Health Meets Human Rights",
abstract = "This chapter describes several public-health and political measures that are needed to prevent an AIDS disaster in Asia. The patterns of HIV spread across Asia have differed in some important ways from those seen in Africa and the West. AIDS in Southeast Asia is a valuable lens for analyzing the epidemic throughout the region. For Thais, as throughout Asia, one of the most difficult aspects of the epidemic is to openly confront the commonality of sex outside marriage and of prostitution. India has serious and unresolved issues related to the safety of blood supplies and medical procedures. In 1998, WHO estimated that perhaps one-fifth of all of India's infections are because of improperly screened blood and blood products. There is an immediate need to make modern antiretroviral therapy (ART) and medical services available to all individuals, regardless of socioeconomic status and nationality. The stated goal of the Indian government is to eventually provide ART to all individuals with AIDS. The government has to work out agreements with the nation's pharmaceutical industry, expand health delivery systems for testing and treatment follow-up, and effectively integrate a huge influx of international assistance.",
author = "Chris Beyrer and N. Kumarasamy and Pizer, {H. F.}",
note = "Funding Information: There was active collaboration between the Thai Army, Thai agencies and numerous NGOs from abroad, such as the Centers for Disease Control and the National Institutes of Health (NIH) in the United States, the World Health Organization, Unicef, the Thai and International Red Cross, the European Union, and university-based projects from institutions in North America and Europe. Collaborations between Chiang Mai University (CMU) in northern Thailand and Johns Hopkins University (JHU) in the United States began in 1991 and have continued. In 1992 the JHU-CMU was awarded the first of the PAVE grants (Preparation for AIDS Vaccine Evaluations) from the NIH, which supported cohort development, laboratory capacity building, and intensive behavioral research. In 1993 Thailand became the first developing country to have a national plan for HIV vaccine research. It has now done the world's first HIV vaccine efficacy trial in developing countries, and is participating in the second – clear evidence of the extraordinary commitment of Thai scientists and officials to participating in the search for solutions to the pandemic. History will show this was a remarkable effort on the part of the Thai people and its government. Funding Information: Asia has lagged behind Europe and North America in establishing harm reduction and drug treatment programs ( Gray, 1995 ; Des Jarlais and Friedman, 1998 ). Pilot projects have been set up in India, Nepal, and Vietnam, but their scope is limited. Except perhaps in Thailand, there has not been sufficient acknowledgment that these services are needed. With support from M{\'e}decins Sans Fronti{\`e}res and the Soros Foundation, the Russian Far East and Vietnam are virtually the only Asian states with active harm reduction programs for drug users. China, Malaysia, and Burma have very limited treatment programs, or focus, as in Malaysia, almost exclusively on incarceration. This is a human rights and health issue. Needle exchange programs are, of course, feasible in Asia; the question is one of political will and societal acceptance. The obstacles to setting up these programs appear to fall into three categories. First, they are seen as condoning or facilitating injecting drug use. Second, they face legal, security, and policy challenges. {\textquoteleft}Safe{\textquoteright} domains have to be set up where IDUs can get treatment, education, and referral without risking arrest. A third issue is to insure adequate funding and coverage. Unsafe injection practices promote epidemics of other blood-borne pathogens, like hepatitis C. The underlying need is clear. The problem is societal acceptance and governmental implementation. ",
year = "2005",
doi = "10.1016/B978-012465271-2/50018-2",
language = "English (US)",
isbn = "9780124652712",
pages = "374--397",
booktitle = "The AIDS Pandemic",
publisher = "Elsevier Inc.",
}