John J. Lumpkin

Russia, China, India Face HIV Crisis

McLEAN, Va. — The spread of HIV is expected to accelerate in Asia and Africa over the next decade with 75 million cases likely in five of the world's most populous countries by 2010, a U.S. intelligence report predicts.

The rapid growth of HIV as well as AIDS cases will heavily tax the economies and public health systems of such countries as China, India, Russia, Ethiopia and Nigeria, according to the report, prepared by the National Intelligence Council, a group of senior analysts who report to CIA Director George J. Tenet.

Those countries — which have 40 percent of the world's population among them — are estimated to have between 14 and 23 million cases of HIV now, says the report entitled "The Next Wave of HIV/AIDS."

"Their governments are at a critical phase of determining their response," said David F. Gordon, a principal author of the report, during a briefing at CIA headquarters on Monday. "The disease is building up a significant momentum in each of the five countries."

The growth in the five countries is expected to outstrip the number of cases in central and southern Africa, where the disease currently is most widespread, according to the report.

The report says the governments of Uganda, Thailand and Brazil have made HIV and AIDS awareness a priority and have slowed the disease's spread. In contrast, South Africa, beset with other issues, did little, and infection rates skyrocketed in the 1990s.

Because so many people in those countries are already infected and dying, the net number of HIV-positive people in the region is only expected to increase from 25 million to 35 million.

The report projects each country will see a significant increase in HIV cases in the next decade:

India: The country is expected to have between 20 million and 25 million HIV-positive people by 2010, the highest estimate of any country. India's public health institutions have taken some steps to combat the disease.

Heterosexual activity is the key driver of the disease in India and Indians have little awareness of the disease, said the report. In Bombay and some other areas, as many as half of the prostitutes are believed to be infected.

China: The government has raised its official estimate of the number of HIV cases in the country to one million, but some experts say the total is likely twice that. The report projects, China, the world's most populous nation, will have between 10 million and 15 million people infected by 2010.

In rural areas, the practice of blood brokering is spreading the disease, although the government has ordered a stop to the practice. In the cities intravenous drug users are they key problem.

Russia: Sharing infected drug needles is the main cause of spreading HIV in Russia, where drug use is widespread. Experts estimate Russia may have as many as 2 million HIV-positive people now. The number is project to between 5 million and 8 million by 2010.

Nigeria and Ethiopia: The disease is already taking hold in the general population. Family breadwinners, as well as key leaders in government and industry, are at substantial risk, and their loss could devastate the two countries' economies. Heterosexual activity are driving the spread in both countries.

The government of Nigeria, a regional power in western Africa, has tried to raise public awareness about HIV and AIDS. The current 4 million to 6 million cases are expected to increase to 10 to 15 million, and impact one-fourth of the adults in the country.

In Ethiopia, a key driver of the spread of HIV has been the demobilization of the military after wars with neighboring Eritrea. Soldiers and prostitutes from military encampments are returning to their homes and spreading the disease. The current 3 million to 5 million cases is expected to increase to between 7 million and 10 million.

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