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Subject: Legalise prositition to stop the spread of AIDS: UN expert 

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 Legalise prositition to stop the spread of AIDS: UN expert 
 

AFP, Yangon, 13 November 1999.  The decriminalisation of prostitution 
would held stop the spread of the worldwide AIDS epidemic, a
United Nations expert told a seminar here Saturday. 

Dr Wiwat Rojanapithayakorn from UNAIDS said the epidemic was growing 
at an alarming rate, with 11 people contracting HIV -- the virus which causes 
AIDS -- every minute of every day. 

With sex workers among the most vulnerable to HIV infection, Wiwat said 
laws should be drawn up to regulate prostitution and safe sex practices. 

"Criminal law should be reviewed with the aim of decriminalising, then legally 
regulating occupational and safety conditions to protect sex workers and their
c
lients, including support for safe sex," Wiwat said. 

World Health Organisation data presented at the conference showed up to 
64 percent of prostitutes in Cambodia were HIV positive, along with 27 
percent of sex workers in Thailand and 26 percent in Myanmar. 

Wiwat said the underground nature of prostitution made it very difficult to 
ensure sex workers used condoms. 

He said governments should also ensure legislation does not impede 
HIV-prevention among injecting drug users, another high risk group. 

"Consider the authorisation or legalisation and promotion of needle and 
sringe exchange programmes," Wiwat urged the gathering of parliamentarians 
and health experts from throughout the Asia-Pacific. 

Wiwat admitted such measures would be controversial but said drastic steps 
were need to stop the spread of human immunodeficiency virus, known as HIV
 -- which has already infected 47 million people worldwide. 

Acquired Immune Deficiency Syndrome (AIDS) attacks the body's defense 
system and is almost always fatal. 

No known cure has been discovered, although Western patients now have 
access to expensive drugs which slow its development. 

The syndrome is transmitted by sexual contact and the sharing of needles 
by drug users and can be transmitted by a pregnant woman to her foetus. 

Thailand is hosting the "Inter-Country Meeting of Parliamentarians and 
Specialists on HIV/AIDS and Sexually Transmitted Diseases in East And 
South East Asia." 

The conference, which began Thursday, runs to November 14. 

***********************

[NOTE FROM DAVID ARNOTT: I THOUGHT IT MIGHT HE USEFUL 
TO RE-POST THE FOLLOWING ARTCLE FROM "THE LANCET"]


The Lancet

September 25, 1999

Drug use and HIV/AIDS in Burma; Statistical Data Included

Chelala, Cesar; Beyrer, Chris

   Since the military's takeover of Burma in 1962, with its persistent
mismanagement and corruption, the country's economy has deteriorated and in
1987 the United Nations placed it among the group of least-developed
countries. The United Nations High Commissioner for Human Rights, Amnesty
International, and several other human rights organisations have denounced
widespread campaigns of forced relocation and population transfers of
indigenous communities such as the Karen and other minority groups,
religious persecution of Christians, Muslims, Hindus, and Animists,
arbitrary arrests, slave labour, and the use of civilians as human
mine-sweepers.

This economic deterioration and such widespread human rights abuses has had
a dramatic effect on the health status of the Burmese people, a situation
that is compounded by limited access to health care, particularly in the
ethnic-minority regions. According to statistics from WHO and UNICEF, the
maternal mortality rate in Burma is 230 deaths per 100 000 livebirths,
compared with 44 deaths per 100 000 livebirths in neighbouring Thailand.1
UN statistics for 1999 show that the infant mortality rate in Burma is 81
per 1000 livebirths, whereas in Thailand it is 31 per 1000 livebirths.1 In
addition, about one million children are malnourished. The health of the
Burmese people is further jeopardised by another threat: the increasing use
of heroin and the alarming spread of HIV/AIDS.

Burma continues to be the largest source of illicit opium and heroin in the
world; in the USA, for example, Burmese opium makes up about 60% of the
heroin market. The cultivation of opium poppies in Burma has almost doubled
since 1988 and takes place with the complicity of military officials.
Indeed, many internationally wanted drug dealers have found shelter in
Burma, without any interference from the Burmese authorities. The easy
availability of heroin in Burma has led to its growing use inside the
country, especially intravenous use of the drug, and is contributing to a
dramatic increase in HIV infection throughout the region.

According to Burmese official statistics, in some townships up to 25% of
adults are injecting drug users. Government statistics estimate the
drug-addicted population at 66 463. By contrast, the United Nations Drug
Control Program and non- governmental organisations that work in the health
sector estimate the number of addicts to be between 400000 and 500000. In
1994, WHO helped the National AIDS Program to investigate HIV infection
among Burma's drug users and found that the rate was the highest among drug
users worldwide.

According to Dr Peter Piot, UNAIDS's Executive Director, Burma currently
has at least 440000 people with HIV/AIDS-the second worst AIDS epidemic in
Asia after Cambodia. The Southeast Asian Information Network and other
non-governmental organisations have confirmed Piot's estimate. The Burmese
junta, however, claims that there are only 21503 confirmed cases of HIV
infection and 2854 cases of AIDS in Burma.

The reason for the high rates of HIV infection among injecting drug users
in Burma is needle sharing, a necessary measure among addicts because of
the extremely short supply of syringes in the country. Furthermore, the
"paraphernalia" laws in Burma make carrying needles without medical licence
a crime. Habitual drug users work in "tea stall" shooting galleries, where
they reuse needles and in this way transmit HIV.

Another factor that affects the high rates of heroin use and HIV infection
in Burma is the young Burmese internal migrants who work in the jade and
ruby mines in Shan or Kachin states. These workers come from all over the
country to work in the mines, in numbers that, in the dry season, may reach
the hundreds of thousands. Because many of the young adults with HIV
infection in central Burma have worked in the mines, they probably have had
a key role in the transmission of HIV across the country.

The HIV epidemic among drug users in Burma has led to HIV epidemics in
other border countries, such as China and India. The heroin route through
western Burma, across the Indo-Burma border into the northeast state of
Manipur, has led to an explosive parallel increase in intravenous use of
heroin and spread of HIV infection. Something similar has occurred along
Burma's eastern border, particularly in China's Yunnan province.

The Chinese Ministry of Public Health states that 80[middle dot]4% of all
cases of HIV infection and 60[middle dot]0% of all confirmed AIDS cases in
China have been detected in Yunnan since 1995. There has been an increase
in injecting drug users and HIV infection in the Chinese province of
Guangxi, on the border with Yunnan and Vietnam, which is a third route from
Burma and Laos, through northern Vietnam and into China. Drug users in the
Indian state of Manipur have among the highest rates of HIV infection in
India. In 1994, WHO estimated that the rate of HIV infection among drug
users in Manipur state was 56%, and is spreading rapidly into the general
population.

Burmese heroin export routes have a crucial role in the spread of
intravenous drug use and HIV infection throughout south and southeast Asia.
The failure of the Burmese junta to deal effectively with the production
and widespread use of drugs bodes ill for their ability to cope with the
HIV/AIDS problem. By all practical measures, the Burmese junta has become a
threat to the health of not only to Burma's own citizens, but those of
neighbouring countries as well.

Cesar Chelala, Chris Beyrer

390 West Broadway, New York, NY 10012, USA; and Johns Hopkins University
School of Hygiene and Public Health, 615 North Wolfe St, Suite 7132,
Baltimore, MD 21205, USA

1. UNICEF. The state of the world's children 1999. Geneva: UNICEF, 1999.

Official publication of the manual by the United Nations is expected by the
end of the year. In the meantime electronic copies of the version submitted
to the UN may be obtained from several websites (www.phrusa.org,
www.hrft.org.tr, and www.tihv.org.tr). Those who access the manual are
requested to consider signing a letter of endorsement that may facilitate a
UN General Assembly Resolution on the Principles.



Internet ProLink PC User

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Content-Type: text/html; charset="us-ascii"

<html>
&nbsp;Legalise prositition to stop the spread of AIDS: UN expert <br>
&nbsp;<br>
<br>
AFP, Yangon, 13 November 1999.&nbsp; The decriminalisation of
prostitution <br>
would held stop the spread of the worldwide AIDS epidemic, a<br>
United Nations expert told a seminar here Saturday. <br>
<br>
Dr Wiwat Rojanapithayakorn from UNAIDS said the epidemic was growing
<br>
at an alarming rate, with 11 people contracting HIV -- the virus which
causes <br>
AIDS -- every minute of every day. <br>
<br>
With sex workers among the most vulnerable to HIV infection, Wiwat said
<br>
laws should be drawn up to regulate prostitution and safe sex practices.
<br>
<br>
&quot;Criminal law should be reviewed with the aim of decriminalising,
then legally <br>
regulating occupational and safety conditions to protect sex workers and
their c<br>
lients, including support for safe sex,&quot; Wiwat said. <br>
<br>
World Health Organisation data presented at the conference showed up to
<br>
64 percent of prostitutes in Cambodia were HIV positive, along with 27
<br>
percent of sex workers in Thailand and 26 percent in Myanmar. <br>
<br>
Wiwat said the underground nature of prostitution made it very difficult
to <br>
ensure sex workers used condoms. <br>
<br>
He said governments should also ensure legislation does not impede <br>
HIV-prevention among injecting drug users, another high risk group. 
<br>
<br>
&quot;Consider the authorisation or legalisation and promotion of needle
and <br>
sringe exchange programmes,&quot; Wiwat urged the gathering of
parliamentarians <br>
and health experts from throughout the Asia-Pacific. <br>
<br>
Wiwat admitted such measures would be controversial but said drastic
steps <br>
were need to stop the spread of human immunodeficiency virus, known as
HIV<br>
&nbsp;-- which has already infected 47 million people worldwide. <br>
<br>
Acquired Immune Deficiency Syndrome (AIDS) attacks the body's defense
<br>
system and is almost always fatal. <br>
<br>
No known cure has been discovered, although Western patients now have
<br>
access to expensive drugs which slow its development. <br>
<br>
The syndrome is transmitted by sexual contact and the sharing of needles
<br>
by drug users and can be transmitted by a pregnant woman to her foetus.
<br>
<br>
Thailand is hosting the &quot;Inter-Country Meeting of Parliamentarians
and <br>
Specialists on HIV/AIDS and Sexually Transmitted Diseases in East And
<br>
South East Asia.&quot; <br>
<br>
The conference, which began Thursday, runs to November 14. <br>
<br>
***********************<br>
<br>
[NOTE FROM DAVID ARNOTT: I THOUGHT IT MIGHT HE USEFUL <br>
TO RE-POST THE FOLLOWING ARTCLE FROM &quot;THE LANCET&quot;]<br>
<br>
<br>
The Lancet<br>
<br>
September 25, 1999<br>
<br>
Drug use and HIV/AIDS in Burma; Statistical Data Included<br>
<br>
Chelala, Cesar; Beyrer, Chris<br>
<br>
&nbsp;&nbsp; Since the military's takeover of Burma in 1962, with its
persistent<br>
mismanagement and corruption, the country's economy has deteriorated and
in<br>
1987 the United Nations placed it among the group of 
least-developed<br>
countries. The United Nations High Commissioner for Human Rights,
Amnesty<br>
International, and several other human rights organisations have
denounced<br>
widespread campaigns of forced relocation and population transfers
of<br>
indigenous communities such as the Karen and other minority groups,<br>
religious persecution of Christians, Muslims, Hindus, and Animists,<br>
arbitrary arrests, slave labour, and the use of civilians as human<br>
mine-sweepers.<br>
<br>
This economic deterioration and such widespread human rights abuses has
had<br>
a dramatic effect on the health status of the Burmese people, a
situation<br>
that is compounded by limited access to health care, particularly in
the<br>
ethnic-minority regions. According to statistics from WHO and UNICEF,
the<br>
maternal mortality rate in Burma is 230 deaths per 100 000
livebirths,<br>
compared with 44 deaths per 100 000 livebirths in neighbouring
Thailand.1<br>
UN statistics for 1999 show that the infant mortality rate in Burma is
81<br>
per 1000 livebirths, whereas in Thailand it is 31 per 1000 livebirths.1
In<br>
addition, about one million children are malnourished. The health of
the<br>
Burmese people is further jeopardised by another threat: the increasing
use<br>
of heroin and the alarming spread of HIV/AIDS.<br>
<br>
Burma continues to be the largest source of illicit opium and heroin in
the<br>
world; in the USA, for example, Burmese opium makes up about 60% of
the<br>
heroin market. The cultivation of opium poppies in Burma has almost
doubled<br>
since 1988 and takes place with the complicity of military
officials.<br>
Indeed, many internationally wanted drug dealers have found shelter
in<br>
Burma, without any interference from the Burmese authorities. The
easy<br>
availability of heroin in Burma has led to its growing use inside
the<br>
country, especially intravenous use of the drug, and is contributing to
a<br>
dramatic increase in HIV infection throughout the region.<br>
<br>
According to Burmese official statistics, in some townships up to 25%
of<br>
adults are injecting drug users. Government statistics estimate the<br>
drug-addicted population at 66 463. By contrast, the United Nations
Drug<br>
Control Program and non- governmental organisations that work in the
health<br>
sector estimate the number of addicts to be between 400000 and 500000.
In<br>
1994, WHO helped the National AIDS Program to investigate HIV
infection<br>
among Burma's drug users and found that the rate was the highest among
drug<br>
users worldwide.<br>
<br>
According to Dr Peter Piot, UNAIDS's Executive Director, Burma
currently<br>
has at least 440000 people with HIV/AIDS-the second worst AIDS epidemic
in<br>
Asia after Cambodia. The Southeast Asian Information Network and
other<br>
non-governmental organisations have confirmed Piot's estimate. The
Burmese<br>
junta, however, claims that there are only 21503 confirmed cases of
HIV<br>
infection and 2854 cases of AIDS in Burma.<br>
<br>
The reason for the high rates of HIV infection among injecting drug
users<br>
in Burma is needle sharing, a necessary measure among addicts because
of<br>
the extremely short supply of syringes in the country. Furthermore,
the<br>
&quot;paraphernalia&quot; laws in Burma make carrying needles without
medical licence<br>
a crime. Habitual drug users work in &quot;tea stall&quot; shooting
galleries, where<br>
they reuse needles and in this way transmit HIV.<br>
<br>
Another factor that affects the high rates of heroin use and HIV
infection<br>
in Burma is the young Burmese internal migrants who work in the jade
and<br>
ruby mines in Shan or Kachin states. These workers come from all over
the<br>
country to work in the mines, in numbers that, in the dry season, may
reach<br>
the hundreds of thousands. Because many of the young adults with 
HIV<br>
infection in central Burma have worked in the mines, they probably have
had<br>
a key role in the transmission of HIV across the country.<br>
<br>
The HIV epidemic among drug users in Burma has led to HIV epidemics
in<br>
other border countries, such as China and India. The heroin route
through<br>
western Burma, across the Indo-Burma border into the northeast state
of<br>
Manipur, has led to an explosive parallel increase in intravenous use
of<br>
heroin and spread of HIV infection. Something similar has occurred
along<br>
Burma's eastern border, particularly in China's Yunnan province.<br>
<br>
The Chinese Ministry of Public Health states that 80[middle dot]4% of
all<br>
cases of HIV infection and 60[middle dot]0% of all confirmed AIDS cases
in<br>
China have been detected in Yunnan since 1995. There has been an
increase<br>
in injecting drug users and HIV infection in the Chinese province 
of<br>
Guangxi, on the border with Yunnan and Vietnam, which is a third route
from<br>
Burma and Laos, through northern Vietnam and into China. Drug users in
the<br>
Indian state of Manipur have among the highest rates of HIV infection
in<br>
India. In 1994, WHO estimated that the rate of HIV infection among
drug<br>
users in Manipur state was 56%, and is spreading rapidly into the
general<br>
population.<br>
<br>
Burmese heroin export routes have a crucial role in the spread of<br>
intravenous drug use and HIV infection throughout south and southeast
Asia.<br>
The failure of the Burmese junta to deal effectively with the
production<br>
and widespread use of drugs bodes ill for their ability to cope with
the<br>
HIV/AIDS problem. By all practical measures, the Burmese junta has become
a<br>
threat to the health of not only to Burma's own citizens, but those
of<br>
neighbouring countries as well.<br>
<br>
Cesar Chelala, Chris Beyrer<br>
<br>
390 West Broadway, New York, NY 10012, USA; and Johns Hopkins
University<br>
School of Hygiene and Public Health, 615 North Wolfe St, Suite 
7132,<br>
Baltimore, MD 21205, USA<br>
<br>
1. UNICEF. The state of the world's children 1999. Geneva: UNICEF,
1999.<br>
<br>
Official publication of the manual by the United Nations is expected by
the<br>
end of the year. In the meantime electronic copies of the version
submitted<br>
to the UN may be obtained from several websites
(<a href="http://www.phrusa.org/"; eudora="autourl">www.phrusa.org</a>,<br>
<a href="http://www.hrft.org.tr/"; eudora="autourl">www.hrft.org.tr</a>,
and
<a href="http://www.tihv.org.tr/"; eudora="autourl">www.tihv.org.tr</a>).
Those who access the manual are<br>
requested to consider signing a letter of endorsement that may facilitate
a<br>
UN General Assembly Resolution on the Principles.<br>
<br>
<br>
<br>
<div>Internet ProLink PC User</div>
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