Gems and HIV/AIDS

Gems and HIV/AIDS

This is an excerpt from an August 11th interview between US radio programme “Fresh Air” and joufnalist, John Cohen

This is FRESH AIR. I'm Dave Davies, senior writer for the Philadelphia Daily News, filling in for Terry Gross.

Last December, the premier of China, Wen Jiabao, did something regarded as extraordinary. He allowed himself to be photographed greeting a former taxi driver from Shanxi province who's being treated for AIDS. The event signaled the awakening of the Chinese government to the threat HIV poses to its 1.3 billion people at a time when countries across Asia are hoping to avoid the catastrophic AIDS epidemic that has befallen sub-Saharan Africa.

My guest, writer Jon Cohen, recently published a four-part series on AIDS in Asia for the journal Science. In researching the series, Cohen traveled to six countries, talking to doctors, patients, public health officials, sex workers and drug users. Cohen has been writing on the AIDS epidemic for 15 years. His book on the search for a vaccine is called "Shots in the Dark." Cohen has also followed the AIDS crisis in Africa. I asked him how the situation in Asia compares….

DAVIES: You mentioned that the country of Thailand had had a relatively successful campaign battling the growth of the HIV/AIDS problem. By contrast, the country of Myanmar, formerly known as Burma, is ruled by a military dictatorship that took over in 1988. What did you find there?

Mr. COHEN: Well, I toured the country and I went officially again with a minder, and the health-care system itself looks like it has AIDS. It's just a bare-bones system that has very little to offer anyone. Medecins Sans Frontieres, Doctors Without Borders, has a clinic outside of Rangoon, now known as Yangon, that had started to treat people with anti-HIV drugs. They had 13 people on treatment--one three--in a country that probably has a higher prevalence than anywhere in Asia. Now the junta has changed. There is a more aggressive campaign to prevent HIV spread and to help HIV-infected people. But, you know, the virus waits for no one. And it takes advantage of every misstep that politicians make. And the Burmese government, the junta in Myanmar, has allowed the virus to trample through much of the country unabated. And given the role of heroin and the gem mines there, it further exacerbates the situation greatly.

It reminds me of South Africa. You know, South Africa has these diamond mines in the center of the country, and you see all this migration coming from both the east and the west coast. So typically men leave their girlfriends or spouses, their wives, and they go the center of the country for six months, work in these mines, make all this money. There are lots of sex workers there, lots of drugs, lots of alcohol. It's a perfect environment for HIV.

You see a very similar situation in Myanmar with the gem mines. They have ruby, jade, sapphire mines. And I met several men who go work at the mines for three, four months. There are a lot of sex workers there. If you have a good day, you make a tremendous amount of money. And what do you do at the end of the day? Well, you party with your friends, maybe you smoke some heroin, maybe you shoot some heroin and maybe you hire a sex worker.

That's life. And if you're going to really tackle HIV in Myanmar, that's where you've got to go. And I don't see much happening at those places, nor would they let me visit those places, to be frank. I mean, they didn't want me to see them.

DAVIES: Did you say you did speak with some gem mine workers, though?

Mr. COHEN: I did, yes. I met gem mine workers who had become HIV-infected at the mines, they believed. And they described the mines for me. And--I mean, I was very near the mines; they just wouldn't let me go right to the mines. And they had a long list of reasons, some of which may have been valid. There's no telling when you're dealing with a government like that.

DAVIES: What...

Mr. COHEN: I mean, I must say, the government let me in. You know, they let me in officially. Loads of journalists go there as tourists. I didn't want to do that. They were very accommodating to me, given their history and reputation with the media.

DAVIES: What did the gem mine workers tell you about what was going on there, and their own knowledge of HIV when they were infected?

Mr. COHEN: It was a good time. Knowledge of HIV was low. Many people in Asia and Africa learn about HIV after they become infected. They don't even know about the disease. It was a good time had by all. I mean, the descriptions I heard of the gem mines made it sound like the Wild, Wild West.

DAVIES: And does the prevalence of HIV in that community pose a threat to other countries?

Mr. COHEN: Sure. I mean, there have been studies that have looked at HIV's spread outward from Myanmar and that has done--the study did a molecular epidemiological analysis where they looked at the gene sequences of the HIV strains traveling around Asia.

And they could map that the virus moved along the heroin trade routes from Myanmar in every direction. So certainly it spreads from there.

I mean, again, I'm always hesitant to, like, place blame. It's not Myanmar's fault that there's HIV in Asia. There's HIV in Asia because there's HIV anywhere the virus can go, and it will simply take advantage of any situation it can. Heroin trade routes--that's a great situation for a virus. It wants to move around. It wants to copy itself. I think we always have to see the world of HIV through HIV's eyes, so to speak.

To listen to the full interview, please visit:

http://freshair.npr.org/day_fa.jhtml?display=day&todayDate=08/11/2004