Japan's AIDS Trend Looking Scary

Daniel P. Dolan (Principal, Communication Japan)

As we enter the New Year and the excitement and prospects for change it brings, take a moment as well to consider these shockingly sad facts:

• There are 40 million people living with AIDS.
• 2.5 million of these are children under age 15.
• 5 million people were newly infected with AIDS in 2003.
• 3 million people died of AIDS in 2003; 500,000 of these were under age 15.
• There were approximately 14,000 new HIV infections per day in 2003.

December 1, 2003 was World AIDS Day. The World Health Organization released the latest HIV/AIDS statistics noted above to mark the occasion, and also announced an ambitious program called the "3 by 5 Initiative", sponsored jointly by UNAIDS. The goal of the initiative is to provide "antiretroviral treatment to three million people living with AIDS in developing countries and those in transition by the end of 2005".

Clearly, AIDS has not just gone away as many people around the world hoped. While most developed countries are doing relatively well, many poorer countries are suffering terribly. Reasons for this disparity include effective education, government response, cultural practices, and access to and funding for the latest drug treatments. For example, the WHO reports that in Africa and much of Asia, antiretroviral drugs are available to fewer than 5% of people who need treatment. In contrast, 84% of adult HIV/AIDS patients in North and South America received drug treatment in 2003. AIDS in Japan has not been a high-profile news item recently. So how is Japan doing?

AIDS in Japan: Good and Bad News

First, the good news on AIDS in Japan. Compared with all other countries, Japan continues to see below-average HIV/AIDS infection rates per capita in the 15-49 age group—less than 0.1% at the end of 2001. In contrast, Italy's per capita HIV infection rate for 2001 was 0.4%, the United States' was 0.3%, and Australia registered 0.1%. Botswana had the highest HIV infection rate at 38.8%.

The bad news is that since 2002, HIV infection rates in Japan are rising dramatically, particularly among teens and young adults.

Here are several important statistics:

• There were more than 5,300 reported HIV infection cases and 2,600 AIDS patients in Japan by April 2003. But some experts believe that the number of HIV patients could explode to 50,000 by 2010.
• In 2002, Japan had 595 new HIV cases and 301 new cases of AIDS.
• More than 60% of these new HIV infection cases in 2002 were individuals ages15-25.
• Since 2000 there have been approximately 600-700 AIDS-related deaths per year in Japan, and the same rate is projected for 2005.

In addition, although Japan has had an unusually high percentage of HIV transmission via tainted blood transfusions, in 2000 78% of new HIV cases were apparently sex-related.

Japan's bleak AIDS outlook is compounded further by a Daily Yomiuri report of a surprising rise in Japan of drug-resistant strains of HIV.

Turning Back AIDS in Japan

So what can Japan do to attempt to repel the recent advance of AIDS? Some medical authorities and activist groups point to the need for increased condom use. According to the WHO, currently only 6-25% of sexually active Japanese use condoms.

Another important reform target is sex education in schools, which activists complain was not only very late to enter the curriculum mix but also focuses on AIDS discrimination issues rather than practical safe sex guidelines.

Finally, the government needs to turn its attention and resources to home in addition to its laudable contributions to global AIDS issues. Japan recently pledged to contribute up to 100 million dollars in 2004 to the Global Fund to Fight AIDS, so it seems reasonable that adequate AIDS prevention and treatment funding for its own citizens should be a serious concern.