China is moving in the right direction in the fight against HIV/AIDS, a top U.N. official said on Friday, but needs more education to combat discrimination and stigma, particularly in the nation's vast interior.

U.N. China Resident Coordinator Khalid Malik said there was "great unevenness" in the supply of health care and tools in the fight against AIDS at regional level.

"There is no longer a big challenge at the central government level in China. The challenge is now firmly in the provinces," Khalid said.

"Overcoming stigma and discrimination is really what we need to concentrate on."

On Thursday, Vice Minister of Health Wang Longde told Reuters that the ruling Communist Party should educate its cadres to combat prejudices that are still engrained in the lower ranks.

"I think we need to open the leadership's minds, especially at the lower levels," said Wang.

The Health Ministry said last week that the reported number of Chinese HIV/AIDS cases at the end of October was 183,733, up from 144,089 at the end of 2005, but both Beijing and the United Nations estimate the true number of cases at about 650,000.

China has offered free anti-retroviral drug treatment to registered HIV/AIDS patients, but fear of discrimination prevents many from coming forward.

Malik said that the reported number of cases was the "tip of the iceberg" and that more "behavior" education was required to overcome people's fear and ignorance about HIV/AIDS.

"Asian societies are reluctant to talk about sex ... Silence does kill, so we need to talk about it a lot more," he said.

After initially being slow to acknowledge the threat, Beijing has stepped up the fight against HIV/AIDS in recent years, increasing spending on prevention programs and implementing anti-discrimination legislation.

As part of efforts to spread awareness on World Aids Day, China has agreed to allow state television to air "A Closer Walk," an acclaimed foreign documentary on AIDS, this weekend -- albeit minus footage of an interview with Tibet's Dalai Lama, whom the Communist government regards as a separatist.

About 5,000 Beijing cab drivers will distribute HIV/AIDS pamphlets to their customers in the first 10 days of December, state media reported.

The number of recorded HIV/AIDS infections in Shanghai has jumped by well over 70 percent this year compared with 2005, a sharper rise than the rest of China.

In the first 11 months of this year, the city recorded 621 new cases of HIV/AIDS infections, 74 percent higher than the full year total of 356 new cases during 2005, Xinhua news agency reported Wednesday.

State press reported last week that the number of people confirmed with HIV/AIDS across China at the end of October was 183,733, 27.5 percent higher than at the end of 2005.

The newly recorded cases in Shanghai bring the total number of confirmed infections in China's biggest city to 2,261, Xinhua said Wednesday, quoting the Shanghai municipal health bureau.

Most of the sufferers were aged between 25 and 44 and 80 percent of them were male, it said.

The virus was spread mainly through unprotected sex and shared needles among drug users, it said.

Although the number of confirmed cases in China stood at 183,733, that figure is far lower than the estimate of 650,000 HIV/AIDS sufferers announced in a joint report by the United Nations and the Chinese government in January.

The disparity shows the virus remains grossly under-reported in China. AIDS campaigners say this is partly due to the social stigma attached to the virus, and that the real number of sufferers could be far higher than 650,000.

President Bush marked Worlds AIDS Day on Friday by declaring: "The pandemic of HIV/AIDS can be defeated."

Bush and first lady Laura Bush met in the Roosevelt Room with Health and Human Services Secretary Michael Leavitt, U.S. Global AIDS Coordinator Mark Dybul and community leaders from the U.S. and Africa.

"It's a day for the world to recognize the fact that there are 39 million people living with HIV/AIDS," Bush said. "And a day to remember the fact that 25 million people have died of AIDS."

Bush's AIDS initiative, announced in 2003, is the largest international health initiative dedicated to a single disease.

It targets 15 countries that are home to about half of the world's 39 million people who are HIV-positive. The countries are: Botswana, Cote d'Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Vietnam and Zambia.

The Bush initiative committed $15 billion over five years to support treatment for 2 million people, prevention for 7 million and care for 10 million. The White House says that today, more than 800,000 people are receiving lifesaving drugs.

Adding the 770,000 people treated with the drugs through the Global Fund to Fight AIDS, Tuberculosis and Malaria means that more than 1 million people living with AIDS are being treated worldwide. The Global Fund is a public-private partnership that has committed $6.8 billion to fight the three diseases in 136 countries.

"Four years ago, almost nobody in Africa and elsewhere in the developing world was receiving treatment," said Richard Feachem, director of the Global Fund. "That well over 1 million people with AIDS are on now on treatment through the support of Global Fund and PEPFAR is a remarkable achievement. We must now build on this progress to reach the millions more who are still in urgent need."

While the president's treatment program is widely praised, critics of Bush's initiative complain that not enough is being done to prevent people from contracting HIV.

Richard Holbrooke, former U.S. ambassador to the United Nations who now leads the Global Business Coalition on HIV/AIDS, said the treatment program might not be sustainable, because the number of people with HIV continues to grow. According to the U.N. agency on AIDS, there will be 4.3 million new infections this year.

Proponents of the Bush initiative argue that a three-pronged HIV prevention strategy — emphasizing abstinence, fidelity and condom use — offers people the best options to protect themselves from AIDS. Democrats in Congress have condemned a provision in the Bush initiative that requires that 33 percent of all money committed to prevention programs be spent to promote abstinence. That restriction, they say, has more to do with conservative ideology than scientifically proven programs.

Bush also urged Congress to reauthorize the $2.1 billion Ryan White Care Act, the largest federal program specifically for people with HIV/AIDS.

Supporters say changes are needed in the act because AIDS has moved beyond urban centers into rural areas. But in September, they failed to overcome objections from senators in New York and New Jersey, states that stand to lose AIDS money under proposed revisions to the act.

Senate Democratic Leader Harry Reid said that in America, infection rates are skyrocketing in minority communities. HIV/AIDS is the leading cause of death for African American women ages 25-34 and the fourth leading cause of death for both African American and Hispanic women ages 45-54, he said.

"We can — and we must — do more to address this ongoing crisis," Reid said.

Shortly after breaking up with his partner, a British man with HIV found that his address was posted in a shop window along with a warning that he was an AIDS carrier.

Days later he was beaten with chair legs by men in his home.

"I spent years coming to terms with living with HIV, then just one person turned my life around through pure spite," said John, a 36-year-old who lives in the Midlands.

Twenty-five years into the AIDS epidemic, people infected with the virus still face hate crimes, stigma, discrimination and abuse. In Britain where an estimated 63,000 people are infected with HIV, it is driving many sufferers into extreme poverty.

"It is a real enough phenomenon for us to need to do something about it," said Yusef Azad of the National AIDS Trust (NAT) in Britain.

A report by the trust and Crusaid, a charity dedicated to helping people affected by HIV/AIDS, shows a third of all people diagnosed with HIV in Britain have sought hardship help to relieve their poverty.

"We're talking very significant proportions of people living with HIV who are having to deal with poverty issues," Azad said in an interview.

"HIV often drives people into poverty and poverty makes the condition more difficult to manage and deal with," he added.

MONEY FOR FOOD

The report, released on World AIDS Day, highlights cases of people hounded out of jobs because of their HIV status, or who faced discrimination when they tried to get one. Others live in sub-standard housing and have been abandoned by friends and family and ostracized by their community.

"My bosses never said anything in particular but kept making it clear that I should consider taking a long rest and maybe not return at all," said Graham, who eventually quit because he felt so isolated.

Britain has one of the highest increasing rates of HIV in Europe. In 2005 it recorded the biggest ever number of new HIV diagnoses in gay and bisexual men. About 85 percent of the rise in heterosexual transmissions is in people who migrated from other countries with high infection rates.

"The worrying thing is that, at a time when HIV is probably the most serious communicable disease threat for the UK, funds for HIV prevention are being cut," said Azad.

More people are being pushed into poverty because of HIV/AIDS and it is becoming more extreme. In the past people sought money from Crusaid's hardship fund to buy items such as appliances. Now it is for food.

"The depths of destitution and the depths of need are much more severe than they have been in the past. The people in those categories, and there are many more of them, tend to be people within the asylum and immigration system," according to Azad.

The report called for the government and police to establish policies that explicitly address HIV hate crimes and help tackle unemployment and poor housing among people with HIV.

"The asylum and immigration system needs to insure people living with HIV have enough to live on ... and should allow people who have been here for six months the right to work," Azad added.

 

The workplace may be the best setting for millions of people with HIV and AIDS to be administered drugs that could extend their lives, the International Labour Organization (ILO) said on Friday.

In a report published on World AIDS Day, the United Nations agency said that more than 24 million people in the global workforce in 2005 suffered from HIV or the disease it causes, AIDS. Nearly 67 percent of these lived in Africa.

Giving these workers access to anti-retroviral drug therapy, or ARVs, could have lengthened their working lives by more than two years, and considerably increased per capita incomes in places like sub-Saharan Africa, the report found.

"Access to ARVs in the workplace must rise substantially," it said, estimating that 1.8 million more African workers would be alive in 2010 if 80 percent of the workforce were to start and stay on ARV therapy from this year.

Public health experts say that the life-extending drugs have transformed the once-deadly HIV and AIDS into chronic conditions. But they need to be taken at regular intervals to be effective, and can cause drug resistance when taken improperly.

The ILO estimated that the HIV epidemic stripped an average of 0.5 percentage points off the economic growth of 43 affected countries every year between 1992 and 2004.

In sub-Saharan Africa, 31 countries lost 0.7 percentage points of economic growth per year during the period.

Employment growth also suffered markedly. The ILO said HIV and AIDS caused a 0.5 percent yearly decline in sub-Saharan Africa's annual employment growth rate, "equivalent to an employment loss of 1.1 million (jobs) per year for Africa."

North Korea has relied on the wise leadership of Kim Jong-il to make sure there have been no outbreaks of AIDS in the reclusive country, its official media reported on Friday.

North Korean media, which often gives glowing reports of Kim offering expert guidance on subjects as varied as cobbling shoes, firing howitzers and irrigating fields, said its Dear Leader has been deeply concerned about AIDS.

"Under the wise guidance of leader Kim Jong-il, the DPRK (North Korea) established the strategy of prevention and control of AIDS with orderly systems of its information, prognostication and watch, and examination across the country," an official newspaper said.

"On this basis, measures have been taken not to allow a single AIDS case," Minju Josun said in a report carried on the English-language KCNA news agency.

UNAIDS said it has no definitive data on AIDS in North Korea, one of the world's most secretive states.

The U.N. program estimated that by 2002 fewer than 100 cases of HIV infection had occurred in the country of just over 22 million.