China will open 300 needle exchange centers over the next three months in a bid to lower the incidence of HIV/AIDS infections among drug users.

The ambitious plan will more than triple the number of needle exchange centers in China, the official Xinhua news agency reported Friday.

China had just 91 needle exchange centers at the end of last year, the report said, citing Ministry of Health statistics.

It said the expansion of the needle exchange program was needed because 44.3 percent of the estimated 650,000 people in China living with HIV/AIDS were drug users who contracted the disease by sharing needles.

The figure of 650,000 people came from a joint study carried out last year by China's health ministry, the World Health Organization and UNAIDS.

The study said there were between 60,000 and 80,000 new HIV/AIDS cases in 2005. An estimated 25,000 people died from AIDS in 2005.

UNAIDS said in May, as it released its biennial snapshot of the global pandemic, that China was emerging from AIDS' shadow by improving its accounting of the number of cases in the country.

Friday's Xinhua report said China's central and local governments spent 1.08 billion yuan (136.6 million dollars) last year on the prevention and treatment of HIV/AIDS, more than double the amount allocated in 2003.

New cases of tuberculosis found in South Africa have raised fears there could be multiple versions of a highly drug resistant strain that has killed 62 people and threatens to spread across a region ravaged by AIDS.

Health officials said on Wednesday the five new cases were discovered in Gauteng, South Africa's premier economic region, which includes Johannesburg and Pretoria.

The discovery has stoked concerns that extremely drug resistant tuberculosis, or XDR-TB, may be spreading further, complicating efforts to contain the deadly march of AIDS in the region.

Officials said the strain of TB found in Gauteng this week did not immediately match the one that has killed 62 people in eastern KwaZulu-Natal province over the past month.

"A preliminary report suggests they are not the same strain, but to say conclusively a laboratory has to do DNA testing that takes months," said Dr. Joe Khoali, TB adviser for the Gauteng Health Department.

"We are not sure if we're dealing with one or multiple strains," Khoali told Reuters.

The two males and three females had been admitted to isolation units in the Sizwe Hospital in Johannesburg, health officials said.

WIDER PROBLEM?

A senior official of the World Health Organization told Reuters it was probable XDR-TB was not confined to South Africa.

Paul Nunn, coordinator of WHO's Stop TB Department said earlier this week XDR-TB could be present in other regions of Africa afflicted by HIV/AIDS but which lacked the capacity to find and diagnose the illness.

"It isn't just an issue of a particular strain spreading," Nunn said. "It is an issue of (whether) there are outbreaks occurring that we don't know about. We feel it's quite possible."

Experts say XDR-TB has been seen worldwide, but the outbreak in South Africa is acute because of the high number of fatalities in an isolated area.

Nunn said a failure by South Africa to implement a robust infection control program to properly manage the disease, coupled with a high HIV infection rate, could have led to the current outbreak.

An estimated 1 in 9 of South Africa's 45 million people carry the virus, giving the nation one of the worst HIV rates in the world. Infection rates in neighboring countries like Lesotho, Botswana, Swaziland and Zimbabwe are also high.

The outbreak of XDR-TB has coincided with raging controversy over South African Health Minister Manto Tshabalala-Msimang's promotion of alternative AIDS remedies.

The minister has enraged activists and many health experts by pushing "natural" HIV treatments such as beetroot and garlic while playing down anti-retroviral drugs.

In local media interviews this week, Tshabalala-Msimang denied that she had ever held out these nutrition-based remedies as alternatives to anti-retroviral drugs.

A British colonial era law in India that criminalizes homosexuality is "not acceptable" and scrapping it is "fundamental" to the fight against AIDS, the country's top official leading efforts to end the disease said.

Section 377 of the Indian Penal Code carries a maximum penalty of 10 years in jail for men having gay sex.

"This is not acceptable. Section 377 is quite an anachronism," Sujatha Rao, the chief of the state-run National AIDS Control Organization (NACO), told cheering delegates late on Tuesday at the end of a four-day Asia-Pacific conference on male sexual health and HIV. She termed the law "hateful."

The law, enacted in 1861 by British colonial rulers, is being challenged in New Delhi's High Court by an Indian anti-AIDS voluntary group. The challenge has been supported by NACO.

Activists say policemen use Section 377 to extract money from gay men sitting in parks or lanes and the threat of penal action only compounds the problems of social stigma and discrimination the sexual minority faces in India.

NACO estimates India's population of men having sex with men (MSM) to be about 2.5 million but says it could be far higher. It estimates that around 25 percent of MSM are HIV positive.

"It is important to end this (Section 377), otherwise it would be very difficult to reach out to MSMs and end the spread of this infection," Rao told reporters after the conference.

She said only about six to eight percent of gay men were covered by outreach projects, which include distribution of condoms.

India has 5.7 million people living with HIV/AIDS, more than any other country, according to the United Nations.

Gay men are seen as a high-risk group along with female prostitutes and intravenous drug users.

India's home ministry has opposed the removal of the law, saying that public opinion was not in favor of legalizing sex between men.

But Rao said that NACO was talking to the home ministry about reaching a common position before the next court hearing scheduled in October.

Her comments, possibly the strongest public criticism of the law by a government official, came 10 days after leading Indian writers, lawyers and artists wrote an open letter to the government asking it to remove the "monstrous" law.

"With this law, MSMs are scared to come out in the open and we can't work with them (on HIV prevention)."

Those who have been jailed under the law are calling for the government to scrap it immediately.

"I was beaten in jail by policemen, did not get enough water and faced abuse from other prisoners because of the general homophobia," said Arif Jafar, a well-known activist working with gay men in the northern state of Uttar Pradesh.

Jafar, who is gay, had been arrested under Section 377 for 47 days last year. Though out of jail, he still has to attend court in Lucknow, Uttar Pradesh's capital, to fight his case.

"This law must go. No one should suffer the humiliation I went through," he told Reuters after the conference.

This industrial city is reeling after learning that at least 63 children have contracted AIDS through medical negligence many blame on corruption and the illicit sale of blood.

At least five infected toddlers have died after receiving injections or blood transfusions in hospitals in Shymkent, a city in Kazakhstan's most densely population region 1,000 miles south of the capital.

Valentina Skryabina, leader of the nongovernment group Nadezhnaya Opora, which works to prevent AIDS among drug addicts, is convinced the illegal sale of blood is the source of the HIV in Shymkent's hospitals.

"Blood is an article of trade.... Hospitals are offered blood, and not always through the (official) blood center. People trade in blood like they do in human organs."

Skryabina said addicts and the homeless have been accepted by the regional blood center because they agreed to be paid less than the official rate of $47 for about a half-pint of blood.

"Was their blood properly checked? We are not sure," she said.

Officials say they cannot comment on Skryabina's allegations until their investigation is over. Authorities do say, however, that five blood donors who are suspected to be HIV-carriers weren't found at their registered addresses.

Parents in this city of 400,000 are trying to conduct their own investigation. They say regional health officials were aware of the outbreak in March, and have been trying to cover it up by pulling pages from the infected toddlers' treatment records to eliminate any mention of blood transfusions.

The parents allege that up to 40 HIV-infected children aged 3 and under have died, but the true cause of the deaths was being concealed or attributed to diseases such as cirrhosis. Authorities declined to comment on these allegations, too, pending the investigation.

Some 13,000 children who were possibly infected have yet to be tested. Adults, too, could be infected: so far, three mothers of infected toddlers have tested positive for HIV.

Lawmaker Satybaldy Ibragimov says nothing will improve until Kazakhstan roots out corruption, which penetrates even universities where future doctors are graded according to the amount of money they give professors — and later treat people based on their ability to pay.

President Nursultan Nazarbayev's government has taken tough action. The health minister and the regional governor were fired this month, and several top regional health officials, the head of the regional blood center and several senior doctors are under criminal investigation.

New governor Omyrzak Shukeyev, former mayor of the capital Astana, called the situation in Shymkent's health care system "a catastrophe." He ordered an appraisal of medical staff in the region to root out incompetent or corrupt staff.

Shukeyev, under orders from Nazarbayev to urgently resolve the crisis, pleaded with experts at an AIDS crisis meeting this week: "I'm waiting like nothing else for a moment when you say that the virus has been contained."

"We cannot give you a time frame. This is going to be a lingering epicenter of disease," replied Vyacheslav Dudnik, the region's new health chief.

Shukeyev said the government would restructure and modernize the region's medical institutions. Each infected toddler's family will be given about $800 — twice the average monthly salary — in compensation and all treatment will be paid for by the government.

The most immediate problem is the lack of local expertise on how to treat young children with the AIDS virus.

Four AIDS specialists from UNICEF and several experts from Russia have been asked to help. But for now, said Sagdat Masaurov, whose 18-month-old grandson is infected, "nobody can tell us where to go, what to do and how."

Officially, by the end of 2004 Kazakhstan had about 4,700 HIV/AIDS cases, but the real number is believed to be higher. In the first six months of this year, the country recorded 828 new HIV carriers and 70 AIDS patients, a 70 percent increase over 2005.

Parents carrying toddlers come in a steady flow to the rundown two-story AIDS center in Shymkent for HIV tests.

In the center's courtyard, anxious-looking parents with HIV-infected children await examinations by doctors. Children can be heard crying.

Eighteen-month old Baurzhan Alseitov sat in his mother's arms, a blank look on his face. His father, Kanat Alseitov, was afraid the child's listlessness indicated the virus was already sapping his little body.

"He was restless and cried all night. He doesn't want to walk anymore," the father said.

House members from rural areas and the South clashed with big-city lawmakers Thursday over who should get a bigger share of federal money to care for AIDS patients.

"It's shameful and disgraceful," shouted Rep. Eliot Engel (news, bio, voting record), D-N.Y., denouncing amendments to the $2.1 billion Ryan White CARE Act that could take millions of dollars out of New York's health care coffers.

"The HIV/AIDS epidemic is moving," countered Rep. Joe Barton (news, bio, voting record), R-Texas. "This is a very fair compromise. It begins to treat all states on an equal footing."

The House was expected to vote on the bill later in the evening. A two-thirds vote was needed for passage.

Even if it passes the House, the bill faces uncertain prospects in the Senate before Congress recesses at the end of the week to campaign for re-election. Senators from New York, New Jersey and California are blocking it.

Supporters said the election-year updates were needed because of how AIDS has changed since the Ryan White law first passed in 1990. Once a big-city epidemic infecting mostly gay white men, the disease is now prevalent in the South and among minorities.

By some measures federal funding has not kept up, and states like California, New York and New Jersey get more money per patient than Alabama, Kentucky or North Carolina.

The Ryan White amendments, the first since 2000, make a number of changes aiming to spread money more equally around the country.

While current law only counts patients with full-blown AIDS, the revision also would count patients with the HIV virus who have not developed AIDS.

That change would favor parts of the country where the disease is a newer phenomenon, which tend to be southern and rural areas.

New York state stands to lose $100 million over the five years of the bill. New Jersey would lose $70 million.

Alabama, by contrast, would get an increase from $11 million a year to about $18 million a year.

"The problem is that the population of those needing services has grown, but the funding for Ryan White programs has not grown with it," said Rep. Henry Waxman (news, bio, voting record), D-Calif. "That means if we're going to give to some people who are very deserving, we're going to take from others who are very deserving."

California and some other states are worried about a change in the bill that mandates counting HIV patients by name instead of codes. Some states used code-based systems out of concern for patient privacy. California could lose an estimated $50 million in the last year of the bill, when the name-based system would take effect, because it won't be prepared to make the transition.

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