A Seniordoc.org member quoted in a news article

Paul Farkas

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Member Jordan Kassalow, OD, MPH an Adjunct Senior Fellow at the prestigious Council on Foreign Relations is quoted extensively in this article. Read on...


"China must act to prevent AIDS explosion
By Christian Bourge

UPI Think Tanks Correspondent

From the Think Tanks & Research Desk
Published 4/9/2003 10:24 PM



WASHINGTON, April 9 (UPI) -- The outbreak of severe acute respiratory syndrome, or SARS, has spotlighted the Chinese government's ineffectual approaches to fighting dangerous communicable diseases, and has emphasized the significant international economic, healthcare and security implications of China's failure to address the spread of the much deadlier HIV/AIDS virus, according to think tanks policy experts.

Bates Gill, who holds the Freeman Chair in China Studies at the Center for Strategic and International Studies and who is co-editor of a recent CSIS report on the AIDS epidemic in China, said that although the HIV/AIDS is approaching critical mass in China, the Chinese are not giving the problem the kind of attention it deserves.

"There are a lot of links between SARS and AIDS," Gill told United Press International.

"All of the criticism which has been levied at the Chinese government's health care system on the SARS issue can easily be applied to the HIV/AIDS problem," he said. "Just as in the case of SARS, the Chinese government has not really taken up the issue at the highest levels in a serious and sustainable way."

The Chinese government's initial denials that the country had a significant outbreak of SARS and was the source of the epidemic, along with its slow response to addressing the resulting public health crisis, is typical of the China's official responses to disease. HIV/AIDS is expected to have much greater consequences for China than SARS, by killing far more people and producing a greater economic crisis. Although HIV/AIDS is currently found mostly in marginalized Chinese populations -- such as prostitutes, drug dealers and poor farmers in rural areas -- experts believe it will soon spread into mainstream Chinese society.

The CSIS report, "Averting a Full-blown HIV/AIDS Epidemic in China," says that without a major intervention effort, 10 to 20 million of China's 1.3 billion population could be infected with HIV by 2010. Although there are only 30,000 officially diagnosed and registered cases of HIV/AIDS in the country, current estimates place the number of infected individuals at more than one million.

The report calls for a strong bilateral approach that combines dynamic health diplomacy with international cooperation to combat the spread of the disease in China. The recommendations were made by an 18-member delegation of government officials, scholars, and experts who traveled to China in January to examine the issue, at the invitation of Zhang Wenkang, the Chinese minister of health.

Dr. Jordan S. Kassalow, an adjunct senior fellow at the liberal-leaning Council on Foreign Relations and a practicing optometrist, said the impact of HIV/AIDS on the African continent shows not only the toll the disease can take on human life if it is allowed to spread unchecked, but also its economic and security implications.

"If you look at Africa as an example of what can happen in a society where a pandemic is allowed to go out of control, the disease has swept over eight, 10, 20, even 30 percent of (national) populations," he said. "This has happened in a lot of southern African countries where the life expectancy has gone down by 10 to 20 years."

He added that as life expectancy has declined in these countries, so has the Gross Domestic Product. "Being that China is an engine of growth and development in Asia and beyond, this is certainly a concern for global economics," he said.

Beyond the Chinese government's unwillingness to acknowledge major public health crises, Gill said the country's health care system is unable to properly deal with the AIDS virus. Not only is the system underfunded, its public health providers are under-educated, with only a small number of physicians properly trained even to diagnose the disease. Despite its experience with diseases thought to be similar to SARS, the limits of the Chinese public health system became glaringly evident through its ineffective response to the recent outbreak of the disease.

"Their health system is overwhelmed in terms of being able to react medically and scientifically to this dilemma (AIDS), both in terms of identifying it and providing effective treatment," said Gill. "Even after the (Chinese) health ministry and other agencies have acknowledged the problem and mobilized resources against both SARS and the HIV epidemic, it (the response) has simply not been adequate."

The think tank analysts all agreed that the although officials in the Chinese Ministry of Health have recognized the need to address the HIV/AIDS crisis, the agency does not have the power to overcome the view among the upper ranks of the Chinese government that the disease will continue to have an impact only at the margins of society.

David Lampton, director of the China Studies Program at the Johns Hopkins University Paul H. Nitze School of Advanced International Studies, known as SAIS, told UPI that the Chinese government places the highest political emphasis on ministries that bring in money. As a result, the health ministry has little power.

"Public health is one of the areas that requires spending money and doesn't make money," said Lampton.

The CSIS report specifically recommends that top officials in the U.S. administration forge a sustained dialogue on the issue with high-ranking Chinese officials, and expand collaboration between the U.S. National Institute of Health, the Center for Disease Control, and USAID to strengthen emerging Chinese health policy initiatives. The Chinese Ministry of Health has made some effort to preempt the spread of the disease with increased funding, improved intra-governmental coordination and education, but these efforts are considered woefully short of what is required.

The report also says that the Bush administration should invest more diplomatic energy in coordinating international assistance to China through non-governmental organizations, health policy groups like the World Health Organization, and international organizations with unrealized potential in this area, such as the World Bank. United Nations estimates of the total international commitment to address the spread of AIDS in China are approximately $62 million for 2003 and 2004, with funding levels projected to drop in subsequent years.

Gill said this last recommendation remains one of the toughest because the international community has been reluctant to provide significant financial assistance to China as long as the government remains reluctant to take the necessary steps to stop the spread of the disease.

Most analysts see a slim probability that the Chinese government will do more to address the issue, but Lampton said that the newest generation of Chinese leaders coming into power are younger and more open to the outside world than their predecessors. He said that he hopes they are more inclined to address the major issues surrounding HIV/AIDS -- such as drug use and sexual transmission -- than traditional Chinese Communist Party leaders, who have been unwilling to look at them.

Gill said he remains "cautiously pessimistic" about the road ahead because of the lack of a significant response from high-level Chinese government officials on the issue.

"As long as the leaders in China believe that the problem will remain largely marginalized in portions of society which are either seen as nonproductive or not seen as law-abiding, then we are not going to see the push needed to address the spread of this pandemic," he said.

Copyright © 2001-2003 United Press International"

In the interest of full disclosure, Jordan is a former Associate and my Godson. Needless to say I'm proud of him.
 
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Another award for our member

Jordan Kassalow's eyewear company has a Foundation...

"Scojo Foundation, Brooklyn, NY: www.scojo.com"

Their goal is to distribute Scojo products in India to the needy. Jordan's foundation won a $25,000 prize from a contest held by Goldman -Sachs to find those young companies who care about Societal issues.

Congratulation Jordan and the Scojo team for your good work. It should make every OD proud that there are companies who care and are run by Optometrists.

So far the AOA News did not pick up Jordan's important remarks that were reproduced by UPI. I wonder if this newest honor will be reported?

Keep up the good work on both the Council on Foreign Relations and the Scojo Foundation. Your efforts make all ODs stand a bit taller!