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Xenophobic fears in Asia have led to a wave of tough anti-AIDS legislation. China has reported only two deaths from AIDS, but authorities have ordered the testing of more than 4,000 foreign students. In Japan, which admits to 38 cases of AIDS, the Diet (parliament) may soon pass legislation that would deny entry to foreigners who test positive if they present a threat to public health; the bill is mostly aimed at prostitutes, bar girls and foreign sailors. With little more than a year to go before Seoul is host to the 1988 Summer Olympics, South Korea has passed a law that subjects anyone found guilty of knowingly spreading the virus to up to two years in prison.
Governments are also beginning to face the question of who will pay health- care costs for AIDS suffers. American insurers estimate the cost of providing hospital and medical treatment for a single patient at more than $75,000 from diagnosis to death. Around the world, hospitals and medical staffs are ill- equipped to deal with the rising costs and numbers of AIDS cases. Dr. Anthony Pinching of London's St. Mary's Hospital Medical School warns that his facility, which has cared for over 170 AIDS patients, is facing economic burnout. Reason: it lacks funds to hire additional staff and expand its facilities.
Even as the AIDS policy debate rages, however, many painful questions remain unanswered. How, for example, will the U.S. cope with the AIDS medical bill? A Rand Corp. study released last week concludes that the cost of treating a projected 400,000 U.S. AIDS sufferers from 1986 to 1991 may exceed $37 billion, with about $10 million borne by the Medicaid program. Also, who , will treat the patients? New York City, where more than 700 of the 35,794 available hospital beds are already occupied by AIDS patients, has proposed devoting one hospital exclusively to their care.
Perhaps the most fundamental question facing U.S. policymakers is whether they are willing to protect the ordinary rights of those infected with the AIDS virus without resorting to racist or homophobic programs. High-risk groups, after all, are those from which the public will clamor most for protection. Many public health officials feel that education, treatment and counseling programs for homosexuals and intravenous drug users offer the best return on the tax dollar. "IV drug use is the main source of heterosexual spread in this country," says Don C. Des Jarlais, an epidemiologist at the New York State Division of Substance Abuse Services. "That's where we have to concentrate our efforts. There is still time."
FOOTNOTE: *Britain, France, West Germany, Italy, Canada and Japan.