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Clinton supports wider AIDS testing

By CNN's Peter Wilkinson

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Bill Clinton
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LONDON, England (CNN) -- Former U.S. President Bill Clinton has lent his support to compulsory HIV testing of people in developing countries with high levels of infection.

The former president, whose Clinton Foundation HIV/AIDS Initiative is helping to provide cheaper AIDS tests and drugs, said making people aware of their HIV status was the only way to make them change their sexual behavior.

When the AIDS epidemic began two decades ago there was little support for mandatory testing because of the stigma attached to the disease and the lack of treatment for those infected.

But Clinton said countries where there was no discrimination against people with the illness and where anti-AIDS drugs were available should now consider universal testing.

"I think there needs to be a total rethinking of this testing position in the AIDS community and a real push for this," Clinton told reporters during a briefing in London on Tuesday.

He said he only supported mandatory testing if the country itself wanted to do it and could guarantee there would be no discrimination and full access to life-saving medication.

The Clinton Foundation has brokered deals with pharmaceutical companies to bring the price of an instant test for HIV, the virus that causes AIDS, down to between 49 and 65 cents, or about half the normal cost. It has also brought down by about 70 percent the prices of some anti-retroviral drugs that slow the spread of disease.

According to the foundation, more than 90 percent of the 40 million people living with HIV do not know they are infected. Developing countries need to run at least 200 million HIV tests in the next four years, according to the foundation.

He added though that "when someone tells you there are 40 million sufferers, they're just extrapolating."

"If 90 percent don't even know (they have the disease) how can you ever reduce the number of sufferers?" Clinton said.

"They need to know their status," he said. Rapid HIV tests can do that even in remote areas because they're easy to use and give results in 20 minutes, the 59-year-old former president said.

He said that in countries with low levels of infection, compulsory testing would be a waste of money. But once the level of infection rises to 5 percent, "you're in trouble" and that is when testing becomes invaluable to reduce the spread of the disease.

Clinton said that even though a friend of his in Arkansas died from AIDS 20 years ago he remained against mandatory testing until recently. However, he now realized "we can save lives and reduce stigma."

"This is a public health problem, it's not about rich and poor. AIDS affects the social stability of a country and it is inconceivable that you can have drastically lower rates (of infection) without testing."

Clinton said he supported the African kingdom of Lesotho, which is the first country that has pledged to introduce the compulsory testing of all its 2.2 million citizens, of whom 27 percent are HIV-positive.

"Way over half the people in that country are at risk ... many of them totally innocent. We must stop looking at testing as a burden, but say we're going to save your life. We must treat it as a public health issue ... without shame."

Those who tested positive would be told, "you're going to die, but (with anti-retroviral drugs) we can give you a normal life. However you can't infect anyone," Clinton said.

Clinton added that he himself was tested. "I got sick of burying people and didn't want anyone saying I was a hypocrite." He admitted there wasn't much support for compulsory testing, but he hoped to tackle the stigma surrounding the disease, so more people will be tested voluntarily.

Asked for his perspective on his post-White House role, Clinton said: "I may be more popular as an ex-president, but I don't do as much good. When I was president ... my actions could affect hundreds of millions of people.

"But directly and indirectly, I can have influence ... by chain reaction I might do some good. Tens of thousands of kids are alive now that might not have been" without his foundation.

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