Foreign Relations of the United States, 1981–1988, Volume XLI, Global Issues II

35. Memorandum From the Chairman of the Foreign Intelligence Priorities Committee, Central Intelligence Agency, [name not declassified] to the Deputy Director of Central Intelligence (Gates)¹

Washington, December 11, 1987

SUBJECT

• Establishment of DCID 1/2 Topics and Priorities for Intelligence on the AIDS Pandemic [portion marking not declassified]

1. Action Requested: That you approve the establishment of DCID 1/2 topics and priorities for the subject of AIDS intelligence, as defined and listed in the attachment. [portion marking not declassified]

2. Background: Both State and CIA requested the establishment of priorities on this subject because of its growing importance.² Committee discussion led to the judgment that the priority assigned to a country for intelligence on the epidemiology of AIDS may often be quite different from the priority assigned to sociopolitical impact. Therefore, the Committee agreed to establish topics and priorities for both aspects of the subject, with CIA preparing the proposal on epidemiology and State that on sociopolitical impact. [portion marking not declassified]

3. Staff Position: The proposals were addressed at Committee meetings³ attended by NIO-at-Large Kate Hall, NSA’s SINIO for Global Issues Gail Reinheimer, and Community analysts. Because of the range of uncertainty about the AIDS situation in particular countries, and about U.S. interests that might be affected, there was considerable discussion of individual priority nominations. The Committee achieved a consensus on the assignment of country priorities worldwide at the [less than 1 line not declassified] levels, as described in the attachment. All of the member agencies and departments agreed that the attached proposal should be sent to you for approval. [portion marking not declassified]

4. Recommendation: I recommend that you approve the establishment of the proposed topics and country priorities. [portion marking not declassified]

[name not declassified]

Attachment A

Paper Prepared in the Central Intelligence Agency⁴

Washington, undated

A. PROPOSED TOPIC DEFINITIONS

The subject of AIDS will be listed in the FIRCAP as a new sub-category of two topics within the Special Subjects category. [portion marking not declassified]

4.0 SPECIAL SUBJECTS

4.9 ACQUIRED IMMUNE DEFICIENCY SYNDROME

4.9.1 AIDS (Acquired Immune Deficiency Syndrome): epidemiological aspects. Population groups infected with the HIV (Human Immune Deficiency Virus and its variants), the virus that initiates the acquired immune deficiency syndrome; statistics on infected persons and cases of clinical AIDS; causes of and expected spread of disease within population groups; national surveillance and diagnostic capabilities; impact of AIDS on national health structures and budgets. Population movements into and out of the country that pose an infection threat to the U.S. and other countries. [portion marking not declassified]

4.9.2 AIDS (Acquired Immune Deficiency Syndrome): sociopolitical impact. Incidence and extent of AIDS within political and economic, elites, the military leadership, and key insurgent movements; impact on political, social, economic, and military organizations, processes, and capabilities. Government responses to in-country AIDS and reactions to international defensive strategies. Country attitudes toward the U.S. relating to AIDS. Indications of and reactions to disinformation concerning AIDS aimed at resident individuals or groups, or against foreign groups and governments. [portion marking not declassified]

Attachment B

Paper Prepared in the Central Intelligence Agency

Washington, undated

B. PROPOSED PRIORITIES

[Secret; [handling restriction not declassified] 5 pages not declassified.]

Attachment C

Paper Prepared in the Central Intelligence Agency⁵

Washington, undated

C. JUSTIFICATIONS

The justifications in this section provide relevant factual material and judgments on the AIDS situation in different regions of the world and its potential impact on US interests. The justifications were provided by different individuals and organizations. To maintain a consistent approach to the assignment of country priorities, the Committee assessed the following factors with respect to each country worldwide:

4.9.1 AIDS: epidemiological aspects:

—Infection threat to U.S.

—Infection threat to neighboring countries.

—Importance of country as a source of epidemiological data.

—Importance of epidemiological data to assess likely impact on political, economic, and military capabilities of country—together with consideration of importance of country to U.S.

—Rate of disease spread/control capability and possibility of future priority increase if warranted.

4.9.2 AIDS: sociopolitical impact:

—Impact on country’s political, commercial, or military relations with US. Importance of country to US interests.

—Impact on country’s political, economic, or military capabilities and relationships. Importance of country to U.S. interests.

—Importance of intelligence on disinformation.

—Likelihood and timing of impacts and possibility of future priority increase if warranted. [portion marking not declassified]

1. East Europe	Topic 4.9.1 Epidemiological Aspects	Topic 4.9.2 Sociopolitical Impact
Albania	[1 column not declassified]	[1 column not declassified]
Bulgaria
Czechoslovakia
GDR
Hungary
Poland
Romania
USSR
Yugoslavia		[portion marking not declassified]

In August 1987 the Politburo adopted a series of dramatic measures against Acquired Immune Deficiency Syndrome (AIDS) and thereby acknowledged the existence of an AIDS problem in the USSR. While the possibility of AIDS has been minimized for several years, intelligence reporting revealed serious concerns among Soviet scientists as early as mid-1985 and confidential estimates of AIDS infection are much larger than the hundred cases officially admitted to date. Fighting AIDS may cause the regime considerable political embarrassment because it highlights deficiencies in the health care system and requires discussing unmentionable realities of Soviet life such as homosexuality and prostitution. Fighting AIDS will also be costly economically because it will force the regime to correct the massive problems of the health care system. These deficiencies include inability to test all blood transfusions and the vulnerability of spreading AIDS through the use of reusable hypodermic needles. The regime has set out to determine the exact extent of AIDS through massive testing, including mandatory testing of high risk groups. Additional definitive information on the disease should be circulating within the Soviet and world scientific communities. [portion marking not declassified]

The course of AIDS within the USSR may have an impact on political standing of the current leadership, the resource options available, and ultimately the country’s overall strength. The Soviets have also made AIDS an international issue by fostering the spread of disinformation, blaming the US for the disease and, recently, calling for increased bilateral and multilateral cooperation on medical research. US national concern with the epidemiological aspects of AIDS in the USSR is compatible with the priorities proposed for Cuba, Brazil, and South Africa. [portion marking not declassified]

Very few cases of AIDS have been officially reported by any of the East European Communist governments. The largest number, 11 cases, has been reported by Yugoslavia. Data on this subject is important to provide early indications of potential impact on the economic and military capabilities of these countries. Intelligence on AIDS defensive strategies is important with respect to each of the Soviet Bloc countries because the outcomes of these strategies can have a bearing on their trade, travel, and military exchange relationships and on their political relationships. [portion marking not declassified]

2. West Europe	Topic 4.9.1 Epidemiological Aspects	Topic 4.9.2 Sociopolitical Impact
Austria	[1 column not declassified]	[1 column not declassified]
Belgium
Canada
Cyprus
Denmark
FRG
Finland
France
Greece
Greenland
Iceland
Ireland
Italy
Liechtenstein
Luxembourg
Malta
Netherlands
Norway
Portugal
Spain
Sweden
Switzerland
Turkey
UK		[portion marking not declassified]

According to the World Health Organization, the number of Europeans ill with AIDS is expected to double every nine to 11 months. In addition to over 4,000 West Europeans reported ill with AIDS, half a million to one million are carrying the AIDS virus. If ten to thirty percent of them actually develop AIDS, as seems likely, there will be from 50,000 to 300,000 deaths from AIDS in Western Europe over the next five years. [portion marking not declassified]

In West Germany and France, the number of cases of AIDS jumped 150 percent over the past year. France has the most cases in Western Europe. Switzerland and Denmark have the highest per capita rates. Italy, Netherlands, the United Kingdom, and Canada also have a significant number of reported AIDS cases. [portion marking not declassified]

Major Western European nations have launched significant prevention campaigns and allocated increased funds to seek cures, develop vaccines, care for the ill, and test for the virus. Mandatory testing proposals are highly controversial, and mandatory testing for high-risk groups has been adopted in the West German state of Bavaria. [portion marking not declassified]

3. East Africa	Topic 4.9.1 Epidemiological Aspects	Topic 4.9.2 Sociopolitical Impact
Comoros	[1 column not declassified]	[1 column not declassified]
Djibouti
Ethiopia
Kenya
Madagascar
Malawi
Mauritius
Seychelles
Somalia
Sudan
Tanzania
Uganda
Zambia		[portion marking not declassified]

Ethiopia’s regional political importance, its active insurgencies, its large population, and its food and refugee problems that spill over into neighboring countries make the monitoring of the epidemiological aspects of AIDS important from the standpoint of the disease’s effects on neighboring countries as well as on US interests in Ethiopia. While Ethiopia officially reports a low incidence of AIDS at the present time, Ethiopians abroad have been found to have the virus, and its social disorganization, due to civil war and famine, threaten to cause conditions conducive to a rapid spread of disease. [portion marking not declassified]

There is not much information for Somalia, Sudan, and Djibouti, although their geographic locations, large refugee populations, and insurgencies and dissident activity suggest their populations are probably heavily infected. Kenya, Malawi, Tanzania, Uganda, and Zambia are reporting relatively high incidences of the disease and probably have significant portions of their populations infected. Monitoring the epidemiological aspects of AIDS in these countries is deemed of some importance, possibly pointing to future developments in other countries that are as yet not so highly infected. [portion marking not declassified]

4. West Africa	Topic 4.9.1 Epidemiological Aspects	Topic 4.9.2 Sociopolitical Impact
Benin	[1 column not declassified]	[1 column not declassified]
Burkina
Cape Verde
Chad
Gambia
Ghana
Guinea
Guinea-Bissau
Ivory Coast
Liberia
Mali
Mauritania
Niger
Nigeria
Senegal
Sierra Leone
Togo		[portion marking not declassified]

US concerns over Chad’s war with Libya and Libyan efforts to support dissidents and infiltrate terrorists into southern Chad, as well as domestic food shortages and refugee movements, are the principal reasons for the selection of Chad for a high rating in this group of countries. While Chad’s reported incidence of AIDS cases to the World Health Organization is low, the conditions for rapid spread of the virus are high—the movements of relatively large numbers of people because of the war and food shortages, and the return of refugees from neighboring countries where the reported incidence of AIDS is higher than in Chad. [portion marking not declassified]

Nigeria’s high rating is due to its regional importance in western Africa and its large population. There is interest in monitoring the incidence and impact of AIDS in other countries of the region, even though the reported incidence of AIDS is low and their populations are small, because of the great potential for the relatively rapid spread of the disease, with consequent severe sociopolitical impact. [portion marking not declassified]

5. South &Central Africa	Topic 4.9.1 Epidemiological Aspects	Topic 4.9.2 Sociopolitical Impact
Angola	[1 column not declassified]	[1 column not declassified]
Botswana
Burundi
Cameroon
Cent. African Rep.
Congo
Equatorial Guinea
Gabon
Lesotho
Mozambique
Nambia
Rwanda
Sao Tome and Principe
South Africa
Swaziland
Zaire
Zimbabwe		[portion marking not declassified]

For the Central and Southern Africa Region we assigned high priority to South Africa. South Africa is of concern to US political and economic interests, and has great importance for the political, economic, and military interests of neighboring countries. In this regard, South Africa has offered to assist neighboring countries in assessing the spread and incidence of AIDS through survey and monitoring teams sent to those countries, and testing of blood samples sent to South Africa. Although the incidence of AIDS among white South Africans follows the western pattern and is openly reported, the spread and incidence among its black population and among its foreign labor force is not nearly as well known. We believe South Africa may become the depository of intelligence on the epidemiological aspects of AIDS for neighboring states through its assistance activities, and through its monitoring of the foreign labor force it could be gathering the intelligence necessary to warn of future problems in the home countries of the foreign workers. [portion marking not declassified]

Angola, Mozambique, and Zaire were also assigned relatively high ratings. Angola and Mozambique were selected because of their importance to US interests—and because their active insurgencies, severe food and social problems, and geographic location are conducive to the rapid spread of the virus, despite the small number of cases officially reported. Adjacent countries have reported high infection and incidence rates, harbor large numbers of Angolan and Mozambican refugees, and have active, though informal, trade and tribal contacts across borders. Moreover, Cuba apparently suspects that some cases of infection have been contracted by their troops while stationed in Angola. We believe countries that have active insurgencies and resulting social disruption are creating conditions that favor the spread and incidence of AIDS and should be monitored closely. As for Zaire, its large population is already heavily infected. Major international research organizations are based in Zaire and may produce early and important intelligence relating to the epidemiological aspects of AIDS for all of Africa. [portion marking not declassified]

Burundi, Rwanda, and Zimbabwe have relatively high incidence of the disease. Information on each of these countries became available early in the epidemic, and following up on this body of data may yield important intelligence for understanding the epidemiological aspects of AIDS in other countries. [portion marking not declassified]

Other countries in the region should be monitored because of the serious threat further spread of the disease poses to their development and stability. [portion marking not declassified]

6. South America	Topic 4.9.1 Epidemiological Aspects	Topic 4.9.2 Sociopolitical Impact
Argentina	[1 column not declassified]	[1 column not declassified]
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela		[portion marking not declassified]

For the countries of South America, we assigned our highest priority [less than 1 line not declassified] only to Brazil. According to a recent WHO report, Brazil, with over 1,700 cases of AIDS, has more reported cases than any other country in the world outside of the United States. Not only is the absolute and relative number of AIDS victims high, but Brazil’s bilateral social and economic relationships with the United States and its importance to US foreign policy are also critical. [portion marking not declassified]

Argentina, Colombia, and Venezuela [less than 1 line not declassified] have relatively high AIDS’ incidences, with just under 100 cases each, but also because they are key countries in the region in terms of population, economic power, and strategic interest to the United States. [portion marking not declassified]

The rest of the countries in the region were picked [less than 1 line not declassified] but with no priority importance. None of the rest of the South American nations have much of a reported problem with AIDS. [portion marking not declassified]

7. Central America	Topic 4.9.1 Epidemiological Aspects	Topic 4.9.2 Sociopolitical Impact
Antigua & Barbuda	[1 column not declassified]	[1 column not declassified]
Bahamas
Barbados
Belize
Bermuda
Cayman Islands
Costa Rica
Cuba
Dominica
Dominican Rep.
El Salvador
French Caribbean
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Panama
St. Lucia
St. Vincent
Trinidad & Tobago
Turks-Caicos
Nicaragua		[portion marking not declassified]

In this region, we assigned the highest priorities, [number not declassified] to Cuba, the Dominican Republic, Haiti, and Mexico. Because of Communist Cuba’s relationship with the United States, few governments in the world and none in the Western Hemisphere are of such strategic concern for the United States. While the Castro regime claims that the incidence of AIDS is quite small, various other sources indicate that the government is greatly understating the problem largely to prevent the AIDS linkage from further undermining public support for Castro’s African adventures. While the current levels of bilateral business, tourism, and immigration are small, since Castro seized power in 1959 more Cubans have immigrated to the United States than any other single nationality, and a new wave of Cuban immigrants is possible should Castro decide to loosen emigration controls. [portion marking not declassified]

Haiti and the Dominican Republic were included in this group principally because of their high incidence of the disease and the very large level of social and cultural exchange between the United States and those countries. As reported by the World Health Organization, in Haiti, the absolute number of AIDS cases and the number relative to the population are among the highest in the world. For the Dominican Republic, the number of reported AIDS cases is substantially smaller than for Haiti, but still among the highest in Latin America. For its part, however, the bilateral contacts between the United States and the Dominican Republic are very high. During the 1980s, more Dominicans have immigrated to the United States than any other nationality. Mexico was included because of its high incidence of AIDS (Mexico has the third largest number of cases among Latin American countries), because of its enormous social and economic exchange with the United States, and because of the strategic importance Mexico plays in US international considerations. [portion marking not declassified]

Seven countries received a Priority [less than 1 line not declassified] on epidemiological aspects of AIDS: Jamaica, Panama, the Bahamas, Barbados, Bermuda, French Caribbean, Trinidad and Tobago. Although Jamaica and Panama each have a relatively small number of AIDS cases, they have fairly large populations and close social and economic relations with the United States. The Bahamas, Barbados, Bermuda, French Caribbean, and Trinidad and Tobago, are included because of their high incidence of AIDS, despite their limited size and importance for US foreign policy. While the absolute number of AIDS cases in these small Caribbean island countries is small, as a share of their population, Bermuda, the French Caribbean, and the Bahamas have the highest reported incidence of AIDS in the world, and Barbados and Trinidad and Tobago are not far behind. [portion marking not declassified]

Because of their proximity to the United States, there is U.S. Government interest in monitoring the incidence and impact of AIDS in the remaining countries. [portion marking not declassified]

8. Near East	Topic 4.9.1 Epidemiological Aspects	Topic 4.9.2 Sociopolitical Impact
Algeria	[1 column not declassified]	[1 column not declassified]
Iran
Israel
Libya
Morocco
Tunisia
Western Sahara		[portion marking not declassified]

9. Arab States
Bahrain	[1 column not declassified]	[1 column not declassified]
Egypt
Iraq
Jordan
Kuwait
Lebanon
Oman
Qatar
Saudi Arabia
Syria
U.A.E.
Yemen (Aden)
Yemen (Sanaa)
P.L.O.		[portion marking not declassified]

The prevalence of AIDS is, as yet, undetermined or vastly under reported in most Near Eastern countries. These countries, however, are unlikely to remain free of HIV infection or disease. The above priorities reflect the need for information on the incidence and impact of AIDS in these countries. The lack of surveillance and diagnostic capability in both rural and urban areas contribute to the statistical morass. Only a few states have the health care or public health systems with resources adequate for mounting effective programs to cope with AIDS or to reduce HIV transmissions. The Council of Arab Health Ministers recently established a committee to draft legislation on means to combat AIDS in the Arab world. [portion marking not declassified]

High risk groups in the region are probably similar to other countries with cases of AIDS. While the sharing of contaminated needles by intravenous drug abusers is a major factor in the spread of the HIV virus in the West, injectable heroin HCL is relatively uncommon in the region and, where available, expensive. The expense will place the urban elite drug abuser—who is typically more affluent and mobile than his fellow countrymen—at a greater risk of contracting AIDS through this means. As government attempts to cope with the AIDS threat, the US and other Western countries will probably be asked for assistance. [portion marking not declassified]

Urban elites, because of affluence, mobility, and lifestyle, probably have a disproportionate risk of infection. The extent of the disease in rural areas, however, may not be recognized because of the lack of reliable testing. While most Arab states have reported cases of AIDS, officials in some countries—such as Algeria, Western Sahara, Syria, Libya—are often unable to conduct sophisticated study of the disease itself or on the cases that have occurred so far. AIDS testing kits are not available in sufficient quantities, and there is no reliable capability to test for AIDS. Screening of blood supplies—particularly in Syria and Morocco—is insufficient, placing those who require blood transfusions at higher risk of contracting AIDS. Israel, Jordan, and Egypt are taking steps to establish national health measures to screen blood supplies and to educate the public on AIDS and AIDS prevention. Tunisia, on the other hand, is aware of the AIDS threat, but is trying to down play the problem lest it have a negative impact on tourism. Relatively little is known about the extent of AIDS in Lebanon and among the PLO.

Many states in the Persian Gulf are devising and implementing a variety of measures to deal with the AIDS threat. Kuwait is attempting to become the regional AIDS testing/research center and recently hosted a conference on AIDS in the Arab world. Many of the states—such as Saudi Arabia, Iraq, Bahrain, Oman, and the UAE—are increasingly concerned with testing foreign residents and some are considering requiring AIDS-free certificates before issuing work permits. Several cases of AIDS and the AIDS virus have been reported in Iran. Iranian doctors believe the disease is primarily spread through blood transfusions and unsanitary needles. Information on AIDS in the remaining Persian Gulf states is of some interest to US officials. [portion marking not declassified]

10. Near East	Topic 4.9.1 Epidemiological Aspects	Topic 4.9.2 Sociopolitical Impact
Afghanistan	[1 column not declassified]	[1 column not declassified]
Bangladesh
Bhutan
India
Maldives
Nepal
Pakistan
Sri Lanka		[portion marking not declassified

With the exception of India, information on AIDS is limited. The ability of many of these countries to evaluate and respond to AIDS is low due to the inadequate hospital care and other health resources. These factors will hinder governments’ efforts to fight the spread of AIDS. India, on the other hand, has established AIDS surveillance centers in various provinces in an attempt to track and monitor the disease. AIDS disinformation in the Indian press is rampant, fueling misconceptions and suspicions on the causes of AIDS. Pakistan, according to local press, is concerned about the spread of AIDS by US navy personnel during port calls. Information of the remaining South Asian countries—Bangladesh, Bhutan, Maldives, and Nepal—is of interest to US officials. [portion marking not declassified]

11. East and Southeast Asia	Topic 4.9.1 Epidemiological Aspects	Topic 4.9.2 Sociopolitical Impact
Burma	[1 column not declassified]	[1 column not declassified]
Cambodia
China
Taiwan
Japan
North Korea
South Korea
Laos
Mongolia
Thailand
Vietnam		[portion marking not declassified]

12. Pacific	Topic 4.9.1 Epidemiological Aspects	Topic 4.9.2 Sociopolitical Impact
Australia	[1 column not declassified]	[1 column not declassified]
Brunei
Fiji
Hong Kong
Indonesia
Kiribati
Macao
Malaysia
Nauru
New Caledonia
New Zealand
Papua New Guinea
Philippines
Singapore
Solomon Islands
Tonga
Tuvalu
Vanuatu		[portion marking not declassified]

The PRC currently is reported to have almost no AIDS transmission among its resident citizens. The few identified cases have been in foreign visitors, or in Chinese returning from residence abroad or associating closely with foreigners. The Chinese Government, however, is taking the threat quite seriously and hopes to block importation of the disease by comprehensive testing of foreign visitors and other preventive measures. The task of excluding AIDS is made more difficult because of the primitive status of China’s health care system; the presence of the infection in Taiwan, Thailand, and Hong Kong; and extensive encounters with foreigners both in China and abroad. Xenophobia, already significant, will be intensified if AIDS becomes a larger problem. [portion marking not declassified]

The Philippines are highly vulnerable to AIDS because of high rates of other sexually transmitted diseases for many years and heavy exposure to international travelers. Should disinformation, which links AIDS among Filipinos to U.S. servicemen stationed there, become widely believed, U.S. basing rights could be threatened by strong anti-Americanism. The Republic of Korea is in a similar posture. Both nations are exhibiting increased signs of nationalism. Proponents find the AIDS issue a popular rallying point. Japan, Australia, and New Zealand are cooperating with the W.H.O. program against AIDS, and they are fully able to employ and to contribute to Western technology relating to AIDS detection and treatment. Indonesia, Malaysia, and Vietnam have provided little information, but are also probably highly vulnerable. [portion marking not declassified]

1. Source: Central Intelligence Agency, Community Management Staff, Job 00B01635R: Committees, Task Forces, Boards, Councils Files, Box 6, Folder 390, FIPC Change Notice #27 Topics For Intelligence on the AIDS Pandemic. Secret [handling restriction not declassified]. Approved by Gates on December 17.
2. See Document 29.
3. Not found.
4. Secret. [handling restriction not declassified]
5. Secret. [handling restriction not declassified]