VANCOUVER, British Columbia (AP) In Canada's trendiest city, a short
stroll from chic harborside hotels and bistros, a pocket of skidrow
poverty is reeling from one of the worst AIDS epidemics of any wealthy
nation.

The 15 blocks known as Downtown Eastside form the poorest urban
neighborhood in Canada a seamy mix of pawn shops, taverns and decrepit
rooming houses. The Eastside's drug addicts are contracting the
AIDScausing HIV virus at such a rapid pace that health officials have just
declared the first medical emergency in Vancouver's history.

Experts estimate more than 6,000 addicts frequent the area, perhaps half of
them infected with HIV because of pervasive sharing of contaminated needles.

Dr. Martin Schechter, a University of British Columbia epidemiologist, said
the infection rate among Eastside drug users is the highest in North
America at nearly 20 percent annually. In other words, out of every 100
addicts who were were free of HIV at the start of the year, 20 would be
HIVpositive by year's end.

The problem has been building for several years, but came into the
spotlight this month when Bud Osborne, a community activist and former
addict, convinced fellow members of Vancouver's health board to declare a
medical emergency.

``This epidemic is kind of like the plague,'' Osborne said in an interview.
``It's going to spread.''

Under the emergency, the province has allocated $3 million ($2.2 million
U.S.) to combat the epidemic, and pressure is mounting for the federal
government to help. Vancouver's coroner and deputy police chief have joined
AIDS specialists in urging the government to decriminalize possession of
small amounts of illegal drugs for personal use.

``It's time to recognize that we have a public health crisis and take it
out of a criminal context,'' Schechter said.

The epidemic is raging despite Vancouver's ambitious needleexchange
program, which started in 1988. More than 2.5 million clean needles are
distributed annually, but many addicts don't bother to participate and
instead share used needles.

Schechter said HIV infections in the Eastside began multiplying about four
years ago when many addicts changed habits switching to a dozen or more
injections a day of cheap cocaine rather than two or three injections of
heroin.

``The number of injections per day goes up the ability to take
precautions goes way down,'' he said. ``That's how you get this explosion.''

Though other Canadian cities also have problems with HIV among drugusers,
Vancouver's Eastside stands out a blight in an otherwise prosperous city
that will play host to 18 heads of state next month at an AsiaPacific
economic summit.

Some of Vancouver's addicts are Indians from British Columbia's
impoverished rural reservations, but mild winters and traditionally
generous social programs attract the downandout from across Canada. Some
are fleeing provinces where conservative governments have recently slashed
welfare benefits.

``These are people who are totally marginalized, and there's a very callous
attitude toward them,'' said Libby Davies, elected this year to Parliament
from a district that includes the Eastside.

Ms. Davies has been frustrated by the federal reaction to her pleas for
assistance. She said the health minister told her it was a problem for the
justice ministry, and the justice minister told her it was a health problem.

``It was just an appalling response,'' said Davies, who wants the
government to permit doctors to prescribe hard drugs to addicts.

Precise statistics on the epidemic are hard to come by, but the Vancouver
Native Health Society earlier this year registered 600 drugaddicted
Indians in the Eastside who were HIVpositive. The society says at least 31
of them have died in recent months, and is recording roughly one new
HIVpositive diagnosis a day.

The health board has asked its staff to develop a comprehensive action plan
by the end of October. It will likely include expanded needleexchange and
addictiontreatment programs, and recommendations to improve living
conditions in the Eastside.

Real estate prices in many Vancouver neighborhoods are among the highest in
Canada, and very little new lowincome housing is being built. Osborne said
owners of the Eastside's cheap hotels are content to let them deteriorate,
hoping gentrification will sweep into the area in a few years and boost
property values.

``If you don't have a decent place to sleep, all the health care in the
world isn't going to make a difference,'' said Vancouver's chief medical
officer, Dr. John Blatherwick.