Authors: Jacques du Guerny, James R. Chamberlain and Lee-Nah Hsu

Foreword

The sequence of events leading to the preparation of this paper is an apt illustration of the method of building blocks used in this Project.
One can consider the Mapping Assessments conducted in several countries of the region as the first set of blocks. The mapping exercises studied the socio-economic and cultural vulnerabilities which could lead to HIV infection emerging along selected important highways.
The second block was the ASEAN Workshop on Population Movement and HIV Vulnerability held in Chiang Rai in November 1999 which brought together national authorities and experts to consider the results, initially focusing on migrants. However, the conjunction of the assessments, decision-makers and experts led to shifting the focus from migrants to underlying mobility systems.
Then, bringing together the road improvements and constructions taking place with the mobility systems, two ideas began to emerge: i) a development centred early warning system could perhaps be established, and ii) all these stretches of road joined together were perhaps more than just a network from the perspective of the HIV epidemics.
This led to the third block, in the form of the Think Tank Consultation held in May 2000 in Bangkok which, again, brought together national AIDS authorities of the Greater Mekong Subregion (GMS) and experts. The discussion not only endorsed the proposed Early Warning and Rapid Response System (EWRRS). but presented a number of the ongoing and planned highway developments.
This information on the developments in land transport demonstrated that when considering the possible inter-relations between the rapid socio-economic changes taking place in the GMS. the mobility systems highlighted in Chiang Rai and the road networks being established, dynamic hubs could be forming which potentially could connect different epidemics into a larger pandemic with a possible multiplier effect.
Hence, a new building block, in the form of this paper on hubs. This paper is meant to be a thought provoking paper on work in progress. It should really be considered in conjunction with the papers already mentioned, especially the EWRRS one. We would like this paper to start a discussion on the possible role of hubs in HIV epidemics, in relation to an EWRRS and. more broadly, in the area of mobility systems, development and HIV.

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August 2000