Third World AIDS Continues to Skyrocket, UN Says

by Gustavo Capdevila

The study released by the Joint United Nations Program on HIV/AIDS (UNAIDS) and the World Health Organization (WHO), the first country- by- country analysis of the epidemic, says the gap is mainly the result of differences in prevention efforts and uneven access to the latest therapies.

While the spread of HIV has begun to level off or even decline as a result of prevention efforts in most industrialized countries and a handful of developing nations, the infection rate has hit alarming new highs in much of the developing world, said Peter Piot, Executive Director of UNAIDS.

At the release of the report during a media briefing in Geneva, Piot pointed out that an average of 16,000 people a day were infected with HIV worldwide. "Let's be realistic and aware that AIDS is with us to stay for a very long time," he stressed.

The report provides the latest data on the expansion of HIV. Since the epidemic first broke out, more than 42 million people have contracted HIV, over 11 million have died of AIDS, and the overwhelming majority of those presently living with HIV -- 30 million -- will not be alive 10 years from now.

But rather than simply listing the number of AIDS-related deaths or the number of persons living with HIV, the document provides data on sexual behavior and the transmission rate among specific groups, while assessing prevention efforts.

The study, which takes a new approach to epidemiological controls, provides "good news," said Piot. "Fortunately we know now that prevention works.

"The evidence documented in this report has never been more clear. Stable or decreasing HIV infection rates are being reported from many industrialized countries," but only those which have adopted a consistent focus on prevention, he emphasized.

And although the secondary effects and problems linked to the latest therapies are well-known, the impact of "combination" therapy on forestalling AIDS-related infections and cancer has been significant in countries where the drugs have been widely available, he added.

But the good news has been eclipsed by the tragic confirmation that AIDS is actually gaining ground nearly everywhere else, Piot lamented.

AIDS is one of the world's biggest killers today. In 1997, 2.3 million people died of AIDS, nearly as many as died from malaria, another of the world's most lethal epidemics.

In the past three years, the HIV transmission rate has doubled in 27 countries.

In two other southern African countries, Botswana and Zimbabwe, one of every four adults is HIV-positive, a record high that far outstrips even the most pessimistic projections issued 10 years ago. And the adult death rate has risen two or even threefold due to AIDS in Zambia and other countries of southern Africa.

HIV is also spreading fast in Asia. Due to the enormous populations of India and China, the future of the epidemic will be played out in that region, said Piot, who predicted "exponential growth" in HIV transmission worldwide over the next few years.

The report's new country-by-country data on HIV problems, risk factors, impact and trends provides a clear picture of the growing AIDS gap separating countries.

"This is the kind of data that we need to convince policy-makers and politicians that AIDS is a big problem, that it's indeed becoming one of the major obstacles to human and social economic development," Piot underlined.

According to the report, the main reason for the gap between rich and poor countries is uneven access to combination therapy with anti-retrovirals, drugs that combat HIV in the body and forestall the development of AIDS-related cancer and infections such as tuberculosis and diarrhea.

Combination anti-retrovirals have come into widespread use in industrialized nations over the past two years, yet because they are costly and difficult to administer, they remain inaccessible to most people living with HIV in the developing world and in countries whose economies are in transition, the report adds.