HIV Surveillance Systems in Many Countries Are ‘Poorly Functioning,’ Survey Shows
Forty percent of the world's HIV/AIDS surveillance systems are "poorly functioning" or "non-existent," a UNAIDS survey team reports in the journal AIDS. Reuters Health reports that investigators led by Dr. Neff Walker of UNAIDS in Geneva, Switzerland, examined 167 surveillance systems while compiling HIV/AIDS statistics at the end of 1999. Forty-seven of the systems had been "fully implemented," 51 were judged to be "good" and 69 were labeled "poor" or "non-existent." However, there is "encouraging evidence that many of the countries worst affected by HIV have sound and functioning surveillance systems that can be gradually expanded," the researchers said. The three overall weaknesses shared by most low-ranking systems were a lack of surveillance among gay and bisexual men, "poor coverage" of rural populations and "inconsistency" in surveillance data over time. Most of the countries with poor or non-existent systems were in the Middle East and Northern Africa, while several countries in Eastern Europe, Central Asia and Latin America also had low-ranking systems. Countries were also ranked by epidemic level: 55 have HIV epidemics among the general population, 46 have "concentrated" epidemics among certain population groups and 53 have "low-level" epidemics. The United States has a concentrated epidemic and a fully operational surveillance system, according to the survey (Reuters Health, 9/17).
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