UNAIDS Releases Updated Global AIDS Figures That Show Rising Number of Infections in Eastern Europe, Asia
HIV infection rates in Eastern Europe are rising faster than anywhere else in the world and the HIV/AIDS epidemic continues to grow in Asia, surpassing one million newly infected people this year for the first time, according to UNAIDS' annual report, "AIDS Epidemic Update 2001," released yesterday in preparation for World AIDS Day on Saturday (UNAIDS release, 11/28). Forty million people worldwide now have HIV/AIDS and approximately three million people will have died of AIDS-related complications this year. Eastern Europe has now become the region with the fastest growing number of HIV infections (BBC News, 11/28). "HIV is spreading rapidly throughout the entire Eastern European region -- a quarter of a million new cases only this year," UNAIDS Executive Director Peter Piot noted, adding that the epidemic "will get worse before it gets better" (UNAIDS release, 11/28). Two-hundred and fifty thousand new infections were reported this year in the Russian Federation (Reuters Health, 11/28). Half of those infections occurred in people under the age of 20, reflecting a worldwide trend. "About one-third of those living with AIDS are aged 15-24," the report states, emphasizing that most of those infected are unaware of their status and could continue to infect others (Maugh, Los Angeles Times, 11/29). A combination of "economic insecurity, high unemployment and deteriorating health services," along with a rise in intravenous drug use, has contributed to the rise of new infections in the region, U.N. officials in Moscow said. Ukraine has the highest HIV prevalence in region, with 1% of adults infected (Bellaby, AP/Fresno Bee, 11/28).
Success and Leadership
Poland, where HIV prevalence remains 0.07%, has been the one exception to the trend in Eastern Europe, largely due to an aggressive government campaign to reach drug users. "When the first data came out about the spread of HIV among injection drug users, the Polish government appointed a priest ... as head of their AIDS program, which I think was a very smart political move," Piot said, explaining that it "allowed [the] program to be very open about harm reduction (including) methadone treatment, needle exchange ... and an aggressive promotion of condoms" (Brown, Washington Post, 11/29). Piot, speaking in Moscow, called for "vigorous leadership at the top level" in Eastern Europe and specifically asked Russian officials to "put together a high-level committee that would include all the key ministries, to define what can be done." According to Piot, there are "many good, small projects going on in Russia ... [b]ut now it has got to get to a scale that will make a difference." Russian officials must "recognize at the highest political level and in the legislature that AIDS is a matter of national priority for the security and future of the nation," he said, adding that a "mass education program for the general public" was in order (Besserglik, Agence France-Presse, 11/28). He noted that the president of Ukraine has been the only head of state in the region to address HIV/AIDS and said "it is still too much business as usual" with regard to the disease in Eastern Europe (Altman, New York Times, 11/29).
Newly Infected in Asia Reach One Million
Nearly 1.1 million people in Asia and the Pacific were infected with HIV in 2001, bringing the total of HIV/AIDS cases in the region to 7.1 million. The Asian epidemic had been largely contained in Cambodia, Myanmar and Thailand, but has now spread to China, India and Indonesia. There are probably more than one million HIV-positive individuals in China, according to the report. Seven Chinese provinces are experiencing "serious local HIV epidemics," and nine more "are possibly on the brink" (Agence France-Presse, 11/28). The report also estimated that 3.86 million Indians had HIV/AIDS, second only to South Africa. Although less than 1% of the Indian population is infected, the "seemingly low" overall level may "mask" localized epidemics. The states of Maharashtra, Andrha Pradesh and Tamil Nadu all had prevalence rates of "at least" 2% among pregnant women and more than 10% among people with STDs other than HIV (New York Times, 11/29). Meanwhile, Indonesia, the world's fourth most populous country, saw a "surge" in new infections among sex workers and intravenous drug users, "offer[ing] an example of how suddenly an HIV/AIDS epidemic can emerge," the report states (Agence France-Presse, 11/28). "Few countries are acting vigorously enough to protect sex workers and clients. Yet it is from the comparatively small pool of sex workers first infected by their clients that HIV steadily enters the larger pool of still-uninfected clients who eventually transmit the virus," Piot noted. However, there are signs of progress in Asia. Large-scale prevention campaigns in Cambodia and Thailand have dramatically lowered HIV infection rates in those countries, and infection rates among pregnant Cambodian women dropped to 2.3%, down a third from 1997 (New York Times, 11/29).
African Life Expectancy Cut
About 28.1 million people in sub-Saharan Africa are now infected with HIV, and lacking proper treatment and care, "most of them will not survive the next decade," the report states. Life expectancy has dropped from 62 years to 47 years in the region because of HIV/AIDS, and gross domestic product in the most heavily affected countries could drop by more than 20% by 2020, according to the report (Agence France-Presse, 11/28). "AIDS has become the biggest threat to the continent's development and its quest to bring about an African Renaissance. Essential services are being depleted at the same time as state institutions and resources come under greater strain and traditional safety nets disintegrate," the report states (MSNBC.com, 11/28). The number of new infections dropped to 3.4 million this year from 3.8 million in 2000, but the "extremely high numbers 'show that there is still an enormous potential for spread of AIDS in Africa,'" Piot acknowledged. Areas of North Africa are showing signs of increasing infection, with Algeria registering a 1% infection rate among pregnant women and Libya experiencing HIV outbreaks among intravenous drug users (New York Times, 11/29).
Amassing Resources to Fight HIV/AIDS
Piot called the Sept. 11 attacks on the World Trade Center and the Pentagon a "major blow to the global (AIDS) agenda," diverting funding and "interrupting the momentum" that had begun to build in the international community after last year's Durban AIDS Conference (Sternberg, USA Today, 11/29). Donations to the Global Fund to Fight AIDS, Tuberculosis and Malaria have declined since the attacks, with only Italy having handed over money to the fund since Sept. 11. About $1.5 billion has been pledged so far (Garrett, Newsday, 11/29). "People aren't putting up the bucks right now," Paul Zeitz of the Global AIDS Alliance, which on Friday will release a report "sharply critical" of the funding "shortfall," said. Piot also "lament[ed]" the lack of access to affordable AIDS drugs in the developing world, despite price concessions from many major pharmaceutical firms (USA Today, 11/29).
Reason for Hope
Despite the growing number of people with HIV/AIDS, 2001 marked a "turning point" in the fight against the disease, U.N. Secretary-General Kofi Annan said in his World AIDS Day message. "At no time in the two decades of dealing with this catastrophe, has there been such a sense of common resolve and collective possibility -- among governments, civil society and the private sector; among foundations, opinion makers and people living with the disease," he said, citing the "impressive" amount of money pledged to the Global Fund in its first few months of existence. "Thanks to the United Nations General Assembly's special session on HIV/AIDS last June, we now have globally agreed goals. All of us have a part to play in reaching those goals. On this World AIDS Day, let us all pledge to translate our concern into action; let us resolve that we care enough to build a world free of AIDS for future generations," he concluded (Annan release, 11/20). The full UNAIDS report is available online.