In a new report on global HIV/AIDS trends, UNAIDS, the agency that coordinates United Nations AIDS programs, warns that 68 million people will become victims of AIDS in the next two decades unless the developed countries dramatically increase their role in the global fight against the disease. According to the report, the spread of AIDS globally is still in its early stages. Russia, Eastern Europe, and Central Asia are cited in the report as regions with the highest acceleration of new HIV infections, mostly through intravenous drug use.
United Nations, 3 July 2002 (RFE/RL) -- The UNAIDS report released this week is considered to be the most authoritative reference on the state of HIV/AIDS in the world, and was issued ahead of the 14th International AIDS Conference, which begins Sunday in Barcelona, Spain. The data in the report is comprehensive through the end of 2001.
The report contains country-by-country estimates on a number of indicators that help to understand the magnitude of the HIV/AIDS epidemic, as well as the response on local, national, and global levels.
Peter Piot is the executive director of UNAIDS and presented the report yesterday at United Nations headquarters in New York. Piot said that despite its two-decade rampage throughout the world, it is clear now that the HIV/AIDS epidemic is still in its early stages. "The first major finding is that AIDS continues its expansion relentlessly, that from a historic prospective it's now clear in my mind that we are only at the beginning of this epidemic, this epidemic which is already the largest epidemic in human history. That's very clear at first sight in continents like Asia where HIV is starting to spread now in very large countries [China and India]. It's clear also in Eastern Europe and Central Asia," Piot said.
Despite the forecast by some scientists that the HIV/AIDS epidemic would eventually level out due to a decline in the pool of people at risk, that hasn't happened yet. The report notes that even in Botswana, the country most devastated by AIDS, there was an increase in the rate of infection from 36 percent of the adult population two years ago to 39 percent at the end of 2001.
Piot said the consequences of the HIV/AIDS epidemic are far-reaching, and that they affect every country and every society. "Secondly, the report gives many examples of the devastating impact of AIDS on about every walk of life and every aspect of society. Of course, [AIDS is] a major cause of suffering for individuals and their families, but it drives households into poverty. It affects all aspects of social and economic development. For example, last year about 1 million African children lost their teachers because of AIDS -- the teachers died of AIDS. We can give examples like that for every country, from every sector in society," Piot said.
Perhaps the most dramatic finding in the report is that in the next two decades more than 68 million people in poorly developed and medium-developed countries will become casualties of AIDS unless rich countries contribute $10 billion annually in the global fight against AIDS.
In comparison, the total number of AIDS-related deaths since the discovery of the disease in 1981 is approximately 25 million.
The report finds that HIV/AIDS is spreading most rapidly through the countries of the Russian Federation and Eastern Europe, and that HIV is moving from intravenous drug users into the wider population. In Ukraine, almost 25 percent of new infections now occur through heterosexual contact.
In Russia, new reported cases of HIV/AIDS have almost doubled since 1998, up to 173,000 in 2001. The real numbers are believed to be four times higher.
The report also notes soaring rates of reported infections in Azerbaijan, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Tajikistan, and Uzbekistan.
Awareness of the epidemic is also described as dismal among vulnerable groups. For example, only 10 percent of 15- to 19-year-old girls in Tajikistan said they had ever heard of HIV/AIDS. In Ukraine, only 9 percent of adolescent girls were aware of HIV prevention methods.
Ukraine, however, is the hardest-hit country in all of Europe, with an estimated 250,000 people infected with HIV in a country of 50 million people.
Despite the grim statistics, Piot said there has been a major shift in the attitude toward HIV/AIDS in the last two years. "It is clear in the last two years that the world is entering a new era in its response to AIDS, that the world is finally waking up. We had the [UN General Assembly] Special Session [on AIDS] last year, but we have a number of indicators that tell us that it's not business as usual any longer in many countries. Many countries have established national AIDS committees and commissions which are chaired by the prime minister or president or vice president and are attached to the presidential office. We have many statements, declarations, commitments from [all] kinds of regional political bodies," Piot said.
For example, by mounting a strong national response, the report says the Polish government has successfully curtailed the epidemic among intravenous drug users and prevented it from gaining a foothold in the wider population. Prevalence also remains low in countries such as the Czech Republic, Hungary, and Slovenia, where UNAIDS says well-designed national HIV/AIDS programs are in operation.
The report also mentions that members of the Commonwealth of Independent States were the first to organize a regional follow-up to the 2001 United Nations General Assembly Special Session on HIV/AIDS. The report says the budgets of national AIDS programs have increased considerably in countries such as Bulgaria, Romania, the Russian Federation, and Ukraine.
Besides the shift in the attitudes toward HIV/AIDS, the report notes that in the last two years the world is entering a new approach in its response to the disease. Funding for prevention and treatment of HIV/AIDS in low- and medium-income countries has increased sixfold since 1999. Still, the committed funds today are approximately $2.8 billion annually, while low- and medium-income countries need at least $10 billion per year to fight the HIV/AIDS epidemic.
As a relative success, said Piot, the sharp decrease in the price of HIV/AIDS-treatment drugs should be noted. "Over the last two years, we've seen a decline by 90 percent of the price of the so-called antiretroviral drugs: drugs that are used to treat people with AIDS, with HIV. That's a result of several factors: voluntary price reductions by the research-based companies, generic competition -- generic producers coming into the market -- [and] pressure from activists. The UN secretary-general, [Kofi Annan,] himself has repeatedly met with the chief executive officers of the big pharmaceutical companies. I wouldn't call this cooperation or collaboration, rather competition is what is driving down the price," Piot said.
Although the price of antiretroviral AIDS drugs dropped recently to about $1 a day, Piot said, the cost of treatment has to fall even more to save lives, especially in Africa.
(The full text of the report can be accessed on the Internet at www.unaids.org.)