For all the liters of ink and hours of television broadcasts devoted over the last 20 years to information about the international epidemic of Acquired Immune Deficiency Syndrome, or AIDS, many people, especially those most at risk, remain woefully ignorant about this deadly disease. For all the billions of dollars spent on research to combat AIDS, a huge number of AIDS victims still lacks access to the drugs already available. RFE/RL reports on the 14th International AIDS Conference now under way in Barcelona.
Prague, 8 July 2002 (RFE/RL) -- The following are some startling and disheartening facts about Acquired Immune Deficiency Syndrome, more commonly known as AIDS:
-- The disease has killed 20 million to 25 million people worldwide since it was identified in the United States in 1981.
-- About 40 million people have the disease now. Three out of four people who have AIDS live in Africa.
-- The AIDS pandemic now is moving into Eastern Europe and Asia. In Russia, new reported cases of infections by the HIV virus that causes AIDS reached 173,000 last year, double the 1998 figure. The UNAIDS agency estimates that the true incidence of the disease is four times higher.
-- The disease has hit Ukraine harder than anywhere else in Europe, with an estimated one person in every 100 infected.
-- Numbers of reported cases of AIDS are soaring in Azerbaijan, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Tajikistan, and Uzbekistan.
This information comes from the United Nations AIDS agency, UNAIDS. The agency this week convened the 14th International AIDS conference in Barcelona.
Henning Mikkelsen, UNAIDS senior adviser for Europe, told RFE/RL today in a telephone interview from Barcelona that Eastern and Southeastern Europe are emerging as the next AIDS hot spots. "For now, let's just say it is happening very quickly there. We see that it is the fastest-growing epidemic in the world in that particular region, not just in Russia and Ukraine but basically in all the countries of the former Soviet Union," Mikkelsen said.
Health authorities say the epidemic got a later start in the region than it did in Africa, but is accelerating dangerously. Mikkelsen said one factor has been the social disruptions that the transition from communism have brought. "And I think that this reflects that young people are suffering some of the bad consequences of the transition in the way that they feel very insecure and they have no role models with the parents and so on, and they are experimenting with their lives. And many of them have started to experiment with injecting drugs and with unsafe sex," Mikkelsen said.
The UNAIDS adviser said that a World Bank study forecasts that, unless the Russian government intervenes successfully, Russia's gross domestic product could be cut by 4 percent in the next few years through people either being unable to work or because of resources being redirected to fight the epidemic. "Most alarming, I think, is that this is obviously only the very beginning of the epidemic we are facing there, and so we are really looking toward a larger-scale sexually transmitted epidemic in those countries, which will have a devastating impact for the countries themselves," Mikkelsen said.
In preparation for the Barcelona conference, UNAIDS published a report last week that concluded, among other things, that despite 20 years of increasing publicity and information dissemination about the disease, the world's young people remain ignorant about the nature of AIDS and how to avoid it. The report says, for instance, that in Ukraine, although almost everyone has heard of the disease, fewer than one in 10 girls has much information about how to avoid contracting it.
Billions of dollars have been spent on AIDS research over the last 20 years, and some remarkably effective drugs have been developed to control it. And even better drugs are in the late stages of development. But, the report says, these treatments are so expensive that only the wealthiest countries can provide them for their infected citizens.
The report says that prevention provides more promise than treatment does for controlling the disease. UNAIDS proposes a worldwide campaign of education, publicity programs to increase knowledge and reduce stigma, free HIV screening and counseling, and condom distribution.
In a speech at the opening of the Barcelona conference, UNAIDS Director Peter Piot said the world must act to prevent the AIDS experience in Africa from being repeated elsewhere. "The world stood by while AIDS overwhelmed sub-Saharan Africa. Never again [can the world let this happen]," Piot said.
He said that $10 billion a year is needed to combat the disease, three times more than is available now. Piot said that the knowledge and the resources exist to control AIDS but that the world needs to develop the political will to do so. As he put it: "The answers are political. They are about power and priorities."
Mikkelsen said one hoped-for result of this week's conference in Spain is to win a recommitment from international leaders who promised last year in New York to support an international anti-AIDS campaign. "Well for us, in a way, this is a follow-up of the UN special session, which was held last year in New York. There were heads of state and governments from all over the world who committed themselves to action there. And now we are here to [ensure] that the promises will be kept by the highest levels of policymakers, that action will be [taken] in the countries," Mikkelsen said.
Stefano Vella, president of the International AIDS Society, lamented at a news conference in Barcelona today that the international community failed to place equal emphasis on prevention earlier. "The message of this conference, I think, is the grave [end] of the debate between prevention and care. I think we lost months and years and maybe some lives in this debate. I think, now, it is over. We know that these two important elements should be hand in hand, and that's, I think, the one important message of [this] conference," Vella said.
AIDS first showed up in epidemic numbers in the United States in the 1980s, with the majority of victims being homosexual men. Soon, intravenous drug users who shared contaminated needles became a significant at-risk population. Then the epidemic spread to heterosexuals, especially young people with multiple sex partners.
It remains an incurable disease but one that is increasingly controllable through newly developed drugs.