On November 28 UNAIDS (the Joint United Nations Programme on HIV/AIDS) and the World Health Organization issued their annual report on the status of the global epidemic -- an authoritative though not infallible report that provides a worldwide common basis for discussion. The 30-page AIDS Epidemic Update: December 2000
is difficult to summarize, but here are some of the highlights:
- In 2000, the best estimates predict that 3 million people will die of AIDS, and 5.3 million will become newly infected with HIV. There have been over 21 million AIDS deaths since the epidemic began.
- A major trouble spot is Eastern Europe. For example, the Russian Federation will have more new HIV infections in 2000 than in all previous years combined.
- In Africa, new infections are down slightly (3.8 million last year vs. 4 million the year before) -- partly due to a smaller pool of people at risk since so many have been infected already, and partly due to prevention efforts in some countries. Deaths are up slightly. An estimated 8.8% of all adults (ages 15-49 years in these statistics) in sub-Saharan Africa as a whole now have HIV, and over 25 million adults and children in this region are now living with HIV. No one knows if the epidemic will explode in Nigeria and other countries, as it has in southern Africa.
- In the U.S. and Western Europe, "prevention efforts are stalled," with about 45,000 adults and children being infected with HIV in North America.
- Australia and New Zealand hardly appear in the report, with only 500 new HIV infections in 2000. (Australia has long had effective prevention programs which the U.S. and many other countries could have implemented but did not.)
- There are many success stories in certain areas; these can be models for wider use. For example, in Belarus, a harm-reduction program for drug users prevented 2,000 cases of infection by its second year of operation, at a cost of about $29 per infection prevented. And in Zimbabwe, church groups have recruited community members to assist households keeping orphans in homes where they live, helping over 2700 households at a cost of about $10 per family supported, vs. several hundred dollars a year to keep a child in an orphanage in Africa. And in one study, factory workers were trained to provide prevention information to their colleagues -- cutting new infections by a third compared to factories that did not provide the information, at a cost of about $6 per worker.
"At least U.S. $1.5 billion a year could make it possible to achieve massively higher levels of implementation of all the major components of successful prevention programmes for the whole of sub-Saharan Africa. These would cover sexual, mother-to-child and transfusion-related HIV transmission, and would involve approaches ranging from awareness campaigns through the media to voluntary HIV counseling and testing, and the promotion and supply of condoms." Another $1.5 billion would provide basic care for many of the orphans and AIDS patients who need it, although "making a start on coverage with combination antiretroviral therapy would add several billion dollars annually to the bill."
ISSN # 1052-4207
Copyright 2000 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used.
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