August 31, 2007
UNAIDS in two recently published books has "come under stinging attack" and been accused of "allowing politics to trump science in its efforts to combat" HIV/AIDS, AFP/Yahoo! News reports. According to AFP/Yahoo! News, the books have "sparked a wide-ranging debate" among HIV/AIDS advocates about how to fight the spread of the disease and "raised questions about UNAIDS' leadership."
U.S. epidemiologist James Chin in his book, "The AIDS Pandemic," accused UNAIDS of inflating HIV prevalence estimates to "dramatize the epidemic" and increase donor funding. Chin "appeared vindicated" earlier this year, when India reduced its HIV/AIDS caseload estimate to 2 million to 3.1 million people, AFP/Yahoo! News reports. UNAIDS previously estimated that the country had about 5.7 million people living with HIV/AIDS. In addition, the organization estimated that 1.6% of adults in Cambodia were HIV-positive, but the estimate later was reduced to 0.6% of adults, AFP/Yahoo! News reports.
Prasada Rao, UNAIDS regional director for Asia, said that the higher estimates were based on data from clinics, which experts used to estimate the number of people in the general population living with the virus. Rao added that the lower estimates were based on improved, random surveys among households, which provided a better analysis of the general population. "I don't see any motive on the part of UNAIDS to inflate numbers," Rao said, adding that he does not "think there is any axe to grind in this case."
Most experts agree that HIV/AIDS caseload estimates "remain a guess best used to show trends in each country," according to AFP/Yahoo! News. "There is a fine line between deliberately lying with the numbers or using the upper range of estimates that are based on slim assumptions and unrepresentative data," Chin said in an e-mail to Agence France Press. Both Chin and Rao agreed that the debate should focus more on how to spend resources than on the number of people living with HIV/AIDS.
In another recently published book, "The Invisible Cure," Helen Epstein, who studied HIV/AIDS in Africa, wrote that UNAIDS either misunderstood or ignored data in the mid-1990s that showed the practice of having multiple, long-term sexual partners was common in Eastern and Southern Africa and allowed HIV to spread quickly through the region. According to Epstein, rather than encouraging people to be faithful to one partner, UNAIDS focused on condom use and abstinence, which she says was less effective but more politically appealing.
Epstein added that the organization "overblew the prospects" for an HIV epidemic in Asia, where the virus is spread mainly through high-risk groups, whereas in Africa it is spread among the general population. "They got it almost perfectly wrong in some places," she said. Epstein added that UNAIDS previously focused more on potential HIV/AIDS outbreaks in other parts of the world rather than on addressing the disease in the most affected African countries.
Rao said he is concerned that if advocates believe UNAIDS is manipulating data, the agency's reputation and efforts to eradicate the disease could be damaged. "UNAIDS is not saying the data is wrong. It is accepting the data and trying to harmonize the facts," Rao said, adding, "That shows the openness that the organization has got on this issue. And it is prepared to correct its data (and) revise its data based on other sources of information" (Shea, AFP/Yahoo! News, 8/29).
Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2007 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.