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UN Report: AIDS Pandemic
Could Kill Nearly 70 Million

Kaiser Daily HIV/AIDS Report

The global AIDS pandemic is "still in its early stages," and nearly 70 million people worldwide will die of AIDS-related causes within the next 20 years if wealthy nations do not "step up" contributions to fight HIV/AIDS, according to a new UNAIDS report released yesterday, Reuters/Philadelphia Inquirer reports.

According to the report, more than 40 million people worldwide currently have HIV/AIDS, up from 34 million two years ago, and HIV infection rates are still climbing (Rigby, Reuters/Philadelphia Inquirer, 7/3).

The report predicts that in the 45 nations most affected by the disease, approximately 68 million people will die of AIDS-related causes between 2000 and 2020 if prevention and treatment efforts are not "drastically expanded."

This casualty estimate is more than five times as high as the 13 million deaths that have occurred in these countries during the previous two decades of the epidemic (UNAIDS release, 7/2).

"We have grossly, grossly underestimated how bad this was going to be," UNAIDS Executive Director Peter Piot said (Maugh, Los Angeles Times, 7/3). The epidemic continues to spread rapidly in Africa, Asia, the Caribbean and Eastern Europe, and infection rates in many other parts of the world are either rising or holding steady (BBC News, 7/2).

"It's clear to me that we're only at the beginning of the AIDS epidemic in historical terms," Piot said (Bor, Baltimore Sun, 7/3). The report, titled "Report on the Global HIV/AIDS Epidemic," was released yesterday at the U.N. Economic and Social Council in advance of the XIV International AIDS Conference in Barcelona next week (BBC News,7/2).

The study analyzes the HIV/AIDS epidemic on a regional and worldwide scale; findings by region are summarized in the following sections.

Sub-Saharan Africa

Former South African president Nelson Mandela has led the effort to fight AIDS in Africa With 28.5 million HIV-positive residents, sub-Saharan Africa continues to be the region with the largest number of people living with HIV/AIDS (Agence France-Presse, 7/2). Last year approximately 3.5 million Africans became infected with HIV, and 2.2 million died of AIDS-related causes.

The report predicts that approximately 55 million Africans will die prematurely of AIDS-related causes by 2020 as the epidemic continues to spread on the continent. "Even if exceptionally effective prevention, treatment and care programs take hold immediately, the scale of the crisis means that the human and socio-economic toll will remain significant for generations," the report states.

The average life expectancy in Africa has dropped to 47 years; that of people without HIV/AIDS is 62 years, the report states. Among some of the statistics noted in the study:

  • Seven southern African countries have overall HIV/AIDS prevalence rates of more than 20% of the adult population (Agence France-Presse, 7/2).

  • Botswana has the highest proportion of HIV-positive residents in the world, with 38.8% of the country's adult population infected with the virus. Zimbabwe has the second-highest proportion of HIV-positive adults, with 33.7% of its adult population infected with the virus (Reuters, 7/2).

  • HIV prevalence among pregnant women is rising in many southern African countries, including Botswana, Zimbabwe, Namibia and Swaziland.

  • HIV infections are also "rapid[ly]" rising in parts of Western Africa, where many countries were thought to have "enduring, stable rates of disease" within the past five to eight years.

  • The report noted Uganda's success at reversing its HIV/AIDS epidemic. HIV prevalence continues to decline in the country. Senegal and Zambia have also made progress in lowering their new HIV infection rates (Agence France-Presse, 7/2).


    With 5.6 million HIV-positive residents, the Asia-Pacific region is the area with the second-highest number of people living with HIV, and the report warns that the epidemic could reach sub-Saharan African levels if the virus continues to spread in large countries, particularly China and India (Los Angeles Times, 7/3).

    "The trend ... looks like the same as the beginning of the epidemic in Africa," Sandro Calvani, chair of a U.N. working group on HIV/AIDS in the Asia-Pacific region, said (Agence France-Presse, 7/2). "Low national prevalence rates conceal serious, localized epidemics in several areas, including China and India," the report states (Agence France-Presse,7/2). Among the report's findings:

  • One million adults in the Asia-Pacific region became infected with HIV last year (Agence France-Presse, 7/2).

  • Four million people in India currently have HIV, giving the country the second-highest overall number of HIV-positive residents. South Africa has the largest HIV-positive population with five million HIV-positive residents (Katyal, Reuters Health, 7/2).

  • Approximately 850,000 Chinese people are HIV-positive, and reported HIV infections rose more than 67% in China during the first six months of 2001 (Agence France-Presse, 7/2).

  • HIV infection rates are rapidly rising in Indonesia, the world's fourth-most populous country (UNAIDS release, 7/2).

  • Thailand is successfully reversing its HIV/AIDS epidemic -- new HIV infections in Thailand dropped from 143,000 in 1991 to 29,000 in 2001 (Agence France-Presse, 7/2).

    U.N. officials said that they would like to see the governments of Asian nations make greater efforts against the disease. "The governments of the region are committed via official statements. ... However, this commitment in words does not reflect on the same commitment in facts," Calvani said (Agence France-Presse, 7/2).

    Eastern Europe and Central Asia

    New HIV infections are spreading more rapidly in the Eastern Europe and Central Asia regions than anywhere else in the world, the report states (Brown, Washington Post, 7/3). Eastern Europe reported 250,000 new HIV infections last year (Toros, Associated Press, 7/2).

    The disease is now moving from injection drug users, where it has been most prevalent, to the general population (UNAIDS release, 7/2). Several statistics appear below:

  • New HIV infections in the Russian Federation have been nearly doubling every year (Los Angeles Times, 7/3).

  • In the Ukraine, nearly 25% of new HIV infections occur through heterosexual sex.

  • Poland has curbed HIV infection among injection drug users and has managed to keep the virus from "gaining a foothold in the wider population" (Altman, New York Times, 7/3).

    The Rest of the World

    The report warned that an increase in unprotected sex in Europe and North America is leading to higher rates of HIV infection in these areas. Piot stated that although AIDS-related deaths have declined in the United States, the country has held a steady rate of new HIV infections over the past decade (Associated Press, 7/2).

    North America currently has 950,000 HIV-positive residents, while Latin America is home to 1.5 million people with HIV. There are 420,000 HIV-positive individuals living in the Caribbean and 550,000 people with HIV in Western Europe (Los Angeles Times, 7/3). The report does not contain data for approximately 20 countries, half of which are Arab nations (Holloway, Agence France-Presse, 7/2).


    "These data demonstrate that HIV/AIDS is spreading rapidly in parts of the world where the epidemic had seemed stable or was previously confined to groups at highest risk of infection," Piot said (UNAIDS release, 7/2).

    The report notes that antiretroviral drugs are out of reach for the majority of people with HIV/AIDS in developing nations. Although there are six million people with AIDS in developing countries "who could benefit" from antiretroviral therapy, only 230,000 people are currently receiving such treatment, and most of these people are living in Brazil, which has produced its own versions of patented medicines (Russell, San Francisco Chronicle, 7/3).
    This summary is from the Kaiser Daily HIV/AIDS Report provided by, a free health policy news summary and webcasting service of The Henry J. Kaiser Family Foundation. The Kaiser Daily Health Policy Report is published for by National Journal Group Inc. © 2001 by National Journal Group Inc. and Kaiser Family Foundation. All rights reserved

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