By John S. James
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.
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The Politics of Life and Death:
Global Responses to HIV and AIDS
Africa and the Devastation
of the Human Species
Access to Treatment Worldwide:
From Talk to Action at Durban
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"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."
AIDS Treatment News
Published twice monthly
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E-mail: aidsnews@aidsnews.org
Editor and Publisher: John S. James
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Statement of Purpose:
AIDS Treatment News reports on experimental and standard treatments, especially those available now. We interview physicians, scientists, other health professionals, and persons with AIDS or HIV; we also collect information from meetings and conferences, medical journals, and computer databases. Long-term survivors have usually tried many different treatments, and found combinations which work for them. AIDS Treatment News does not recommend particular therapies, but seeks to increase the options available.
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ISSN # 1052-4207
Copyright 2000 by John S. James.
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