New World AIDS Day Report
-------------------------
New World AIDS Day Report finds global HIV infections increased 10% in
1998
-------------------------------------------------------
Source: Community Research <aids98.Community@hivnet.ch>
Press Release - Joint United Nations Programme on HIV/AIDS Geneva,
24 November 1998
- Half of all new infections now in 15-24 year olds
- Development gains being wiped out
- Sub-Saharan African countries hardest-hit
- Already 34 million infections and almost 12 million deaths
- Fewer deaths in North America, Western Europe, but no progress in
prevention; HIV infection rates unchanged for a decade
According to a report issued today by the Joint United Nations Pro-
gramme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) -
The AIDS Epidemic Update, December 1998 - during the past year a fur-
ther 5.8 million people were infected with HIV - approximately 11 men,
women and children every minute - and the total number of people living
with the virus rose by one-tenth, to 33.4 million world-wide.
Half of all new infections are now occurring among young people aged 15
to 24. This year's World AIDS Campaign "Young People: Force for Change"
was prompted in part by the epidemic's threat to those under 25 years
old, for as HIV rates rise in the general population, new infections
are increasingly concentrated in the younger age group.
The global epicentre of AIDS continues to be sub-Saharan Africa. Since
the epidemic began, 34 million Africans have been infected, and almost
12 million of them have already died. In 1998 the region experienced
four million new infections and rising AIDS death tolls, seen in an es-
timated 5,500 funerals per day. In the southernmost countries of the
continent, where HIV spread took on epidemic proportions only recently,
infection rates continued to rise dramatically during the past year.
Four countries now estimate that 20% to 26% of adults are living with
HIV, and South Africa alone accounts for one out of every seven new in-
fections on the continent. In contrast a number of countries in West
Africa remain relatively less affected, in part as a result of early
and sustained prevention efforts.
In the regions of North America and Western Europe, the availability of
new more potent anti-HIV drug combinations has helped people with HIV
live longer, healthier lives. In the United States, for example, the
number of people dying from AIDS dropped by two-thirds between 1995 and
1997, when these anti-retroviral combinations came into wide use.
Alongside this undoubted therapeutic success, there is a disturbing
lack of progress in prevention. Every year for the past decade, the
numbers of new HIV infections have remained stagnant in North America
and Western Europe, with close to 75 000 people acquiring the virus in
1998 alone.
"Two decades into the AIDS epidemic, we know better than ever before
about prevention --- how to persuade people to protect themselves, make
sure they have the necessary skills and back-up services, and remove
social and economic barriers to effective prevention," said Dr Peter
Piot, Executive Director of UNAIDS. "Yet almost six million people be-
came infected this year. Every one of these new HIV infections repre-
sents a prevention failure - our collective failure."
In many Asian and Eastern European countries, where the epidemic
started later than in other regions, HIV is rapidly gaining new foot-
holds. In India, for example, recent research shows that HIV is now
firmly embedded in the general population and is spreading into rural
areas that were previously thought to be relatively spared. In the
state of Tamil Nadu (population: 25 million), a new survey reveals that
almost half a million people are already infected with HIV and that the
infection rate is three times higher in villages than in the cities.
In Latin America, while infections are concentrated in men who have sex
with men and drug injections, transmission through sex between men and
women is on the rise.
Development gains being wiped out
In the worst-affected countries the AIDS epidemic is now making sig-
nificant in roads into precious development gains that have been built
up over the past decades.
In nine countries where at least 10% to the adult population is HIV-
positive, it has been estimated that AIDS will soon be costing an aver-
age of 17 years of life expectancy, compared with what these countries
could look forward to in the absence of the epidemic. These dismal de-
clines are not only due to adult deaths. Over half a million children -
- most of whom acquired the infection before or at birth, or through
breast-feeding - died in 1998 alone. By 2005-2010, the infant mortality
rate in, for example, Namibia is expected to reach 72 per 1000 live
births as opposed to 45 per 1 000 without AIDS.
The onslaught of AIDS is also denting the prospects for economic devel-
opment in hard-hit countries. In Zimbabwe, some companies have reported
that AIDS costs are now absorbing as much as one-fifth of company earn-
ings and, for instance, in Tanzania and Zambia, other firms estimate
that AIDS illness and death cost them more than their total profits for
the year.
Says David Heymann, Executive Director, Communicable Diseases Cluster,
WHO, "AIDS is a deadly serious public health threat. But as the epi-
demic continues to spin out of control, countries face more than just a
health crisis. They face a growing threat to human development and to
economic and social stability."
Forces that fuel the epidemic
Some of the reasons behind HIV's spread remain undetermined. It is not
fully understood why, for instance, HIV infection rates take off in
some countries while remaining stable in neighbouring countries over
many years. What is known is that a number of factors clearly influence
the shape and scope of the epidemic in different parts of the world.
Wars and armed conflicts generate fertile conditions for the spread of
HIV. The UNAIDS/WHO report notes that in Rwanda, before the political
turmoil of the mid-1990s, infection rates were approximately 10% in
cities and towns and around 1% in the countryside, where most people
lived. Yet by 1997, both urban and rural rates were just over 11%. A
revealing fact is that HIV infection rates rose six-fold among the
mostly rural people who had fled to refuges camps.
In many places people have no access to voluntary HIV testing and coun-
selling. Yet even when these services are offered, many do not want to
know or acknowledge their HIV status because of the blame and shame at-
tached to AIDS. For example, in Cote d'Ivoire, where more than 13 000
pregnant women were offered interventions to increase their chances of
having a healthy baby, fewer than half accepted testing and returned
for the results.
In Zimbabwe's city of Mutare, surveillance data indicate that close to
40% of pregnant women are HIV-infected and probably 30 000 adults are
living with HIV. Yet the sole HIV support group in the city has just 70
members, leaving thousands of others to struggle alone with the impli-
cations of their infection, including the dilemma of how to explain the
sudden need for condom use with a spouse or other stable partner.
Secrecy can persist even in the face of sickness and death, which in
immuno-deficient people is often caused by tuberculosis or other common
illnesses. In one study of home-based care schemes in southern Africa,
fewer than 1 in 10 people who were caring for HIV-infected relatives at
home acknowledged that they were suffering from AIDS, and the patients
themselves were barely more open.
"One might think that in a country with a quarter or third of the popu-
lation infected, people would become more open about the epidemic. Ex-
perience teaches us that this doesn't happen automatically," said Dr
Piot. "The silence needs to be broken, publicly and courageously, by
leaders who encourage their people to face the truth about AIDS."
For more information, please contact:
Anne Winter,
UNAIDS, Geneva,
Mobile phone: +41-79-2194312
mailto:press@unaids.org
or
Rosemary Hennings,
UNAIDS London
Phone: +44-181-8568643
or
Lisa Jacobs,
UNAIDS, Geneva,
Phone: +41-22-7913387
You may also visit the UNAIDS Home Page on the Internet for more infor-
mation about the programme at:
http://www.unaids.org
Note: For those with Internet access, the full report will be available
soon at:
http://www.unaids.org/highband/document/epidemio/index.html
--
Send mail for the `AFRO-NETS' conference to `afro-nets@usa.healthnet.org'.
Mail administrative requests to `majordomo@usa.healthnet.org'.
For additional assistance, send mail to: `owner-afro-nets@usa.healthnet.org'.