The Religious Consultation
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New York Times, June 3, 2005 Gains Made to
Contain AIDS, but Its Global Spread Goes On,
U.N. Says UNITED NATIONS, June 2 - Although a small but growing number of countries are beginning to contain the spread of the AIDS virus, the epidemic is expanding in all areas of the world, outpacing the response, the United Nations secretary general, Kofi Annan, said here on Thursday. "It is clear that the epidemic continues to outrun our efforts to contain it," Mr. Annan said at a special session of the General Assembly to address the disease. At the session, delegates received a report on the progress that countries have made since 2001, when the United Nations' member countries unanimously declared that they should work to halt the spread of AIDS and H.I.V. and begin to reverse it by 2015. Dr. Peter Piot, who directs the United Nations AIDS program, said: "The epidemic has yet to display a natural saturation point. In Swaziland, the country most affected by AIDS in the world, adult prevalence continues to climb; 42.6 percent of pregnant women there tested positive for H.I.V. in 2004. "By 2006, 11 countries in sub-Saharan Africa will have lost more than one-tenth of their labor force to AIDS," Dr. Piot said. Studies have failed to determine why the AIDS epidemic has been most severe in southern Africa and why certain countries, like the Philippines and Sri Lanka, have low infection rates. Mr. Annan said that billions more dollars would be needed annually for decades to keep people free of H.I.V. and to treat the 40 million people who are infected. Though much of the report was grim, Mr. Annan cited some bright spots in fighting AIDS, among them the Bahamas, Brazil, Cambodia, Cameroon, Kenya, Thailand and Zambia. Dr. Piot said that H.I.V. rates among people 15 to 24 years old seemed to be falling in some areas most ravaged by the disease. "In East Africa, for example, in every big city" there had been declines in the rates for young people, "and particularly among women and girls," Dr. Piot said in an interview. He cited Addis Ababa, Kigali, Lusaka and Nairobi - the capitals of Ethiopia, Rwanda, Zambia and Kenya - largely because they are the places with the most extensive AIDS education and prevention programs, particularly for young people. But, he added, with regard to why rates decreased in some places and not others, "There is something going on there that we don't pretend we fully understand." For the first time, truly comprehensive responses to AIDS, including prevention and treatment, are emerging, Dr. Piot said. "Iran has one of the best AIDS programs," he added, citing in particular its needle-exchange efforts. The report found that in several countries in Central and South America, deaths from AIDS have declined since the expansion of programs to deliver antiretroviral drugs. Haiti, which has the lowest per-capita income in the Western Hemisphere, has made significant strides in expanding access to antiretroviral treatment with support from the Global Fund to Fight AIDS, Tuberculosis and Malaria. By December 2004, tens of thousands of people had been counseled and tested, and 2,000 people in urban and central Haiti had started taking the drugs. Dr. Piot said such treatment had become a reality for a number of infected people in the third world - a feat unimaginable only a few years ago, although worldwide only 12 percent of those who need them were receiving the drugs as of last December. The United Nations considers prevention the mainstay in the battle against AIDS: 4.9 million people became infected in 2004 and 3.1 million died from the disease that year. Prevention lags because many countries have not directed their efforts at the people at the greatest risk of infection. A 2004 survey of national AIDS spending in 26 countries found that some countries had used limited prevention resources for less effective initiatives aimed at the general population, including people at low risk. "This approach misses the critical opportunity to prevent an epidemic that is concentrated in the most vulnerable populations from spreading to the population at large," Dr. Piot said. Worldwide, services to prevent transmission of H.I.V. from mother to child reach only 8 percent of pregnant women, including just 5 percent of pregnant women in Africa. Prevention, Dr. Piot said, must be an integral part of programs to treat infected people. Meeting the goals set in 2001 will require greater success in reaching young people with essential information, education and services, the report said. Although many young people are learning about AIDS, more than half of those surveyed in nine sub-Saharan countries lacked comprehensive information about H.I.V. prevention. AIDS accounts for 3 percent of deaths in children under 5 years old, but in hard-hit countries, the figure reaches 50 percent. Also, AIDS has orphaned 12 million children in Africa and an additional 3 million elsewhere. National efforts and financing are insufficient to address the problem of orphans, which is expected to grow in coming years, but, Dr. Piot said, political commitments to combat the spread of AIDS, sorely lacking in the early stages of the epidemic, have increased significantly since 2001 at the national, regional and global levels. The response to AIDS in the Caribbean is being transformed by the leadership and collaboration of the region's political leaders, under the umbrella of the Pan Caribbean Partnership Against H.I.V./AIDS. Still, political commitment remains inadequate in many countries where the epidemic is emerging as a major problem. The United Nations cited disturbing signs of growth of the epidemic in Asia, home to half of the world's population. "Strong and energetic leadership is especially vital in all countries in Asia and Eastern Europe, where the opportunity to prevent the epidemic from becoming generalized is quickly vanishing," the report said. At the same time, an acute shortage of workers who possess the skills and expertise needed to combat AIDS has become a major barrier to starting and expanding essential prevention and treatment programs. "Stopping the epidemic will require development of microbicides to protect women and a vaccine," and that will take years, Dr. Piot said. Delegates ended the one-day session by agreeing that a more comprehensive five-year follow-up report would be sent to the United Nations next year. << New York Times -- 6/3/05 >>
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