United Nations warns of Asian AIDS crisis by The Guardian / ABC News / The Australian 11:27am 7th Jul, 2004   July 11, 2004    "Annan warns of Asian AIDS crisis" (The Australian).    THE largest global conference of AIDS experts, activists and leaders opens in Bangkok today amid chilling warnings about the growing threat of the disease. Activists and agencies working to combat the disease are expected to use the 15th International AIDS Conference to demand more money to fight the pandemic, with new catastrophes threatening Asia and Eastern Europe.    UN Secretary General Kofi Annan today warned that Asia's economic successes were threatened by the spread of HIV/AIDS after experts warned that the region's leaders had only three years to head off a crisis that could exceed anything seen in sub-Saharan Africa.    The UN has warned that the effects could be disastrous if the virus takes hold in India, China and Indonesia - the big three countries in the Asian region that represent some 40 per cent of humanity. "Here in Asia, HIV/AIDS stands at a turning point," Annan told delegates to the second Asia-Pacific meeting on HIV/AIDS, held in the run-up to the international meeting. "But let us be clear: how you address this challenge will impact the very future of the region."In recent decades, more people have escaped from poverty in Asia and the Pacific than in any other part of the world, and more than in any previous time. "These gains have impressed the whole world. You must cherish, and carefully nurture them. Above all, you must not let them be reversed by HIV/AIDS."    More than 20 million people have died of AIDS since the condition was first detected among a group of US homosexuals in 1981. Around 38 million people are infected with the human immunodeficiency virus (HIV), which wrecks the immune system and leaves the body vulnerable to opportunistic diseases such as tuberculosis, cancer and pneumonia. Two-thirds are in sub-Saharan Africa but Asia and Eastern Europe are seen as the new key battlegrounds.    China's Premier Wen Jiabao warned Saturday that AIDS had spread to every level of Chinese society, after the UN said it was worried that the country could see 10 million people infected with HIV within six years. China has 840,000 people with HIV, only 0.1 per cent of its population, but the UN fears that the conditions are ripe for numbers to surge.    Contributions to fighting AIDS had risen substantially in the past two years but were still woefully short of what was needed, UNAIDS said. The World Health Organisation (WHO) has set a target of giving three million poor people access to antiretroviral drugs by the end of 2005, but it is behind schedule with the tally currently around 440,000.    July 7, 2004    "AIDS defeating World's best efforts as record numbers are infected", by Sarah Boseley (The Guardian).    The lethal spread of the HIV/Aids pandemic across the globe is speeding up, in spite of intensifying efforts on the part of UN agencies, the US, Britain and other European governments to turn the tide. A record five million people were infected by the virus last year and nearly three million died.    The UN's latest bi-annual report on the state of the pandemic made it plain yesterday that the HIV virus that causes Aids is defeating man's best efforts to contain it. There are 38 million people carrying the virus, sub-Saharan Africa is being devastated, and the fastest spread is in Asia and eastern Europe.    "More people than in any previous year became infected with HIV. That is clearly a failure to reach the people who need it with prevention methods. More people than ever before died of Aids. That is a failure to reach them with treatment," said Peter Piot, executive director of Unaids, at the launch of the report in London yesterday. The epidemic, he said, is reaching its global phase, and is no longer a problem largely confined to sub-Saharan Africa.    One in every four new infections is occurring in Asia, where huge populations are at risk, said the report, published just before the international Aids conference in Bangkok which opens this weekend. There have been sharp increases in the numbers infected in China, Indonesia and Vietnam, while India alone has 5.1 million people with HIV - the second largest number infected in any country, after South Africa.    In eastern Europe and central Asia, 1.3 million have the virus, spread largely by injecting drug use. Russia, with more than three million injecting drug users and 860,000 with HIV, is one of the worst hit.    It is a dispiriting picture, because more work and money is going into the battle against the world's worst disease outbreak than ever before, both in helping people to protect themselves against contracting the virus and more recently in efforts to get drugs that can prevent HIV developing into Aids to people in poor countries.    But still not enough is being done, said Dr Piot. "The world is falling short on prevention. Preventing new infections will at the end of the day stop this epidemic," he said. "Only one in five who need it have access to HIV prevention - [such as] education of children in schools, access to condoms and access to clean needles for those who are injecting drugs."    There had been some progress on treatment, he said, but too little. There are now about 440,000 people in the developing world on Aids drugs, which keep the level of the virus in the blood low, although they are not a cure. Half of those people are in Brazil, although the drugs are becoming more available in Asia. Where they are most needed - in sub-Saharan Africa with its 25 million infected and where 2.2 million people died of Aids last year - the antiretroviral drugs that can keep people alive are still rare. Treatment, said Dr Piot, "is still dramatically, shockingly low in Africa".    He expects it to improve. The World Health Organisation has set a target of three million people on treatment by 2005 and international funds are being made available to poor countries that want to put into place treatment plans. President George Bush has pledged $15bn (£8.1bn) over five years to fight Aids, which the US has recognised as a threat to world security. Philanthropic foundations, such as that of Bill and Melinda Gates and also Bill Clinton, are putting money and muscle into the struggle.    But nobody yesterday was underestimating the scale of the challenge, even though drug prices have come down dramatically.    Many of the worst affected countries are hard-pressed to draw up treatment plans and are very short of nurses, doctors and hospitals, even without the Aids epidemic. They need to train people to administer the drugs and overcome the stigma of the disease to persuade people to come forward for testing before they become sick.    But there is little alternative. Prevention efforts have been successful in a few countries such as Thailand and Uganda but have not slowed the pandemic and need a rethink, said Dr Piot.    For many women in Africa, the mantra of ABC - abstinence, be faithful and condoms - which is regularly recited by outside agencies and especially the US is "pretty irrelevant", he said.    The Aids pandemic in Africa is hitting women worst. Nearly 60% of the victims are female, and they often do not have the option of abstinence, fidelity or condom use. Many are subject to violent, non-consensual sex by men.    "To ensure women become less infected, we have to target men," said Dr Piot. "We are getting into a need for quite fundamental and long-ranging behaviour change. We have to change norms in society."    One of the best hopes for women, he said, was the development of a microbicide - a drug that can prevent the transmission of HIV during intercourse.    Clare Short, as international development secretary, put substantial British funding into microbicide research, which has not yet born fruit, although her successor, Hilary Benn, said yesterday that five clinical field trials were about to get under way.    The UK is the second biggest donor to HIV/Aids initiatives, and yesterday Mr Benn announced a further £116m to two UN agencies involved in the fight - Unaids and the United Nations Population Fund. He also launched a paper setting out how the Department for International Development plans to push for high quality family planning in developing countries.    "Sexual and reproductive health and Aids are inextricably linked. By taking action on one, we know we are also helping to tackle the other," he said.    The statistics in the Unaids report have been collated from a number of sources, including countries' own estimates of the numbers infected, surveys and data from anonymous testing of women at antenatal clinics.    Unaids says some of the estimates are lower than previously, because of improved methodology, but there is no doubt of the upward trend of infections and deaths.    7 July , 2004     Anger over Bush administration approach to AIDS Epidemic ( ABC News: AM - Reporter: Peter Lloyd).    TONY EASTLEY: The Bush administration has been accused of not doing enough to try and prevent the dramatic spread of AIDS in Asia. Its critics say the White House's conservative policies are holding back the fight, when infection rates are at the highest on record. A United Nations report warns that the epidemic is gathering pace in Eastern Europe and Asia, and could soon dwarf the crisis already present in Africa. South East Asia Correspondent Peter Lloyd reports.    PETER LLOYD: When delegates gather for the World AIDS Conference in Bangkok on Sunday, the words of Kathleen Cravero from UNAIDS may well be ringing in their ears.    KATHLEEN CRAVERO: There's a famous window of opportunity to get prevention programs up to scale in Asia. If we miss it, we will see an epidemic the likes of which we never imagined despite what has happened in Africa.    PETER LLOYD: Kathleen Cravero says an epidemic that has long been largely considered an African problem has now become one for Australia and its near neighbours to consider more urgently.    KATHLEEN CRAVERO: The epidemic in Asia is in fact expanding rapidly. Much of this has to do to continued growth, rapid growth in the epidemics in China, Indonesia, and Vietnam, which make up approximately 50 per cent of Asia's population.    PETER LLOYD: Through sheer might and money, the United States remains one of the biggest forces of influence in the worldwide response to AIDS.    Under George W. Bush, American AIDS policy has been driven by the belief that abstinence only is crucial in prevention of new HIV infections. The White House has earmarked close to $20-billion over five years to fight AIDS in the developing world, but there are many strings attached. Recipients aren't allowed to encourage condoms and other forms of birth control, and they can't readily buy cheaper generic drugs. Asia Russell, from spending advocacy group, Health GAP, says the White House is railroading recipients of US aid into a failed, Christian-right policy.    ASIA RUSSELL: Global AIDS is the greatest public heath threat of my generation, and my President is... got some of the most extreme views around. That sort of combination is quite incendiary. We're talking about more than 8,000 deaths every single day and in the war against AIDS we know the tools that work, we know the sorts of intervention that work, and if an administration is choosing other than these, and is doing less than it ought, then they're absolutely responsible. It's not enough for them to sit back on their hands and say that they tried.    PETER LLOYD: Kathleen Cravero from the United Nations didn't mention the US by name, but the message that abstinence only was a failed policy in developing nations was clear enough.    KATHLEEN CRAVERO: Most of the women and girls in the world, especially in Asia, they don't have the option to abstain when they want to. They don't have the option... they are faithful and are getting infected despite that, and have no control over whether their partner is faithful and they are in no position to negotiate condom use.    PETER LLOYD: Very few in the Bush administration will hear the message directly at the AIDS conference. Despite pleas from organisers, the US is sending one of the smallest delegations.    10th July, 2004    Asia's annual Aids bill could soar to $30b . (Straits Times)    BANGKOK - The annual cost of the Aids epidemic in Asia could jump by US$10.5 billion (S$18 billion) by 2010 unless countries in the region take urgent steps to halt its spread, the Asian Development Bank (ADB) and the United Nations said. Failure to bolster current HIV treatment and prevention programmes could result in about 10 million more infections by the end of the decade, according to a joint report by UNaids and the ADB.    At present, about 7.2 million people are living with HIV in the Asia-Pacific region with hundreds of thousands dying each year. The cost of fighting the epidemic in Asia is expected to soar to US$17.5 billion (S$30 billion) annually by 2010 from the current US$7 billion if anti-Aids programmes are not improved, the report said. Some US$1.5 billion is required yearly to contain the Aids epidemic in Asia, and that amount is expected to increase significantly as more people are diagnosed with the disease, said Dr Peter Piot, executive director of Unaids. 'The cost of inaction, of not acting against Aids, is very high,' Dr Piot said. 'The longer one waits, the higher the bill becomes.'    That's bad news for the economic future of Asia - where stunning growth in the past two decades has lifted many out of grinding poverty. The report called for Asian nations to step up their anti-Aids programmes to include programmes for vulnerable groups and young people and condom promotion, among other measures. The report warned that about 5.6 million people could become poor or fall deeper into poverty every year from 2003 to 2015 'if the epidemic isn't checked now', particularly in Cambodia, India, Thailand and Vietnam.
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