AIDS Infections reach record high, U.N. says by UN News / New York Times / AFP / IPS News 8:34am 24th Nov, 2004   23 November 2004    Number of HIV-infected women rising worldwide- UN report. (UN News)    The number of women living with HIV has risen in each region of the world over the past two years, with the steepest increases in East Asia, followed by Eastern Europe and Central Asia, according to a new United Nations report released today.    In East Asia there was a 56 per cent increase followed by a 48 per cent rise in both the other two regions, according to AIDS Epidemic Update 2004, the annual report by the Joint UN Programme on HIV/AIDS (UNAIDS) and the UN World Health Organization (WHO).    The number of people living with HIV globally has also reached its highest level with an estimated 39.4 million people, up from an estimated 36.6 million in 2002. “We do not yet have a vaccine, but we do know that prevention and treatment work and we have the tools to deliver them. Government leaders, civil society and the private sector are all affected and we must all mobilize to save lives, WHO Director-General Lee Jong-wook said.    These latest trends firmly establish AIDS as a unique development challenge, UNAIDS Executive Director Peter Piot added of the report's indication that there is no single AIDS epidemic worldwide, with many regions and countries experiencing diverse epidemics, some still in the early stages. The time of quick fixes and emergency responses is over. We have to balance the emergency nature of the crisis with the need for sustainable solutions, he added.    Women are increasingly affected, now making up nearly half of the 37.2 million adults aged 15 to 49 living with HIV worldwide. In sub-Saharan Africa, the worst-affected region, close to 60 per cent of adults living with HIV are women or 13.3 million.    The steepest increases in overall HIV infections also occurred in East Asia, Eastern Europe and Central Asia, with a 50 per cent rise in East Asia largely attributable to growing epidemics in China, Indonesia and Viet Nam. The 40 per cent increase in Eastern Europe and Central Asia is mainly due to Ukraine's expanding epidemic and the growing number of people living with HIV in the Russian Federation.    With an estimated 860,000 people living with HIV at the end of 2003, Russia has the largest epidemic in Europe. As the numbers of people becoming infected and living with HIV increases, so does the number of those needing antiretroviral treatment, as well as care for opportunistic infections.    Women are more physically susceptible to HIV infection than men. Male-to-female HIV transmission during sex is about twice as likely to occur as female-to-male transmission. For many women in developing countries, the ABC prevention approach (Abstinence, Being faithful and reducing number of sexual partners, and Condom use) is insufficient.    Strategies to address gender inequalities are urgently needed if we want a realistic chance at turning back the epidemic, Dr. Piot said. Concrete action is necessary to prevent violence against women, and ensure access to property and inheritance rights, basic education and employment opportunities for women and girls.    According to the report, millions of young people are becoming sexually active each day with no access to prevention services. In sub-Saharan Africa, three quarters of all 15 to 24 year-olds living with HIV are female. Young women there are three times more vulnerable to HIV infection than their male counterparts. In addition to being biologically more vulnerable to infection, many women and girls, particularly in southern Africa, find themselves using sex as a commodity in exchange for goods, services, money or basic necessities often with older men.    November 23, 2004    "AIDS Infections reach record high, U.N. says", by Lawrence Altman. (New York Times)    AIDS virus infections have reached a record high in the world this year, and the number of women with H.I.V. has risen in every region of the world, the United Nations said today.    An estimated 39.4 million people are living with the virus, up from 38.1 million in 2003, the United Nations said in issuing its annual report on AIDS in advance of World AIDS Day on Dec. 1.    The report focused on women, who make up nearly half of infected adults. The steepest increases in this group over the last two years have occurred in East Asia, followed by Eastern Europe and Central Asia.    In Africa, the most heavily affected continent, women account for nearly 60 percent of infected people. The increasingly female face of H.I.V. in the world "has major implications" because it means that treatment and prevention programs must focus on women if the world wants to stop the epidemic, said Dr. Peter Piot, the director of the United Nations AIDS program in Geneva.    The new trend "touches at the deepest and most profound societal norms that are driving the AIDS epidemic," Dr. Piot told reporters in a telephone news conference. Often, when a woman becomes a widow, "she loses everything and is pushed to extreme poverty" and forced to sell her body, Dr. Piot said.    So, he also said, "concrete action is necessary to prevent violence against women, and ensure access to property and inheritance rights, basic education and employment opportunities for women and girls."    But even if property rights are protected, new laws need to be passed to protect women against male sexual violence within marriage. Many women cannot refuse to have sex with their infected husbands. Also, a disproportionately small number of women are receiving anti-H.I.V. drugs. Even if their husbands can afford the anti-retroviral drugs, many refuse to buy them for their wives. And fewer women than men seek anti-retroviral treatment.    The United Nations is collecting more information to document the problem. "We are focusing on what exactly and concretely we can do to change some of these elements in society that make women so vulnerable," Dr. Piot said.    With the world now spending about $10 billion a year on AIDS, "our main challenge is to show that the money works," Dr. Piot said. Lack of coordination among donors has become a critical issue and even "a big mess in some countries," Dr. Piot said. In some countries, representatives of donor agencies visit so often, demanding to spend time with the key people involved in AIDS work, other government officials, and doctors that "it paralyzes the few people in charge," Dr. Piot said. The United Nations plans to hold a meeting this winter to improve the efficiency of donor programs.    November 23, 2004.    Generations of Africans will be affected by AIDS. (AFP)    AIDS has hit sub-Saharan Africa so badly that the disease will cast a shadow over generations to come, even in countries that succeed in the battle against it, the United Nations has warned. Africans account for some 25.4 million of the 39.4 million people around the world who have either the human immunodeficiency virus (HIV) or AIDS, the UN's World Health Organisation (WHO) and UNAIDS said in an annual report.    "HIV infection is becoming endemic in sub-Saharan Africa," AIDS epidemic update, released ahead of World AIDS Day on December 1, said. "Current high prevalence levels mean that even those countries that do eventually reverse the epidemic's course will have to contend with serious AIDS epidemics for many subsequent years. "The havoc wrought by AIDS will shape the lives of several generations of Africans."    Commercial sex, sexual abuse and violence were pinpointed as the big vectors of HIV/AIDS in Africa.    The good news is that east Africa has seen modest declines in HIV prevalence among pregnant women, and levels have stayed steady in central and west Africa. This has helped keep the continent's HIV prevalence to 7.4 per cent of the adult population, compared to 7.5 per cent in 2003.    On the downside, HIV prevalence among expectant mothers has risen sharply in southern Africa from 5 per cent in 1990 to more than 25 per cent this year.    Southern Africa is "the worst affected sub-region in the world," the report declared bluntly.    Around 11.4 million people in the nine countries that make up this sub-region live with HIV or acquired immune deficiency syndrome (AIDS), representing "almost 30 per cent of the global number of people living with HIV in an area where only 2 per cent of the world's total population resides," the report said.    South Africa has the highest number of people living with HIV in the world - 5.3 million, more than half of them women.    Four other countries in the region - Botswana, Lesotho, Namibia and Swaziland - all have "very high HIV prevalence, often exceeding 30 per cent among pregnant women". Across sub-Saharan Africa, women are the hardest hit by the disease, with "13 women living with AIDS for every 10 infected men".    The gender gap, which shows no signs of shrinking, widens among younger women, with 36 women aged between 15 and 24 infected with HIV for every 10 men from the same age group. In east Africa, Uganda saw HIV rates fall from 13 per cent of the adult population in the early 1990s to 4.1 per cent by end-2003 and Kenya "could be on a similar path," UNAIDS and the WHO said.    Prevalence rates were also falling in Burundi and Ethiopia. Infection rates appeared to have stabilised in west and central Africa, although there were pockets where "serious epidemics are under way."    "Stabilisation does not necessarily mean the epidemic is slowing," the report cautioned.    "On the contrary, it can disguise the worst phases of an epidemic - when roughly equally large numbers of people are being newly infected with HIV and are dying of AIDS." Even in countries which have seen a decline in HIV prevalence, it is "too early to claim that recent declines herald a definitive reversal" in the epidemic, the report warned. "The need for treatment, care and support will continue to increase for years to come."    UNAIDS is a joint venture between 10 UN-system organisations to help prevent the spread of AIDS, care for those already infected and mitigate the impact of the epidemic.    December 1, 2004    "If unchecked Asia could be another Africa - U.N. Envoy", by Zofeen T. Ebrahim. (Inter Press Service News)    She had no qualms whatsoever of putting the harsh realities on the table - especially on World AIDS Day. And for anyone listening to Nafis Sadik, a medical doctor who is also the U.N. special envoy for HIV/AIDS in Asia and the Pacific, the prognosis is alarming when she warns that Asia-Pacific societies could collapse like some in Africa as a result of the pandemic.    'We can't afford to be complacent. AIDS is transmitted in the same way in Asia as it did in Africa -- the dynamics are not all that different,' she told the opening of a regional Women, Girls and HIV/AIDS Best Practices Conference in Islamabad.    'HIV/AIDS is the greatest long-term threat to human security, human rights and economic development that the Asia-Pacific region will face in the next decade,' warned Sadik.    Asia-Pacific is now about 13 years behind Africa, where societies in the worst affected countries, including prosperous Botswana, are collapsing and economic growth is disappearing, said Sadik.    'It could happen in this region; it will happen, unless we act,' cautioned the special envoy of U.N. Secretary-General Kofi Annan.    Speaking at the regional Women, Girls and HIV/AIDS Best Practices Conference in the Pakistani capital, Sadik said same high-risk behaviour is being displayed in the Asia- Pacific as in Africa.    'The same factors (are here) and yet we don't recognise them. We keep saying our value systems are going to protect us...I heard all that in Africa,' she pointed out. 'Asia Pacific countries need to act against HIV/AIDS, and they need to act now.'    'There is no cure for AIDS and none in sight. The cost of treatment for large populations living with HIV/AIDS is beyond the reach of any government in the region,'' added Sadik bleakly.    The regional HIV/AIDS organised by the Amal development Network, with help from the National AIDS Control Programme, was opened by Pakistan's Prime Minister Shaukat Aziz on Nov. 28 and ends on Wednesday to coincide with World AIDS Day.    The first of its kind to be organised by a Muslim country, the conference drew over 400 participants from Bangladesh, Burma, Cambodia, China, India, Iran, Nepal, Vietnam and Britain. The three-day conference is also the region's first to examine best practices in controlling the spread of HIV.    Seven million people in Asia-Pacific countries are currently infected with HIV/AIDS, according to U.N. figures. One third are women, and four million of them are in India. More than half a million people die each year and the cost to the region in 2001 was 7.5 billion U.S. dollars.    In South Asia, women and girls are most vulnerable. Young women on the subcontinent account for 62 percent of infections in the 15-24 year old age group. In India, 90 percent of HIV-positive women are married and monogamous.    'The complete answer to the suffering of married women lies first in empowering women with health care, education and the power of the purse; and second in changing the behaviour and underlying attitudes of men,' she said. 'A widening pandemic will mean the end of efforts to eradicate poverty, and empower women and girls, who are most of the poor.'    Added Sadik: 'As a matter of human rights it is intolerable to expose Asia Pacific's women unnecessarily to HIV/AIDS; as a matter of practical economics, it is insupportable.' But is anyone listening to these alarming details? 'Yes,' insisted Sadik in an interview with IPS. 'People are listening. Every time there is a response.'..'We've moved from denial to trying to grapple with the reality,' she said talking about the situation of South Asia in general and Pakistan in particular.    The U.N. special envoy, however, said that the onus of responsibility was with the top leaders. 'Leaders must be willing to challenge entrenched attitudes and ingrained ideas.' HIV/AIDS, according to Sadik, must be addressed as a development issue rather than being mainstreamed at all levels as an ailment. 'HIV/AIDS is not a health issue, it only becomes one when you get the opportunistic infections or you get the full-blown AIDS. It's a socio-cultural issue; it's about behaviour and attitudes. You have to get everyone on board.'    She also underscored the importance of leaders talking about the issue more and ''not just restricting themselves to talking about the topic at HIV/AIDS conferences. 'The more you talk, the less controversial it becomes and it breaks the communication barriers,'' said Sadik.. 'Most leaders don't want to talk about sex; I recognise that and feel very strongly about finding a way to make it easier. We need to devise a vocabulary that is easy to understand and which everyone is comfortable with.'    But Sadik also acknowledged the way statistics are being used by international bodies to gain public attention in their fight against the pandemic.    'In countries where the quality of surveillance systems are better - like India, where they have estimated five million cases - the numbers increase every time the surveillance sites are increased,' she pointed out.    'The numbers also increase when care and treatment is introduced as more people begin to seek treatment. This is both a good and a bad sign,' added the U.N. envoy. 'Good because people are realising finally and coming out of the closet, and bad because the problem is there and needs to be taken care of on an urgent basis,' she explained.
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