Failure on AIDS by New York Times / Reuters / The Economist 1:19pm 2nd Dec, 2005   4 December 2005    UN"s senior AIDS official says disease"s spread is outstripping Africa"s containment efforts.    Despite a decline in some countries, the overall spread of HIV in Africa was greater this year than ever before, the head of the Joint United Nations Programme on HIV/AIDS (UNAIDS) said today, calling for urgent and sustained action to help the continent prevent and treat the disease.    “The reality is that in sub-Saharan Africa over 3 million people were newly infected with HIV in 2005 – that"s 64 per cent of all new infections globally and more than in any previous year for the region. Young people are making up half of these new infections,” said Dr. Peter Piot in Abuja, Nigeria, at the opening of the 14th International Conference on AIDS and STIs (sexually transmitted infections) in Africa. “AIDS continues to outstrip Africa"s efforts to contain it and continues to pose an acute threat to future generations,” he added.    December 1, 2005    Failure on AIDS. (New York Times)    AIDS is outrunning us. The annual report of the United Nations" AIDS agency, released last week to mark World AIDS Day, informs us that this year there will be five million new infections, a record, and more than 3.1 million deaths, another record.    The most troubling aspect of the report by the agency, Unaids, is its grim evidence that many large countries are still closing their eyes to limited AIDS epidemics that will soon explode into the general population. India is providing numbers no one believes. Russia has the world"s fastest-growing epidemic, fueled by intravenous drug abuse. Drug abuse also now accounts for half of China"s AIDS cases, and it is spreading AIDS infections rapidly in Vietnam, Indonesia and Pakistan.    There is a proven way to halt the spread of AIDS among intravenous drug abusers: Provide them with clean needles so they need not share dirty ones. But many governments won"t do it because they fear being seen as endorsing drug abuse. The United States prohibits the use of its money for needle exchanges and is actively trying to prevent anyone else from working on the issue. In Russia, whose epidemic is nearly entirely due to drug abuse, it"s illegal even to advocate for needle exchanges. The price of this shortsightedness will be AIDS epidemics that spread into the general population.    Unaids reports that a small handful of places are making some progress. Zimbabwe, despite all its problems, is seeing a lower rate of AIDS in pregnant women: from 26 percent in 2003 down to 21 percent in 2004, apparently in large part because of the increased use of condoms. Kenya and Burkina Faso have also apparently reduced the prevalence of the disease. And in Caribbean countries, the area with the second-worse AIDS problem, after Africa, the AIDS prevalence is stable or dropping.    It"s heartening to see that work with community groups, the promotion of consistent condom use and less risky sexual behavior, and the expansion of testing can make a difference. Yet bright spots are few. The world has finally increased AIDS spending, much of it too recent to be reflected in the report"s data. But the increases are not keeping up with the disease, and funds aren"t being spent effectively.    A new study of programs in six key countries reports that efforts to save lives are undermined by bureaucratic infighting, government indifference, a lack of training and corruption. The World Health Organization set a goal of having three million people outside rich nations on treatment by the end of this year. The world will fall about two million short. Even cheap and easy programs to prevent mother-to-child transmission reach only a small percentage of those who need them.    Despite the lags, AIDS treatment will reach more and more people - many countries are just now getting started. But their success depends on the largess of wealthy nations. The leaders of rich countries who met in Scotland over the summer pledged that by 2010, everyone in the world who needs AIDS treatment would get it. But at current financing levels, that goal is doomed.    The Global Fund to Fight AIDS, Tuberculosis and Malaria, which is carrying out most of these programs (President George W. Bush"s program focuses on only 15 countries), is running so short of money that its officials don"t know whether it will start a new round of grants in 2006. The United States, which has consistently pledged to contribute a third of the Global Fund"s budget, is not doing so. Bush has asked Congress for far less than he has promised. Congress has added money, but is now threatening another cut.    The AIDS story this year is mostly one of failure - the failure of rich countries to give the promised money, the failure to muster the political will in poor nations. All around, it"s a failure of leadership.    December 1, 2005    Annan: "We must do far, far more" against AIDS, by Ellen Wulfhorst. (Reuters)    Around the globe, leaders, activists and victims used World AIDS Day on Thursday to send the message that far stronger action is needed in the battle against the disease that kills millions of people every year.    The United Nation"s special envoy for AIDS in Africa proposed big business dedicate a portion of profits to the fight, French President Jacques Chirac suggested schools install condom vending machines and Indian Prime Minister Manmohan Singh called on people to talk openly about safe sex.    The number of people living with HIV, the virus that causes AIDS, has reached its highest level with an estimated 40.3 million people, UNAIDS Executive Director Peter Piot said. Nearly half of them are women.    "We must do far, far more," U.N. Secretary-General Kofi Annan said. "It is time to recognize that although our response so far has succeeded in some of the particulars, it has yet to match the epidemic in scale."    Others, including U.S. President George W. Bush, noted what progress had been made. Speaking in Washington, he said U.S. efforts were helping 400,000 people in sub-Saharan Africa get treatment.    With just over 10 percent of the world"s population, sub-Saharan Africa is home to more than 60 percent of all people infected with HIV. Africa saw about 3.2 million of the almost 5 million new infections recorded in 2005.    "These countries, and many others, are fighting for the lives of their citizens, and America is now their strongest partner in that fight," he said. The 400,000 getting treatment, he said, was up from 50,000 two years ago.    However, critics including senior U.N. officials say Bush"s emphasis on abstinence-only programs has hobbled efforts by playing down the role of condoms.    Taking up the cause of promoting condom use to prevent infection with the HIV virus that causes AIDS, officials in Buenos Aires covered the city"s most famous landmark, the obelisk, with a giant pink condom.    "It seemed like we could have the biggest impact by putting a condom on the most important symbol of the city," said Sandra Castillo, an organizer of the campaign.    AIDS killed 66,000 Latin Americans in the past year, according to a U.N. report. "The international response to HIV and AIDS was woefully slow. This is one of the scars on the conscience of our generation," said U.N. General Assembly President Jan Eliasson in remarks prepared for a ceremony in New York. "We cannot turn back the clock. But we must ensure that, when historians look at the way the world responded to HIV and AIDS, they see that 2006 was the year when the international community finally stepped up to the mark," he said. "This vast human tragedy is all the more unacceptable because it could have been avoided."    In New York, activists stood by City Hall and solemnly read the names of deceased AIDS victims aloud. The Empire State Building, typically lit in bright holiday hues of red and green at this time of year, was set to go dark for 15 minutes to mark World AIDS Day.    Stephen Lewis, the U.N. special envoy for AIDS in Africa, called upon on major corporations to contribute 0.7 percent of pretax profits to the Global Fund to Fight AIDS. The fund "is in terrible trouble" after increases promised by the Group of 8 industrialized nations in July failed to materialize, he said. "We need a new source of dollars," he said in a statement. "That source must be the private sector."    The United Nations has long called on wealthy nations to donate 0.7 percent of gross domestic product for development aid every year.    African AIDS patients criticized politicians for failing to take adequate measures.    "Money earmarked for HIV/AIDS has gone into everything else but AIDS," said Meris Kafusi, a 64-year-old AIDS patient in Tanzania who only recently began receiving life-prolonging antiretroviral drugs that are widespread in the West.    "Organizations that say they are dealing with AIDS are always in seminars or workshops. They should be buying food for widows and orphans ... Is this fair?"    Lobby group Africa Action targeted pharmaceutical companies. "The prices charged by pharmaceutical companies, and the policies pursued by rich countries at their behest, continue to keep life-saving treatment out of reach for those most affected by HIV/AIDS," said Salih Booker, Africa Action"s executive director.    Politicians say taboos need to be broken to tackle AIDS. In India, which says it has 5.13 million people with HIV/AIDS, the second largest number after South Africa, Singh called on people to shed the inhibitions that keep them from talking about sex. "This, quite obviously, has to change if we are to succeed in creating awareness of the hazards of unsafe sexual practices," he said.    (Additional reporting by Irwin Arieff at the United Nations, Louise Egan in Buenos Aires and Andrew Quinn in Johannesburg))    Nov 30th 2005    The silent tsunami. (The Economist Global Agenda)    As the world marks AIDS Day, there are few victories to cheer, but ever more victims to mourn. Ambitious targets for spreading treatment have been missed by a mile    The death toll of this disaster is now ten times larger than that of last year’s Indian Ocean tsunami. Some 3m people have died of AIDS-related diseases in the past year alone, a sixth of them children. These miserable statistics make a mockery of much-touted promises to be treating many more people for AIDS by now. Where the World Health Organisation (WHO) and UNAIDS hoped to see 3m people taking anti-retroviral drugs by the end of 2005—the widely trumpeted “3x5” initiative launched in 2003—barely a third of that number are now doing so. As a result, the silent tsunami is killing faster with each passing day.    In the run-up to World AIDS Day, on Thursday December 1st, the man in charge of the WHO’s efforts against the disease has said sorry for the failure to spread treatment. Jim Yong-Kim told the BBC this week: “All we can do is apologise…I think we have to just admit we’ve not done enough and we started way too late.” But he is hardly responsible for the collective failure. It has long been known that certain anti-retrovirals help tackle the symptoms of AIDS and prolong victims’ lives by many years. They are no longer expensive: basic therapies cost a few dollars a month. For those infected with the HIV virus in rich countries, they make it possible to live a normal life while avoiding full-blown AIDS. Those kept healthy are also likely to be less infectious, slowing the spread of the virus. But the pills are still not reaching most people who need them.    Some 40m people are probably infected with HIV—a population the size of Spain’s—and the greatest number are spread across parts of Africa where getting so much as an aspirin is tricky. Anti-AIDS drugs need to be taken daily and should be provided by trained nurses, kept within moderate temperatures and guarded from thieves. Ideally the patient should be monitored by doctors, blood samples regularly tested in laboratories, and treatment adjusted over time. In poor and hot countries, all that is proving hard to do. Even when they are available, the drugs should be taken on a full stomach, something the poorest in China, India and Africa too rarely enjoy. Even in middle-income countries with functioning health services, such as South Africa, rolling out treatment is proving slower and more painful than many hoped.    There are small victories to record. The Global Fund, an independent body that helps pay for anti-AIDS efforts, says the number of people getting the drugs from its programmes is rising fast, to some 380,000 today from barely half that a year ago. South Africa, after years of delay and government suspicion, now supplies anti-retroviral drugs—some produced from high-quality local factories—through its hospitals, though local activists complain that progress is still fatally slow. A small study in Belgium suggests one strain of the HIV virus, the one prevalent in Europe, may be weakening. In four countries previously seen as AIDS basket-cases—Burkina Faso, Haiti, Kenya and Zimbabwe—new figures describe a fall in the prevalence of HIV infection. However, this may be worse news than it seems, as the drop may merely reflect the fact that some of the infected are now dying very quickly.    Though the battle against AIDS is increasingly about treatment, prevention matters too. Preventing the spread of HIV in the first place requires better education, wider use of condoms and finding ways to let women choose when—and when not—to have sex. China’s rulers this week said they would take the threat of AIDS more seriously, for example by doing more to stop HIV-contaminated blood being used by doctors. It would be even more useful if the authorities were honest about how many Chinese carry the virus: estimates range wildly, from 430,000 to 1.5m. India, which may now have more people infected with HIV than any other country, over 5m, hopes to educate more of its rural people about the disease.    What else could be done? A slew of reports has just been published by international organisations worried about AIDS. A vaccine would help dramatically, but there is no serious sign of an effective one yet, notes a study this week. More donor money might help roll out treatment and boost prevention efforts, but the need is all but endless: some $55 billion could easily be swallowed up in the next three years, suggested the UN recently. Better co-ordination of donor funds is crucial, added the World Bank this week. Paying for more nurses to be trained in poor countries would be especially useful, not least because so many health workers migrate to rich countries.    The final conclusion might still be optimistic: unlike a tsunami, this disaster is spread by human behaviour, and human behaviour can be altered. Lesotho, a tiny country in southern Africa, has just announced that every citizen will be tested for HIV and educated about the result. If all goes to plan, everyone should know how to avoid catching or spreading the virus, and then how to get treatment if needed.    1 - 12 - 2005    Picturing hope: lives of the global HIV+    Many of the everyday aspects of life can pose tremendous challenges to anyone living with HIV, regardless of gender, economic status, or country. But coping with these challenges can be especially difficult for children in developing countries who have been impacted by Aids and lack access to even adequate health and social services.    Even in situations where children get some form of care and support, their psychological and personal growth is often left underdeveloped or even ignored. These children can feel scared and alone, without a sense of belonging, lacking a voice with which to reach out for others.    Picturing Hope provides these children with an outlet for their view on the world. By first teaching children how to engage with photographs, then sending them out into the community with donated cameras to capture their lives, the children are given an opportunity to demonstrate through words and images that they are special, they are unique, they are not alone, and they have a future.    Click on the link below to access Picturing Hope. Visit the related web page
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