25 November 2005

World AIDS Day, 2005

Image of AIDS red ribbon, from http://www.avert.org/worldaid.htm

AIDS Can Be Stopped, But It's Not Stopping Yet, And It Won't Stop By Itself

1 December is World AIDS Day 2005.

The 2005 report of the Joint United Nations Programme on HIV/AIDS (UNAIDS) says that the number of people living with HIV/AIDS rose this year to a record 40 million. There were a record number of new infections, about 4.9 million. And about three million people died of AIDS in 2005, including more than 500,000 children.

bar graph of number of people living with HIV/AIDS, from http://www.unaids.org/epi2005/doc/EPIupdate2005_html_en/epi05_gifs/figure-1_Intro_En.gif
In addition to the individual human tragedies of suffering, loss and destitution reflected in these grim figures, there is other bad news:
  • Only one in ten of those infected with HIV has been tested and knows his or her status.

  • The epidemic is gaining strength in Asia, where the toll of death and economic disruption is potentially much higher than in the current centers in sub-saharan Africa. (South Africa has the largest number of people living with HIV/AIDS. Second is India, where the epidemic is just getting started.)

  • The outgoing chief of India's official National Aids Control Organization, S.Y. Quraishi, said 70 percent of Indian sex workers either did not know what a condom was or how to use one.

  • High mortality among working-age adults erodes productivity and imposes additional costs on businesses. In regions where infection rates are high this may be a significant deterrent to investment, both by private firms, by governments (for instance in education), and by individuals themselves.

  • This underinvestment in future generations, together with costs of prevention and treatment, and reduced productivity in industry and agriculture, will reduce the economic growth of many nations, and could even cause the economic collapse of some.

  • Refugees from such economic collapse will threaten the stability of affected countries and regions, and their neighbors.

  • In many countries, marriage, and women’s own fidelity are not enough to protect them against HIV infection.
    Among women surveyed in Harare (Zimbabwe), Durban and Soweto (South Africa), 66% reported having one lifetime partner, 79% had abstained from sex at least until the age of 17 (roughly the average age of first sexual encounter in most countries in the world). Yet, 40% of the young women were HIV-positive. Many had been infected despite staying faithful to one partner. In Colombia, 72% of the women who tested HIV-positive at an antenatal site reported being in stable relationships. In India, a significant proportion of new infections is occurring in women who are married and who have been infected by husbands who (either currently or in the past) frequented sex workers. (From the 2005 report -- see last year's discussion of AIDS and women's issues.)
On the other hand, there is some good news:
  • In several countries HIV infection rates have fallen recently. There have also been reversals of worrying trends in such countries as Brazil and Thailand. These reversals indicate that it is possible to control epidemics using effective prevention programs.

  • So although epidemics continue to worsen in many regions, there are demonstrated strategies for stopping HIV/AIDS, if those strategies can be applied.

  • Access to HIV treatment has improved over the past two years. There are now more than one million people in developing countries living longer and better lives because they are on antiretroviral therapy.

  • In short, "AIDS is a problem with a solution," says Dr. Peter Piot, UNAIDS Executive Director
The key to containing, and someday reversing, the number of new AIDS infections will be the willingness of the developed world to spend tens of billions of dollars to help affected nations implement effective long-term prevention and treatment programs. Given the "disaster fatigue" already affecting donor nations, and their own economic problems associated with the costs of war and welfare reform, what will it take to mount an effective effort?
Even in the United States, with all its resources, the number of new HIV infections has held steady at 40,000 per year for the past five years, and may even be increasing slightly.
The world seems to be willing to accept rampant HIV/AIDS and associated social, economic, and personal suffering in Southern Africa. Will similar crises in Eastern Europe, India or China be as easily ignored?

Additional Resources

Test your awareness with this HIV/AIDS quiz

UNAIDS site

World AIDS Day is coordinated by Avert.org

Another useful AIDS information site

Excellent report on The Macroeconomics of HIV/AIDS from the International Monetary Fund

David Wheat's Science In Action site has articles about science and math in the real world, weird science, science news, unexpected connections, and other cool science stuff. There is an index of the articles by topic here.

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2 comments:

Anonymous said...

Do you suppose the increasing numbers of people with aids shown in the graph in this post is representative of increased incedence or just increased diagnosis? Just curious.

David said...

The figures in the graph are UNAIDS estimates, not reported diagnoses. They use many sources and means of estimation. So no, the number isn't rising due to better diagnosing, but just because the number of new infections exceeds the number of deaths of AIDS patients every year.