November 23, 2004
The United Nations warned on Tuesday that the world is facing a "unique development challenge" as new data showed nearly 40 million people now have HIV and over three million will die of Aids this year, the highest toll in the 23-year history of the killer disease. The World Health Organisation (WHO) and the United Nations Joint Programme on HIV/Aids (UNAids) named Asia and Eastern Europe as the regions where the Aids virus is spreading the most swiftly and noted the pandemic was advancing alarmingly among women. Without urgent action "the world is unlikely to gain the upper hand over Aids", the two UN agencies warned bluntly. "These latest developments firmly establish Aids as a unique development challenge," said UNAids chief Peter Piot, who presented a new report at a Brussels press conference. "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.
In an annual report, Aids Epidemic Update, published ahead of World Aids Day on December 1, the two agencies estimated that 3,1 million people will have died from Aids in 2004, the most in any one year and 200 000 more than the mortality in 2003. Around 39,4 million people have the human immunodeficiency virus (HIV) which causes the disease, an increase of 1,6 million over the previous year and another record. In 2004, 4,9 million people, the most in any single year, will have become infected by HIV, compared with 4,8 million new cases in 2003, they estimated. "The number of people living with HIV has been rising in every region," the report said. "A massive effort is needed to achieve a response ... that ... matches the global Aids epidemic." It sounded the alarm for East Asia and countries of the former Soviet Union, but said the situation in sub-Saharan Africa, the world's worst-hit region, where more than 25 million people have the Aids virus, was varied.
It made these points:
• East Asia: 1,1 million people have HIV, an increase of 56% over the past two years that is mainly attributable to an explosive rise in China, where all 31 provinces are now affected.
The disease is being spread in diverse ways, but mainly through sex workers and shared syringes among drug users. "If China is to shape the course of its epidemic, it needs to move swiftly and with great resolve," the report warned.
• South Asia and Southeast Asia: HIV infections have spiralled upwards, from 6.4 million in 2002 to 7.1 million in 2004, of which 5.1 million live in India -- the highest in the world except for South Africa.• Eastern Europe and Central Asia: About 1,4 million people have the Aids virus, compared with a million two years ago. The causes: a resurgence of infections in Ukraine and a relentless rise in Russia, where it is entering the population mainstream through sexual intercourse, after being largely limited to injecting drug users.
• Sub-Saharan Africa: Remains by far the worst-affected region in the world, although the situation varies greatly across the continent. In South Africa, where 5,3 million people are infected, "there is no sign yet of a decline in the epidemic", and HIV prevalence among pregnant women, which in 2003 was already 27,9%, is continuing to rise. However, rates have remained stable in much of West and Central Africa and Uganda has seen modest declines.
• Women: Women are increasingly at risk from the spreading pandemic. In 2004, 47% of new infections occurred among females, a figure that ranges from 21% in Oceania to 57% in Africa. Poor education, domination by men and physical susceptibility to the virus are blamed.
• Treatment: Distribution of the anti-retroviral drugs which can hold HIV at bay is widening, but slowly. Around 440 000 people in poorer countries now have access to this medication, yet they account for only 10% of those currently in need. "If this low level of coverage continues, five to six million people will die of Aids in the next two years," the report said.
