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Global HIV/AIDS & ASIA
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U.N.: HIV Cases Hit Record High in 2003
LONDON (AP, by Emma Ross) - The world is losing the race against the AIDS virus, which caused record numbers of infections and deaths around the globe last year, the United Nations reported Tuesday.
Although there have been successes and money is starting to flow, the virus has now pushed deep into Eastern Europe and Asia, and tackling it will be even more expensive than previously thought, according to the report, which gives the most accurate picture to date of the state of the world's HIV disaster.
The number of people living with HIV has risen in every region of the world. Last year, a record 5 million people became infected, and 3 million died. UNAIDS chief Dr. Peter Piot said those figures were a testament to the world's failure to get prevention and treatment to the people who need it.
Nine out of 10 people who urgently need treatment are not getting it, and prevention is still only reaching one in five who should have it, the report said.
The AIDS epidemic is now entering its globalization phase, Piot said at the international launch of the U.N. AIDS agency's report, which is compiled every two years and released on the eve of the International AIDS Conference, which kicks off this weekend in Bangkok, Thailand.
"AIDS is truly a disease of our globalized world. Whereas until recently AIDS was largely a problem for sub-Saharan Africa, one out of every four new infections is occurring in Asia today, and the fastest growing epidemic is happening in Eastern Europe," Piot said. "The virus is running faster than all of us."
In revised estimates based on better information than was previously available, the report says about 38 million people are infected. Until now, experts had put the ranks of the HIV afflicted at about 40 million.
The cost of tackling the pandemic has also risen. Two years ago, the United Nations predicted that US$10 billion a year would be needed by 2005. Now that figure is US$12 billion, because of the price of delaying action and because the planned campaign is now more comprehensive than it has ever been, said Piot.
Less than half that money has been set aside so far.
London-based aid agency ActionAid termed the latest figures "depressing and worrying."
"Business as usual cannot remain the answer. The world needs to spend a lot more money and it must also be more strategic in its approach to the epidemic," the group said.
However, there have been triumphs.
Many countries, including Brazil, Uganda and Thailand, have reduced HIV infection. Drug prices have dropped dramatically, and money is beginning to flow in for the global effort. More politicians are showing commitment to the fight and drugs are becoming increasingly available in poor countries.
Among the major challenges are improving the plight of women; keeping health workers in the developing world; tackling stigma surrounding the disease; and looking after children orphaned by it. In some places the size of the health work force needs to quadruple, the report found.
AIDS remains untamed in Africa. Progress there has been mixed. Prevalence is still rising in countries such as Madagascar and Swaziland, but declining in Uganda.
In sub-Saharan Africa, the number of people living with HIV appears to have leveled off at about 25 million. However, that stability is deceptive. In fact, both deaths and new infections are up. It is still the worst-hit region.
However, Eastern Europe and Asia, which is home to 60 percent of the world's population, are emerging as the new front lines in the fight against AIDS.
In Asia, the disease is confined mostly to drug addicts, homosexual or bisexual men, prostitutes and their clients, and the sexual partners of people who frequent prostitutes.
"A country like Thailand shows that AIDS is a problem with a solution. In 1991, 140,000 people became infected in Thailand. Last year it was 21,000," Piot said. "So there is a major decrease, thanks to a massive promotion of condoms and of encouraging men to change their behavior, to reduce their partners and not engage in commercial sex."
But worryingly, except for Thailand and Cambodia, leadership of AIDS in Asia is weak or totally absent, Piot said.
"Without such strong leadership, there's no way that we can contain this epidemic," he warned.
Asian AIDS Infections Up as World Response Falters
Tue Jul 6, 2004 07:03 AM ET
LONDON (Reuters, By Patricia Reaney) - AIDS is gaining ground, and Asia, with 60 percent of the world's population, has some of the sharpest rises in HIV infections, according to a report released on Tuesday.
"We are not doing well, at all," said Dr Peter Piot, executive direction of UNAIDS, the Joint United Nations Program on HIV/AIDS.
"More people than ever are newly infected with HIV, more people than ever are dying and there is a globalization of the epidemic outside Africa," he told Reuters.
About 38 million people worldwide are living with HIV/AIDS, including five million who were infected last year, according to the report. Sub-Saharan Africa, with an estimated 25 million cases, remains the worst affected region.
The epidemic that has killed 20 million people in just over two decades, but only about 400,000 of the estimated six million people in developing countries who need treatments are getting them.
The new UNAIDS report, released ahead of the 15th International AIDS Conference in Bangkok from July 11-16, says the rapidly expanding epidemic in Asia, where 7.4 million people are HIV positive, could have global implications.
"Asia is now where Africa was 15 years ago," Piot said.
"The growth of the epidemic is going to depend to a large extent on how the countries react. Will they wait, like in Africa, until there is massive mortality because the epidemic is largely invisible, or will they act now?"
China, Indonesia and Vietnam have experienced some of the steepest increases in Asia while India has the largest number of people living with HIV outside South Africa. HIV is also spreading rapidly in Indonesia.
HIV rates, though, seem to be stabilizing in Africa, according to the report, which also showed that women and young people are particularly vulnerable to infection.
"It is not wonderful news because it means that as many people die as are newly infected, but at least it is not continuing to go up as it is in Eastern Europe and Asia," said Piot.
The epidemics in Central Asia and Eastern Europe are being driven by injecting drug users. About 1.3 million people there have HIV, compared with 160,000 in 1995. More than 80 percent of the infected are under the age of 30.
Russia, with more than 3 million injecting drug users, is one of the worst-hit in the region.
In Latin America, the epidemic is concentrated among drug addicts and homosexuals. Countries have low infection rates overall, but pockets are bad. For instance, in Brazil, the most populous country in the region, national HIV prevalence is below 1 percent, but in some cities, 60 percent of the injecting drug users have the virus.
In the Caribbean, the disease is mainly spread through heterosexual sex and in many places is focused around prostitution. The worst-affected country is Haiti, which has the highest infection rate outside Africa with 5.6 percent of the population afflicted.
Infections are on the rise in the United States and Western Europe, particularly among homosexual or bisexual men.
In the developing world, AIDS is increasingly becoming a women's issue, Piot said.
In sub-Saharan Africa, the infection gap between men and women has widened. There are on average 13 infected women to every 10 infected men, up from 12 for 10 in 2002, the report found.
The gap is even more pronounced among teenagers and young people. The ratio ranges from 20 infected girls to every 10 boys in South Africa, to 45 women for every 10 men in Kenya and Mali.
U.N.: Asia Has Opportunity to Fight AIDS
BANGKOK, Thailand (AP, by Alisa Tang) - Asia has an opportunity to control its HIV/AIDS crisis, but failure to act quickly could lead to an epidemic of major proportions, a United Nations expert said Tuesday.
"Asia is facing life and death choices when it comes to the epidemic," said Kathleen Cravero, deputy executive director of UNAIDS.
Cravero issued the warning at a news conference to introduce the agency's 2004 Report on the Global AIDS Epidemic, which says some of the fastest-growing AIDS epidemics are in Asia, where an estimated 7.4 million people are infected with HIV, the virus that causes AIDS.
The report said that about a half million Asians are believed to have died of AIDS last year, and roughly twice that number were newly infected.
"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," Cravero said.
Sub-Saharan Africa has slightly more than 10 percent of the world's population, but about 70 percent - 25 million cases - of all people afflicted with HIV.
The epidemic in Asia is expanding rapidly, primarily in China, Indonesia and Vietnam, which make up approximately 50 percent of Asia's population, said Cravero.
The report points says that although the rate of HIV prevalence is low in China and India - the world's two most populous countries - both have serious localized epidemics which could spread.
Ten million Chinese may be infected with HIV by 2010 unless effective action is urgently taken, it cautioned. It said that India has the largest number of people outside South Africa living with HIV, an estimated 5.1 million last year.
Cravero explained that many Asian countries have infection rates as high as 1 percent. Once the rate exceeds that level, reversing the spread of HIV becomes considerably more difficult and expensive, she said.
Cravero said the epidemic in Asia has been driven by sex workers, injected drug users and homosexual relations. But the disease is increasingly moving into general populations.
Vietnam HIV Cases to Double by End of Decade
Dec. 8 (Bloomberg) -- The number of cases of HIV infections in Vietnam is more than twice the official number and will probably double by the end of the decade, according to the government.
Vietnam had officially recorded 74,330 HIV infections as of Nov. 21, according to a summary of the epidemic in the country released this month by the Ministry of Health. The actual number of cases -- which exceeds official figures largely because of the lack of a comprehensive testing program -- is more than 169,000, the summary said.
The actual number of HIV cases in the Southeast Asian nation of 80 million is likely to reach 197,000 by 2005 and 350,000 by 2010, leading to more than 60,000 fatalities by then, according to the summary. The epidemic in Vietnam is reaching a stage of migrating into the general population, the World Bank said last month.
"Regarding HIV/AIDS, the signs are ominous," said Jordan Ryan, the United Nations' Development Program's Vietnam resident representative, in a statement at the end of a meeting in Hanoi last week of countries and agencies that provide Vietnam with low-interest loans and grants. "Vietnam's HIV/AIDS epidemic is set to explode."
HIV infections in Vietnam are showing "signs of increasing in the low-risk groups," said a separate Ministry of Health report released this month.
Vietnam's fight against HIV and AIDS is limited by an inadequate budget, the Ministry of Health said. About 60 billion dong ($3.9 million) annually has been allocated from the national budget to HIV and AIDS prevention since 2000, according to the ministry's report. The budget and foreign assistance "can not meet the demand for HIV/AIDS activities," the report said.
The HIV/AIDS epidemic should serve as a "dire warning," Deputy Prime Minister Vu Khoan said at the Hanoi conference.
Insufficient
"Our health-care facilities are poorly equipped and not sufficient," Khoan said. "It is therefore our hope that donors will allocate sufficient resources to help us address this difficult issue."
Khoan's call for international help comes as Vietnam has been cutting the share of government spending it devotes to health care, an unusual trend for a country that is growing wealthier, according to the World Bank.
Health spending in Vietnam as a percentage of total government expenditure was 3 percent last year, down from 4 percent in 1998 and 5 percent in 1994, the bank said in a report last month.
In June, the United Nations said Vietnam's budget for health-care is among the world's lowest. About 20 percent of health-care expenditure in Vietnam is publicly financed, a lower percentage than in China, Thailand, the Philippines, Malaysia and Japan, the report found.
"We urge the government to increase its public education messages about HIV/AIDS, and promote tolerance for those living with AIDS," said the U.S. delegation to last week's Hanoi meeting. "The government of Vietnam needs to dramatically increase its commitment to fighting HIV/AIDS with national-level policies." December 8, 2003 12:21 EST
Hong Kong braces for Aids explosion
Paris Lord, The Standard (China Business Newspaper)
Hong Kong is watching and remained ready to deal with the effects of an expected explosion in Aids infections in China to 10 million cases by 2010, the Department of Health said yesterday.
Also, the territory's reported HIV/Aids cases would likely more than double, possibly to around 5,000 from 2,300 cases now, because people infected with it could infect others before they were diagnosed, a local Aids support group, Aids Concern, said.
The health department spoke after the release of a new United Nations report on HIV/Aids infections which said while rates were lower than previous estimates, governments must not be complacent and instead take action.
Released before the 15th International Aids Conference in Bangkok next week, the UNAids report said about 4.8 million people were infected with HIV in 2003, the most reported in one year.
Worldwide, there were 37.8 million people living with HIV/Aids at the end of 2003, while the disease killed 2.9 million people.
US$12 billion (HK$93.38 billion) will be needed next year to fight the disease in developing countries, but global spending now is under US$5 billion, UNAids said.
After Africa, Aids hot spots are Eastern Europe and Asia - especially China, India and Indonesia.
China officially has 840,000 reported cases, but most Aids support groups and experts say the real figure is far higher, and new infections are occurring at an alarming rate.
There were 21,000 newly diagnosed cases reported last year, against 10,000 in 2002, media reports said.
Among the measures being used to monitor, prevent and control HIV in the Pearl River Delta are regular meetings between health officials in Hong Kong, Macau and Guangdong to exchange information on HIV epidemiology, the health department said.
Other measures are regular professional exchanges and training of staff, and researching the HIV pattern within the delta region, a spokeswoman said.
There are an average of 250 reported new cases of HIV infection and 60 of Aids in the SAR annually. The cumulative number at March 31 was 2,311 HIV cases and 676 Aids cases, the department said.
Aids Concern chief executive Graham Smith said the territory has to first slow down the rate of new infections before it can address reducing them.
"We'd expect this to continue to increase especially as we continue to integrate more with southern China," Smith said.
He said the number of reported cases could exceed 5,000 before being brought under control, but cautioned the real figure could only be guessed at.
One effective prevention measure the territory's health officials could take would be to expand their coverage of vulnerable groups such as gay men, prostitutes and their clients, and intravenous drug users.
The other was the "old Sars lesson" of working on the disease with governments from both sides of the border, Smith said.
"Given the fact that the report has come out about how we mishandled Sars, there are some pertinent lessons in that on how not to mishandle Aids.
"One of those has to do with open cross-border communication channels between the Guangdong health authorities and the Department of Health."
7 July 2004 / 02:13 AM
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