| U.N. forecast: AIDS death toll will soar |
| By Lawrence K. Altman |
| THE NEW YORK TIMES |
| Wednesday, July 3, 2002 |
| BARCELONA, Spain -- AIDS will claim an additional 65 million lives by 2020, more than triple the number who died in the first 20 years of the epidemic, unless more countries vastly expand their prevention programs, according to the first long-range forecast of the epidemic from the United Nations. |
| The forecast is a departure from earlier estimates, which had predicted that the epidemic may have reached its peak in some countries by 2000. It is part of a grim report that was issued Tuesday in advance of the 14th International AIDS Conference, which begins on Sunday in Barcelona. |
| The epidemic is still in its early stages, the United Nations warned, with HIV being transmitted in almost every part of the world, including countries where rates had been very high and others where they had been stable. |
| The alarming extent of the spread is disproving theories that the number of infections might reach a plateau in heavily hit countries as the number of individuals at risk for HIV declines. |
| AIDS is the fourth-leading cause of death in the world. Without a sharp drop in the number of new infections, the AIDS death toll by 2020 will rival the number of people killed in wars in the entire 20th century. |
| The report also includes the first analysis of access to anti-HIV treatment by region of the world. Of the 40 million HIV-infected people, only 700,000, or 1.75 percent, were receiving such drugs at the end of 2001. |
| The overwhelming majority of these, 500,000, live in high-income countries where combinations of anti-HIV drugs have prolonged the lives of many people. In these countries, in 2001, fewer than 25,000 people died of AIDS. But in Africa, fewer than 30,000 of the 28.5 million infected people were receiving anti-HIV treatment at the end of 2001. |
| Preparation of the forecast was aided in large part by development of improved scientific methods to create models of epidemic patterns as well as the collection of large amounts of recent information about AIDS and patterns of sexual behavior from affected countries, said Dr. Peter Piot, the director of the U.N. AIDS program. |
| Earlier, five-year projections underestimated the extent of the spread of HIV, the AIDS virus, in Africa by one-third to one-half, Piot and Dr. Neff Walker, a U.N. epidemiologist, said. |
| "We've constantly underestimated the kind of levels the epidemic can reach," Walker said in discussing the report, which details estimated numbers of people infected and of AIDS orphans and a variety of other statistics about HIV in every country. |
| The report will be available at www.unaids.org. |
| One reason for the earlier miscalculations is that the AIDS epidemic seems far more complex than those of virtually all other diseases, Walker said. Mass migrations, economic upheavals and other social factors have increased the number of people at risk of acquiring HIV, making accurate predictions difficult. |
| Individualsmay move in and out of high-risk groups at different periods of their life, such as happens when large numbers of couples break up or when one partner seeks work outside the community, the U.N. officials said. Under such circumstances, men may take on new and multiple sex partners and more women may become prostitutes to pay for food. |
| Piot said that despite the gloomy trend, there are new signs that transmission of HIV is being curbed in some areas. |
| "Nations with acceleration epidemics must move quickly to adapt proven responses from countries that have succeeded in turning the epidemic around," Piot said. "The essential elements of these are frank, widespread HIV prevention, including access to voluntary counseling and testing, leadership at the highest levels of government, and access to care for people infected and affected by AIDS." |
| Without such action, the spread of the AIDS virus will continue unabated as it has in Botswana, the African country that has had the highest HIV infection rates in the world since 1996, Piot said. |
| In Botswana, nearly 39 percent of adults are infected with the AIDS virus, rise of 3 % since 2000. One-third of adults in two other African countries, Zimbabwe and Swaziland, infected at the end of 2001, up from about 25 % in 1999. |
| In Indonesia, the world's fourth-most-populous country, infection rates are now rising rapidly after a decade of consistently low infection rates there. |
| The Caribbean is the second-most-affected area in the world. Infection rates are 6 percent in Haiti and 4 percent in the Bahamas. |
| The epidemic in China is now spreading through heterosexual sex. Earlier, nearly all HIV infections were transmitted through injection drug use and unsafe use of blood. |
| Worldwide, 15- to 24-year-olds account for half of all new infections. Almost 12 million young people now have HIV, and an additional 6,000 young adults become infected every day. |
| The number of children left orphaned by AIDS continues to increase sharply. About 14 million children living today have lost one or both parents to AIDS. The number will continue to grow rapidly, as up to one-half of today's new mothers are likely to die of AIDS in the worst affected countries. |
| Piot said that although many countries, including some of the world's poorest, have significantly increased their AIDS budgets, they still fall far short of the $9 billion needed annually to combat the epidemic in heavily infected countries. |
| "But so far, these countries are the exception, and not the rule," Piot said. |
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| Amen Ministries of Austin www.aamen.org P.O. Box 27683 Austin, TX 78755 |
| The alarming statistics above cause one to give further consideration to eschatological time-tables and the unfolding events on a World Wide basis, and not just 'local happenings' ! |
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