*EPF209 11/26/2002
HIV/AIDS Epidemic Continues to Spread Worldwide
(UNAIDS releases 2002 report) (1080)

By Judy Aita
United Nations Washington File Correspondent

United Nations -- An estimated 5 million adults and children around the world were newly infected during 2002, bringing the total number living with HIV/AIDS to 42 million, according to a new report released by the Joint United Nations Program on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) November 26.

The annual report, entitled AIDS Epidemic Update 2002, also shows that the epidemic is rapidly expanding into new areas, especially Eastern Europe and the Central Asian Republics. China, Indonesia and Papua New Guinea may also face a huge growth in the number of those infected with HIV/AIDS, the report warns.

Released in recognition of World AIDS Day December 1, the report also focuses on the way HIV/AIDS is fueling other crises, such as the famine in southern Africa, and undermining development programs in low-and middle-income countries.

UNAIDS officials also warn that globally the epidemic is in its early phases and donors must be prepared to fund HIV/AIDS programs for the long term.

"Overall we are looking at a marathon, basically, in terms of how long we are going to be able to address this," said Catherine Hankins, UNAIDS associate director of strategic information. "We can hit it much more quickly and control it much more quickly if we increase the resources."

A maximum of $3,000 million was spent on the epidemic in 2002 in contrast with the UNAIDS estimate that $10,500 million is needed for an adequate comprehensive prevention and care campaign in low and middle-income countries, Hankins said.

UNAIDS calculates that a basic prevention package using mass media campaigns, social marketing of condoms, mother-to-child transmission prevention, reductions in intravenous drug use, blood safety programs, etc. could actually prevent 29 million infections over the next decade, Hankins said at a press conference releasing the report.

"It is a time to take stock, look at that resource gap, and look at what could be done if there was adequate political and resource commitment," she said.

"The monies countries are putting into overseas development assistance are not being supported and sustained by a good approach to HIV," Hankins said. "Some countries almost seem to place a cap on how much they are willing to spend on AIDS and fail to see the link between HIV and development."

"For example, programs are designed to help schools, but if you don't address how HIV is affecting the teaching population or eroding the human resources, then the development programs that are not HIV-related are going to suffer," she said.

Regarding the overall pace of the pandemic's spread, Hankins said that there are "some very promising signs in a few countries in Africa among young people," but overall "the global situation continues to be alarming." As was predicted in last year's version of this UNAIDS report, the epidemic is expanding very rapidly in some parts of the world, particularly among intravenous drug users in Eastern Europe and Central Asia.

In Ethiopia, Zambia, Uganda, and South Africa prevalence rates are dropping, showing that prevention education is beginning to pay off for young women, Hankins said.

"This population is becoming newly sexually active and when we see the declines in rates in that age group it means that the prevention message is getting through," she said. "Those drops in infection rates are corroborated by behavioral studies that show that young people in those settings are actually delaying sexual activity, and when they do become sexually active, they are using condoms more frequently."

But, Hankins said, in several other African countries there is still a high prevalence of about 30 percent in the adult population.

The effect of the AIDS epidemic on the famine crisis in sub-Saharan Africa was highlighted in the report with an outline of the downward spiral of problems as African families try to cope with illness, drought, and hunger.

Dr. Desmond Johns, the UNAIDS representative at U.N. headquarters, said, "The nexus of drought, poor planning, bad economic policies and weak social networks have conspired to produce the worst drought in sub Saharan Africa in recent memory. A total of 14.4 million people are at risk."

Women and girls are responsible for 50 to 80 percent of food production in sub-Saharan Africa, including the most labor-intensive work such as planting, fertilizing, irrigating, weeding, harvesting and marketing. Now, however, a majority of that population is living with HIV/AIDS. The AIDS epidemic has upended this traditional division of labor, often with disastrous results, Johns said.

AIDS-related deaths in a farm household cause crop output to plummet, often by up to 60 percent, the report said. A 2002 study in central Malawi found that about 70 percent of the households had suffered losses due to sickness. The illness or death of a woman can threaten food security often leading to the dissolution of the family, it said.

The report said that 7 million agricultural workers in 25 African countries have died of AIDS since 1985. In 2001 alone, AIDS killed nearly 500,000 people in the six predominantly agricultural countries threatened with famine. Most of the dead were young adults, so the victims, their families and their communities have lost what should have been the most productive years of their lives.

In some areas of the world, the growth in HIV/AIDS cases is startling, according to the report. In Uzbekistan, for example, there were almost as many new infections reported (602) in the first six months of 2002 as in the entire previous ten years. In Kazakhstan, a total of 1,926 HIV infections had been reported by June 2001.

Indonesia is seeing a sharp rise in injecting drug use and could develop a major HIV/AIDS epidemic, the report said. The country now has as many as 200,000 injecting drug users, and statistics indicated that up to 50 percent of them in Jakarta may be HIV-positive compared to 0 percent in 1998.

The epidemics in Latin America and the Caribbean are well established, and the report notes a danger that they could spread more quickly and more widely without a stronger response. UNAIDS estimates that 1.9 million adults and children -- including 210,000 people who acquired the virus in 2002 -- are living with HIV in the region. Haiti remains the worst affected country with a HIV prevalence rate greater than 6 percent.

Another concern of UNAIDS is the complacency that is on the rise in high-income countries. Some evidence from Australia, the United States and Europe suggests that young gay men and drug users now see AIDS as a problem in the older population, believing that safe sexual practices are unnecessary if treatment for HIV infection is available.

(The Washington File is a product of the Office of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)

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